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Diuretic window hypothesis in cirrhosis: Changing the point of view

World Journal of Gastroenterology 2019年第26期25卷 3283-3290页

作者： Anderson Brito-Azevedo Liver Transplant Unit S?o Lucas Hospital Liver Transplant Unit S?o Francisco na Providência de Deus Hospital Liver Transplant Unit Adventist Silvestre Hospital

Since the 1970s,non-selective beta-blockers(NSBB)have been used to prevent variceal upper bleeding in advanced cirrhotic ***,several recent studies have raised the doubt about the benefit of NSBB in end-stage cirrhotic *** fact,they suggested a detrimental effect in these patients that even reduced *** of these studies have been assembled to compose the“window therapy hypothesis”,in which NSBB would have traditional indication to be initiated to prevent variceal upper bleeding;however,treatment should be stopped(or not be initiated)in patients with end-stage *** would reduce the cardiac reserve of these patients,worsening systemic perfusion and ***,it should be emphasized that these studies present important bias issues,and their results also suggested that diuretic treatment may also be behind the effects *** this opinion review,we changed the point of view from NSBB to diuretic treatment,based on a physiopathogenic approach of circulatory parameters of cirrhotic patients studied,and based on diuretic effect in blood pressure lowering and in other hypervolemic disease,as heart *** suggest a“diuretic window hypothesis”,composed by an open window in hypervolemic phase,an attention window when patient present in a normal plasma volume phase,and a closed window during the plasma hypovolemic phase.

关键词： Cirrhosis non-selective beta-blockers Diuretic Window hypothesis Baveno Cardiac output

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Development status and trend of agricultural robot technology

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International Journal of Agricultural and Biological Engineering 2021年第4期14卷 1-19页

作者： Yucheng Jin Jizhan Liu Zhujie Xu Shouqi Yuan Pingping Li Jizhang Wang Key Laboratory of Modern Agricultural Equipment and Technology Ministry of EducationJiangsu UniversityZhenjiang 212013JiangsuChina College of Biology and the Environment Nanjing Forestry UniversityNanjing 210042China

In the face of the contradiction between the increasing demand for agricultural products and the sharp reduction of agricultural resources and labor force,agricultural robot technology is developing explosively on the basis of decades of technical and industrial *** view of the complexity and particularity of the development of agricultural robot technology,it is of great value to summarize its development characteristics and make reasonable judgments on its development *** this paper,the type of agricultural robot systems was first *** the classification of agricultural robot systems,the development of main types of monitoring robots,non-selective and selective working robots for crop farming,livestock and poultry farming and aquaculture were introduced in *** the scientific research,core technology,and commercialization of different types of agricultural robots were *** is believed that navigation in complex agricultural environments,damage-free robot-crop interaction,and agronomy-robot fusion have high scientific value and significance to promote the revolutionary advances in agricultural robot *** characteristics of inter-discipline between agricultural robot technology and new materials,artificial intelligence,bionics,agronomy are research *** fast damage-free operation,autonomous navigation for complex environments,target detection for complex backgrounds,and special design for agricultural robots are considered to be the key technology of agricultural robot development,and the development path is ***,robot-crop interaction simulation,big data support,and artificial intelligence are regarded as paths to realize the breakthrough of key agricultural robot *** summary and prospect of this paper are of positive significance to promote the overall development of agricultural robot technology.

关键词： agricultural robot type selective non-selective trend

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Is it time to replace propranolol with carvedilol for portal hypertension?

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World Journal of Gastrointestinal Endoscopy 2015年第5期7卷 532-539页

作者： Shahab Abid Saadat Ali Muhammad Asif Baig Anam Akbar Waheed Section of Gastroenterology Department of Medicine Aga Khan University

Beta-adrenergic receptor antagonists(β-blockers) have been well established for use in portal hypertension for more than three decades. Different non-selective β-blockers like propranolol, nadolol, timolol, atenolol, metoprolol and carvedilol have been in clinical practice in patients with cirrhosis. Carvedilol has proven 2-4 times more potent than propranolol as a beta-receptor blocker in trials conducted testing its efficacy for heart failure. Whether the same effect extends to its potency in the reduction of portal venous pressures is a topic of on-going debate. The aim of this review is to compare the hemodynamic and clinical effects of carvedilol with propranolol, and attempt assess whether carvedilol can be used instead of propranolol in patients with cirrhosis. Carvedilol is a promising agent among the beta blockers of recent time that has shown significant effects in portal hypertension hemodynamics. It has also demonstrated an effective profile in its clinical application specifically for the prevention of variceal bleeding. Carvedilol has more potent desired physiological effects when compared to Propranolol. However, it is uncertain at the present juncture whether the improvement in hemodynamics also translates into a decreased rate of disease progression and complications when compared to propranolol. Currently Carvedilol shows promise as a therapy for portal hypertension but more clinical trials need to be carried out before we can consider it as a superior option and a replacement for propranolol.

关键词： Portal hypertension Chronic liver disease non-selective beta-blockers Propranolol Carvedilol

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