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Molecular mechanism of Xuebijing in treating pyogenic liver abscess complicated with sepsis

World Journal of Emergency Medicine 2024年第1期15卷 35-40页

作者： Wei Zhou Maiying Fan Xiang Li Fang Yu En Zhou Xiaotong Han Department of Emergency Medicine the First Affi liated Hospital of Hunan Normal University/Hunan Provincial People’s HospitalChangsha 410005China Department of Otolaryngology-head and Neck Surgery the First Affi liated Hospital of Hunan Normal University/Hunan Provincial People’s HospitalChangsha 410005China

BACKGROUND:Xuebijing(XBJ)can alleviate the inflammatory response,improve organ function,and shorten the intensive care unit(ICU)stay in patients with pyogenic liver abscess(PLA)complicated with sepsis,but the molecular mechanisms have not been *** study aimed to explore the molecular mechanism of XBJ in treating PLA complicated with sepsis using a network pharmacology ***:The active ingredients and targets of XBJ were retrieved from the ETCM *** targets related to PLA and sepsis were retrieved from the GeneCards,PharmGKB,DisGeNet,Online Mendelian Inheritance in Man(OMIM),Therapeutic Targets Database(TTD),and DrugBank *** targets of PLA complicated with sepsis were mapped to the targets of XBJ to identify potential treatment ***-protein interaction networks were analyzed using the STRING *** treatment targets were imported into the Metascape platform for Gene Ontology(GO)functional enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment *** docking was performed to validate the interactions between active ingredients and core ***:XBJ was found to have 54 potential treatment targets for PLA complicated with ***-1β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor(TNF)were identifi ed as core *** enrichment analysis revealed important pathways,including the interleukin-17(IL-17)signaling pathway,the TNF signaling pathway,the nuclear factor-kappa B(NF-κB)signaling pathway,and the Toll-like receptor(TLR)signaling *** docking experiments indicated stable binding between XBJ active ingredients and core ***:XBJ may exert therapeutic eff ects on PLA complicated with sepsis by modulating signaling pathways,such as the IL-17,TNF,NF-κB,and TLR pathways,and targeting IL-1β,IL-6,and TNF.

关键词： Xuebijing injection pyogenic liver abscess Sepsis

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Primary hepatic lymphoma presenting as pyogenic liver abscess:A case report

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World Journal of Clinical Cases 2024年第21期12卷 4742-4747页

作者： Zhi-Yang Xu Ying Pan Wen-Jing Ye Jin-Liang Liu Xue-Jie Wu Cui-Lan Tang Department of Infectious Diseases The Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 318000Zhejiang ProvinceChina

BACKGROUND Primary hepatic lymphoma(PHL)is a lymphoproliferative disorder confined to the liver without peripheral lymph node involvement and bone marrow *** is extremely rare in clinical *** etiology and pathogenesis of PHL are largely *** are no common standard protocols or guidelines for the treatment of *** SUMMARY We report the case of a 66-year-old man who presented with fever and abdominal pain for three *** tomography and magnetic resonance imaging scans showed a pyogenic liver *** patient underwent a right posterior *** surgical pathology revealed aggressive B-cell lymphoma,with a primary consideration of diffuse large B-cell lymphoma of non-germinal center *** This article reviews the characteristics,mechanism and treatment of PHL and provides insight into the diagnosis of PHL.

关键词： Primary hepatic lymphoma pyogenic liver abscess Operative Chemotherapy Case report

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pyogenic liver abscess secondary to gastric perforation of an ingested toothpick:A case report

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世界临床病例杂志 2023年第23期11卷 5622-5627页

作者： Yeshong Park Ho-Seong Han Yoo-Seok Yoon Jai Young Cho Boram Lee Mee Young Kang Jinju Kim Hae Won Lee Department of Surgery Seoul National University Bundang HospitalSeongnam-si 13620South Korea

BACKGROUND liver abscess due to foreign body-induced gastrointestinal tract perforation is a rare event that could be misdiagnosed due to low *** than 100 cases have been reported to *** SUMMARY We report a case of a 53-year old female patient with pyogenic liver abscess secondary to ingestion of a toothpick with penetration through the lesser curvature of the *** patient presented with persistent epigastric *** computed tomography demonstrated the presence of a linear radiopaque object associated with abscess formation in the left liver *** changes in the lesser curvature of the stomach indicated gastric wall penetration by the *** the abscess was refractory to antibiotic treatment,laparoscopic liver resection was performed to remove the foreign body and adjacent liver *** surgery,symptoms fully resolved without any *** This rare case demonstrates the importance of considering foreign body penetration as a cause of pyogenic liver abscess,particularly in abscesses of unknown origin that are resistant to antibiotic *** suspicion,early diagnosis,and prompt removal of the foreign body could lead to improved outcomes in these patients.

关键词： Foreign body ingestion liver abscess pyogenic liver abscess liver resection Case report

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Patients with culture negative pyogenic liver abscess have the same outcomes compared to those withKlebsiella pneumoniae pyogenic liver abscess

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Hepatobiliary & Pancreatic Diseases International 2016年第5期15卷 504-511页

作者： Vishal G Shelat Qiao Wang Clement LK Chia Zhongkai Wang Jee Keem Low Winston WL Woon Department of General Surgery Tan Tock Seng Hospital Singapore 308433 Singapore Ministry of Health Holdings Pte Ltd. Singapore 099253 Singapore

BACKGROUND: Etiologic organism is not frequently isolated despite multiple blood and lfuid cultures during management of pyogenic liver abscess (PLA). Such culture negative pyogen-ic liver abscess (CNPLA) is routinely managed by antibiotics targeted toKlebsiella pneumoniae. In this study, we evaluated the outcomes of such clinical practice. METHODS: All the patients with CNPLA andKlebsiella pneu-moniaePLA (KPPLA) admitted from January 2003 to Decem-ber 2011 were included in the study. A retrospective review of medical records was performed and demographic, clinical and outcome data were collected. RESULTS: A total of 528 patients were treated as CNPLA or KPPLA over the study period. CNPLA presented more com-monly with abdominal pain (P=0.024). KPPLA was more com-mon in older age (P=0.029) and was associated with thrombo-cytopenia (P=0.001), elevated creatinine (P=0.002), bilirubin (P=0.001), alanine aminotransferase (P=0.006) and C-reactive protein level (P=0.036). CNPLA patients tend to have anemia (P=0.015) and smaller abscess (P=0.008). There was no differ-ence in hospital stay (15.7 vs 16.8 days) or mortality (14.0% vs 11.0%). No patients required surgical drainage after initiation of medical therapy. CONCLUSION: Despite demographic and clinical differences between CNPLA and KPPLA, overall outcomes are not different.

关键词： culture negative Klebsiella pneumoniae pyogenic liver abscess

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Are our endoscopy patients at risk for pyogenic liver abscess?

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World Journal of Gastroenterology 2017年第30期23卷 5457-5459页

作者： Herwig Cerwenka Peter Schemmer Department of Surgery Medical University of Graz

This is an editorial comment on a recent publication reporting an increased rate of pyogenic liver abscesses(PLAs) after upper gastrointestinal panendoscopy. Its aim is to critically highlight the findings, limitations and potential clinical implications of this study. Issues of the mucosal barrier, the microbial flora, administration of antibiotics and underlying diseases are discussed. The probability of PLAs after endoscopies is not exactly known and the length of the "incubation period" remains unclear, but a possible causality should already suffice to make us think how to avoid them. Especially in patients with risk factors such as diabetes mellitus, end-stage renal disease, liver cirrhosis, biliary tract infection, and malignancies, the potential risk for PLAs should be considered. Unnecessary insufflation during endoscopy(causing mucosal stretching and microscopic tears) as well as mucosal damage(by direct abrasion with the scope) should be avoided in order to limit the invasiveness of the procedure as much as possible. And, in everyday routine, it should be kept in mind that in patients after endoscopy, especially in those with a breach of the mucosal barrier and significant comorbidities, PLAs can potentially develop and require timely administration of antibiotics as well as further diagnostic and therapeutic steps.

关键词： Endoscopy pyogenic liver abscess Mucosal barrier Gastrointestinal microbial flora Comorbidities

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pyogenic liver abscess:An audit of 10 years’experience

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World Journal of Gastroenterology 2011年第12期17卷 1622-1630页

作者： Tony CY Pang Thomas Fung Jaswinder Samra Thomas J Hugh Ross C Smith Upper Gastrointestinal Surgical Unit Royal North Shore HospitalUniversity of SydneySt Leonards NSW 2065Australia

AIM:To describe our own experience with pyogenic liver abscesses over the past 10 years and investigate the risk factors associated with failure of initial percutaneous ***:A retrospective study of records of 63 PLA patients presenting between 1998 and 2008 to Australian tertiary referral centre,were *** and hydatid abscesses were ***,clinical,radiological,and microbiological characteristics,as well as surgical/radiological interventions,were ***:Sixty-three patients(42 males,21 females) aged 65(±14) years[mean±(SD) ]had prodromal symptoms for a median(interquartile range;IQR) of 7(5-14) *** 59%of patients were febrile at presentation;however,the serum C-reactive protein was elevated in all 47 in whom it was *** function tests were non-specifically abnormal.67%of patients had a solitary abscess,while 32%had>3 abscesses with a median(IQR) diameter of 6.3(4-9) *** organisms were:Streptococcus milleri 25%,Klebsiella pneumoniae 21%,and Escherichia coli 16%.A presumptive cryptogenic cause was most common (34%).Four patients died in this series:one from sepsis,two from advanced cancer,and one from acute myocardial *** initial procedure was radiological aspiration±drainage in 54 and surgery in two patients.17%underwent surgical management during their *** hypoalbuminaemia[mean (95%CI) :32(29-35) g/L vs 28(25-31) g/L,P=0.045] on presentation was found to be the only factor related to failure of initial percutaneous therapy on univariate ***:PLA is a diagnostic challenge,because the presentation of this condition is *** antibiotics and radiological drainage in the first instance allows resolution of most PLAs;However,a small proportion of patients still require surgical drainage.

关键词： pyogenic liver abscess Image guided drainage Surgical drainage C-reactive protein Hypoalbuminaemia

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Treatment of pyogenic liver abscess by surgical incision and drainage combined with platelet-rich plasma:A case report

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World Journal of Clinical Cases 2022年第20期10卷 7082-7089页

作者： Jun-Hong Wang Zhen-Hua Gao Hong-Liang Qian Jin-Shun Li Hao-Min Ji Ming-Xu Da The First Clinical Medical College Lanzhou UniversityLanzhou 730000Gansu ProvinceChina Department of Hepatobiliary Surgery The First People’s Hospital of BaiyinBaiyin 730900Gansu ProvinceChina Department of General Surgery People’s Hospital of Gansu ProvinceLanzhou 730000Gansu ProvinceChina

BACKGROUND pyogenic liver abscesses are insidious in the early *** cases progress rapidly,and the patient’s condition can worsen and even become life-threatening if timely treatment is not *** and prolonged antibiotic treatment are often required if the abscess is large and liquefied and becomes separated within the *** SUMMARY We report a case of bacterial liver abscess with a poor outcome following pharmacological treatment,review the literature related to the use of platelet-rich plasma(PRP)in the treatment of hepatic impairment and partial hepatectomy in animals,and discuss the prognostic features of surgical incision and drainage combined with PRP in the treatment of bacterial liver *** is the first case describing the use of PRP in the treatment of a bacterial liver abscess in humans,providing new ideas for the treatment of this *** This case highlights the importance of surgical treatment for bacterial liver abscesses that are well liquefied and poorly managed *** may produce antimicrobial effects and promote the regeneration and repair of liver tissue.

关键词： pyogenic liver abscess Surgical incision and drainage Platelet-rich plasma Case report

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pyogenic liver abscess associated with large colonic tubulovillous adenoma

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World Journal of Gastroenterology 2006年第6期12卷 990-992页

作者： Hsueh-ChouLai Cheng-YuanPeng Chih-BinChen Wen-HsinHuang Cho-Yu Chan Division of Hepatology and Gastroenterology Departments of Internal MedicineChina Medical University Hospital TaichungTaiwanChina Faculty of Medicine National Yang-Ming University School of MedicineTaipeiand Departlnent of Medical Research and EducationTaipei Veterans General Hospital TaipeiTaiwanChina

pyogenic liver abscesses usually occur in association with a variety of diseases. Rarely, liver abscess has been reported as the presenting manifestation of colonic tubulovillous adenoma. We report two cases of pyogenic liver abscess without hepatobiliary disease or other obvious etiologies except that one had a history of diabetes mellitus （DM）. The pathogen in the patient with DM was Klebsiella pneumonia （KP）. In both of the patients, Ueus developed about two to three weeks after the diagnosis of liver abscess. Colonoscopy revealed large polypoid tumors with pathological findings of tubulovillous adenoma in both cases. Two lessons were learned from these two cases：（1） an underlying cause should be aggressively investigated in patients with cryptogenic liver abscess; （2） DM could be one of the etiologies but not necessarily the only cause of KP liver abscess.

关键词： pyogenic liver abscess Klebsiella pneumonia Colonic tubulovUlous adenoma

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Role and outcome of conventional surgery in the treatment of pyogenic liver abscess in the modern era of minimally invasive therapy

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World Journal of Gastroenterology 2008年第5期14卷 747-751页

作者： Simon Siu-Man Ng Janet Fung-Yee Lee Paul Bo-San Lai Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin Hong Kong China

AIM:To evaluate the role and outcome of conventional surgery in the treatment of pyogenic liver abscess in the modern era of minimally invasive therapy. METHODS:The medical records of thirteen patients with pyogenic liver abscess who underwent surgical treatment between January 1995 and December 2002 were retrospectively reviewed to determine the clinical presentation, indication and nature of surgery, and out-come of surgery. RESULTS:The patients were predominantly women (10/13) with a mean age of 65 ± 17 years. Their main presenting symptoms were abdominal pain (100%) and fever (77%). The aetiologies included biliary (n = 6), cryptogenic (n = 3), portal (n = 2), and trauma (n = 2). Seven patients underwent percutaneous drainage as the initial treatment. Of these, three patients developed peritonitis secondary to peritoneal spillage. Another four patients failed to respond because of multilocula-tion. Salvage surgery was required in these patients. Six patients proceeded to straight laparotomy:two had marked sepsis and multiloculated abscess that precluded percutaneous drainage, and four presented with perito-nitis of uncertain pathology. Surgical procedures included deroofment and drainage (n = 9), liver resection (n = 3), peritoneal lavage (n = 2), cholecystectomy (n = 4), and exploration of common bile duct (n = 2). One patient required reoperation because of bleeding. Three patients required further percutaneous drainage after surgery. The overall mortality was 46%. Four patients died of multiorgan failure and two patients died of pulmonary embolism. CONCLUSION:Surgical treatment of pyogenic liver ab-scess is occasionally needed when percutaneous drainage has failed due to various reasons. Mortality rate in this group of patients has remained high.

关键词： pyogenic liver abscess Surgical drainage liver resection Percutaneous drainage Outcome

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Is hepatic neoplasm-related pyogenic liver abscess a distinct clinical entity?

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World Journal of Gastroenterology 2012年第10期18卷 1110-1116页

作者： Siu-Tong Law Ki Kong Li Division of Gastroenterology and Hepatology Department of Medicine and Geriatrics Tuen Mun Hospital

AIM: To compare the clinical characteristics of pyogenic liver abscess (PLA) in patients with and without hepatic neoplasm (HN). METHODS: We performed a retrospective analysis involving patients with PLA. The demographic, clinical features, laboratory and imaging findings, management and outcome of patients with and without HN were studied. RESULTS: From January 2000 to December 2009 inclusive, 318 patients (35 with HN) had PLA, and mean age and comorbidity were comparable between the two groups. More patients with HN experienced right upper quadrant pain (68.6% vs 52.7%, P abscess wall (37.1% vs 19.4%, P < 0.01), septal lobulation (77.1% vs 58%, P < 0.02), gaseous cavitation (17% vs 7.8%, P = 0.03), portal thrombophlebitis (11.4% vs 1.8%, P < 0.01) and aerobilia (25.9% vs 5.5%, P < 0.01). Mixed bacterial growth (40% vs 15.2%, P < 0.01) and Gram-negative bacilli (22.8% vs 60.4%, P < 0.01) were dominant isolates in PLAs with and without HN, respectively. Although incidence of the complications was comparable between the two groups, patients with HN had a higher mortality rate than those without (71.4% vs 8.8%, P < 0.01). Multivariate logistic regression analysis revealed underlying active malignancy [odds ratio (OR): 40.45, 95% CI: 14.76-111.65], hypoalbuminemia (OR: 1.22, 95% CI: 1.14-1.38), disseminated intravascular coagulation (OR: 3.32, 95% CI: 1.19-9.69) and acute coronary syndrome (OR: 4.48, 95% CI: 1.08-17.8) were independent risk factors associated with mortality. However, several HN cases, presented concurrently with PLAs, were found to have curative resectable tumors and

关键词： pyogenic liver abscess Hepatic neoplasms Hepatic malignancy liver abscess

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