检索结果-南通市图书馆

Pathological evolution of hepatitis C virus-“healthy carriers”

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2008年第24期14卷 3861-3865页

作者： Rodolphe Sobesky Pascal Lebray Bertrand Nalpas Anas Vallet-Pichard hélène Fontaine Jean-Luc Lagneau Stanislas Pol INSERM U785 Centre Hépato-BiliaireHpital Paul Brousse United hepatologie Hopital CochinUniversite Paris V-Rene Descartes

AIM： To determine factors associated with fibrosis progression in hepatitis C virus （hCV）-infected patients without significant initial pathological lesions. METhODS： Seventy six untreated hCV-infected patients with initially normal liver as defined by a Knodell score ≤ 3, with 2 liver biopsies and detectable hCVRNA were included. Markers of fibrosis progression were assessed. RESULTS： Median duration of infection and time between paired biopsies was 13 （95% CI： 1-28） and 4 （95% CI： 2-16） years respectively. Alaninetransaminase （ALT） activity was normal in 43.4% of cases. 50% demonstrated progression of the necroinflammation and 34% of fibrosis after a median time evolution of 4 years （95% CI： 2-16）. The median difference in the necro-inflammation and fibrosis score between biopsies was low, 1.5 and 0.0 respectively. Univariate analysis showed there was no difference between fibrosis activity or evolution according to genotype or viral load. A higher fibrosis progression （P = 0.03） was observed in patients with body mass index （BMI）〉 25. Fibrosis progression correlated with the time interval between biopsies （P = 0.01）. A significant progression of activity （1.7 vs 0.4, P 〈 0.05） or fibrosis （0.9 vs 0.0, P 〈 0.01） was observed in patients with elevated ALT. There was a significant correlation between activity progression and fibrosis progression（P = 0.003）. Multivariate analysis demonstrated that fibrosis progression was associated with elevated ALT, BMI 〉 25 and the time interval between 2 biopsies. CONCLUSION： There is no fibrosis progression in 66% of patients without significant initial histopathological lesion. Fibrosis progression is associated with elevated ALT and BMI 〉 25.

关键词： hepatitis C virus Liver fibrosis Liver biopsy Alanine-transaminase Body mass index

Patient with unresectable colorectal liver metastases and asymptomatic primary tumor:end of the debate!

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

hepatobiliary Surgery and Nutrition 2022年第3期11卷 412-414页

作者： Marc-Antoine Allard RenéAdam centre hépato-biliaire Hôpital Paul BrousseAPHPVillejuifFrance Équipe Chronothérapie Cancers et TransplantationUniversitéParisSaclayFrance

In patients with definitively unresectable colorectal liver metastases,whether the primary tumor should be resected prior to chemotherapy is an old *** retrospective studies(1-5)and a meta-analysis with individual data(6)had suggested that primary resection of the primary tumor followed by chemotherapy was associated with better survival than the chemotherapy-first *** prevention of complications related to the primary tumor(occlusion,perforation,bleeding)as well as a better response to chemotherapy were usual justifications to explain the superiority of primary tumor ***,the absence of any randomized study made it difficult to conclude on this question due to the numerous selection biases related to these retrospective analyses.

关键词： chemotherapy colorectal prevention

Emerging concepts in liver graft preservation

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

世界胃肠病学杂志：英文版 2015年第2期21卷 396-407页

作者： Mohamed Bejaoui Eirini Pantazi Emma Folch-Puy Pedro M Baptista Agustín García-Gil René Adam Joan Roselló-Catafau Experimental hepatic Ischemia-Reperfusion Unit Institute of Biomedical Research of Barcelona-Spanish National Research CouncilCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas08036 BarcelonaCataloniaSpain Universidad de Zaragoza CIBER- ehdAragon Health Sciences Institute50009 ZaragozaSpain AP-hP h?pital Paul Brousse Centre Hépato-BiliaireUniversité Paris-Sud Villejuif75008 ParisFrance

The urgent need to expand the donor pool in order to attend to the growing demand for liver transplantation has obliged physicians to consider the use of suboptimal liver grafts and also to redefine the preservation strategies. This review examines the different methods of liver graft preservation, focusing on the latest advances in both static cold storage and machine perfusion(MP). The new strategies for static cold storage are mainly designed to increase the fatty liver graft preservation via the supplementation of commercial organ preservation solutions with additives. In this paper we stress the importance of carrying out effective graft washout after static cold preservation, and present a detailed discussion of the future perspectives for dynamic graft preservation using MP at different temperatures(hypothermia at 4 ℃, normothermia a t 3 7 ℃ and subnormothermia at 20 ℃- 2 5 ℃). Finally, we highlight some emerging applications of regenerative medicine in liver graft preservation. In conclusion, this review discusses the "state of the art" and future perspectives in static and dynamic liver graft preservation in order to improve graft viability.

关键词： Static cold preservation Suboptimal liver grafts P

Transit time ultrasound perivascular flow probe technology is superior to MR imaging on hepatic blood flow measurement in a porcine model

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

hepatobiliary & Pancreatic Diseases International 2018年第6期17卷 538-545页

作者： Mohamed Bekheit Chloe Audebert Petru Bucur hans Adriaensen Emilie Bled Mylène Wartenberg Irene Vignon-Clementel Eric Vibert Inserm Unité 1193 112 Boulevard Paul Valliant CuturierVillejuifFrance Institute of medical sciences University of AberdeenAberdeenUK centre de recherche Inria de Paris ParisFrance Sorbonne Universités UPMC University of Paris 6Laboratoire Jacques-LouisLionsParisFrance ChRU hopitaux de ToursChirurgie Héato-biliaire et pancréatiqueTransplantation HéatiqueToursFrance Plateforme Chirurgie et Imagerie pour le Recherche et l’Enseignement(CIRE) ImagerieUMR-PRC37380 NouzillyCentre INRA Val de LoireFrance AP-hP Hoital Paul BrousseCentre Héato-BiliaireVillejuifFrance

Background: The hepatic hemodynamics is an essential parameter in surgical planning as well as in various disease processes. The transit time ultrasound(TTUS) perivascular flow probe technology is widely used in clinical practice to evaluate the hepatic inflow, yet invasive. The phase-contrast-MRI(PC-MRI) is not invasive and potentially applicable in assessing the hepatic blood flow. In the present study, we compared the hepatic inflow rates using the PC-MRI and the TTUS probe, and evaluated their predictive value of post-hepatectomy adverse events. Methods: Eighteen large white pigs were anaesthetized for PC-MRI and approximately 75% hepatic resection was performed under a unified protocol. The blood flow was measured in the hepatic artery(Qha), the portal vein(Qpv), and the aorta above the celiac trunk(Qca) using PC-MRI, and was compared to the TTUS probe. The Bland-Altman method was conducted and a partial least squares regression(PLS) model was implemented. Results: The mean Qpv measured in PC-MRI was 0.55 ± 0.12 L/min, and in the TTUS probe was 0.74 ± 0.17 L/min. Qca was 1.40 ± 0.47 L/min in the PC-MRI and 2.00 ± 0.60 L/min in the TTUS probe. Qha was 0.17 ± 0.10 L/min in the PC-MRI, and 0.13 ± 0.06 L/min in the TTUS probe. The Bland-Altman method revealed that the estimated bias of Qca in the PC-MRI was 32%(95% CI:-49% to 15%); Qha 17%(95% CI:-15% to 51%); and Qpv 40%(95% CI:-62% to 18%). The TTUS probe had a higher weight in predicting adverse outcomes after 75% resection compared to the PC-MRI( β= 0.35 and 0.43 vs β = 0.22 and 0.07, for tissue changes and premature death, respectively). Conclusions: There is a tendency of the PC-MRI to underestimate the flow measured by the TTUS probes. The TTUS probe measures are more predictive of relevant post-hepatectomy outcomes.

关键词： hepatic blood flow Phase contrast MRI Transit time ultrasound probe Porcine model Liver surgery

Missing metastases as a model to challenge current therapeutic algorithms in colorectal liver metastases

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2016年第15期22卷 3937-3944页

作者： Valerio Lucidi Alain hendlisz Jean-Luc Van Laethem Vincent Donckier Department of Abdominal Surgery H?pital Erasme Centre de Chirurgie Hépato-Biliaire de l’ULB Université Libre de Bruxelles Department of Medical Oncology Institut Jules Bordet Université Libre de Bruxelles Department of Gastroenterology H?pital Erasme Université Libre de Bruxelles Department of Surgery Institut Jules Bordet Department of Abdominal Surgery H?pital Erasme Centre de Chirurgie Hépato-Biliaire de l’ULB Université Libre de Bruxelles

In oncosurgical approach to colorectal liver metastases, surgery remains considered as the only potentially curative option, while chemotherapy alone represents a strictly palliative treatment. however, missing metastases, defined as metastases disappearing after chemotherapy, represent a unique model to evaluate the curative potential of chemotherapy and to challenge current therapeutic algorithms. We reviewed recent series on missing colorectal liver metastases to evaluate incidence of this phenomenon, predictive factors and rates of cure defined by complete pathologic response in resected missing metastases and sustained clinical response when they were left unresected. According to the progresses in the efficacy of chemotherapeutic regimen, the incidence of missing liver metastases regularly increases these last years. Main predictive factors are small tumor size, low marker level, duration of chemotherapy, and use of intra-arterial chemotherapy. Initial series showed low rates of complete pathologic response in resected missing metastases and high recurrence rates when unresected. however, recent reports describe complete pathologic responses and sustained clinical responses reaching 50%, suggesting that chemotherapy could be curative in some cases. Accordingly, in case of missing colorectal liver metastases, the classical recommendation to resect initial tumor sites might have become partially obsolete. Furthermore, the curative effect of chemotherapy in selected cases could lead to a change of paradigm in patients with unresectable liver-only metastases, using intensive first-line chemotherapy to intentionally induce missing metastases, followed by adjuvant surgery on remnant chemoresistant tumors and close surveillance of initial sites that have been left unresected.

关键词： Colorectal Liver Metastases,Surgery Chemotherapy Missing

The quest for optimal and reliable guidelines based on robust evidence for the treatment of cholangiocarcinoma

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

hepatobiliary Surgery and Nutrition 2021年第6期10卷 913-915页

作者： Daniel Azoulay David Bomze Tomer Meirson centre hépato-biliaire Assistance Publique-Hôpitaux de ParisHôpital Universitaire Paul BrousseInstitut National de la Santéet de la Recherche Médicale(INSERM)Unité935and UniversitéParis-SaclayVillejuifFrance Sackler Faculty of Medicine Tel Aviv UniversityTel AvivIsrael Ella Lemelbaum Institute for Immuno-oncology Sheba Medical CenterRamat-GanIsrael The Azrieli Faculty of Medicine Bar-Ilan UniversitySafedIsrael

In 1991,Gordon *** described the evidence-based medicine(EBM)as“a focus on educating front-line clinicians in assessing the credibility of research evidence,understanding the results of clinical studies,and determining how best to apply the results to their everyday practice”(1).In 2010,Graham et *** clinical guidelines as“statements that include recommendations intended to optimize patient care that are informed by a systematic review of the evidence and an assessment of the benefits and harms of alternative care options”(2).Since 2010,the number of clinical guidelines increased exponentially,and the query on PubMed with the term“new guidelines”produces 59,773 results.

关键词： Graham clinical treatment

Systemic review of the robustness of randomized controlled trials for the treatment of cholangiocarcinoma in three domains: survival-inferred fragility index, restricted mean survival time, and the spin effect

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

hepatobiliary Surgery and Nutrition 2022年第6期11卷 861-869,I0016页

作者： Nir horesh David Bomze Chetana Lim Gal Markel Tomer Meirson Daniel Azoulay Unit of hepatobiliary and Pancreatic Surgery and Transplantation Sheba Medical CenterFaculty of Medicine Tel Aviv UniversityTel AvivIsrael Sackler Faculty of Medicine Tel Aviv UniversityTel AvivIsrael centre hépato-biliaire Department of Hepatobiliary and Pancreatic Surgery and TransplantationPitiéSalpetriere HospitalAssistance Publique-Hôpitaux de ParisParisFrance Davidoff Cancer Center Rabin Medical Center-Beilinson HospitalPetah TikvaIsrael Shamir Medical Center(Assaf harofeh) Rishon LezionIsrael The Azrieli Faculty of Medicine Bar-Ilan UniversitySafedIsrael centre hépato-biliaire Department of Hepatobiliary and Pancreatic Surgery and TransplantationPaul Brousse HospitalAssistance Publique-Hôpitaux de ParisUniversitéSaclayVillejuifFrance

Background:The vast majority of patients with cholangiocarcinoma(CC)have advanced disease at diagnosis and are candidates for palliative treatment *** robustness of the randomized controlled trials regarding the treatment of CC are ***:A systematic review of all randomized control trials(RCT)of treatments for both intra-and extrahepatic CC between 2010 and 2020 was *** survival-inferred fragility index(SIFI;the minimum number of reassignments of the best survivors between arms that would overturn the statistical outcomes)was *** addition,the gain,or loss,in survival in RCTs was evaluated by the restricted mean survival time(RMST)***,the level of spin i.e.,misrepresentation of study outcomes,was measured in inconclusive studies to assess distorted reporting ***:Out of 6,167 studies retrieved,11 could be retained for full text revision(7 with both intra-and extrahepatic CC,3 with peri-hilar CC,and 1 with peri-hilar or distal CC).Only 3 studies included resected patients(2 with both intra-and extrahepatic CC and 1 with peri-hilar or distal CC).Nine studies investigated systemic chemotherapy(including 3 after surgical resection),one study evaluated photodynamic therapy,and another investigated the use of an endoscopically inserted stent in the biliary *** median SIFI was−2[interquartile range(IQR):−6.25,−0.25]across all ***,the median RMST difference was 0.56 months(IQR:0.10,0.95).Finally,for inconclusive studies,the level of spin was high,moderate,and low in respectively 12.5%,25%,and 62.5% of the ***:RCTs of CC showed a low degree of robustness with a frequent proportion of associated spin.

关键词： Cholangiocarcinoma(CC) randomized controlled trials robustness of evidence survival-inferred fragility index(SIFI) restricted mean survival time(RMST) spin effect

Adult human liver slice cultures:Modelling of liver fibrosis and evaluation of new anti-fibrotic drugs

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of hepatology 2021年第2期13卷 187-217页

作者： Daria Kartasheva-Ebertz Jesintha Gaston Loriane Lair-Mehiri Pierre-Philippe Massault Olivier Scatton Jean-Christophe Vaillant Vladimir Alexei Morozov Stanislas Pol Sylvie Lagaye Institut Pasteur Immunobiologie des Cellules DendritiquesINSERM U1223Paris 75015France BioSPC Universitéde ParisParis 75005France Service de Chirurgie digestive Hépato-biliaire et EndocrinienneAPHPGroupe Hospitalier CochinParis 75014France Service de Chirurgie digestive et hépato bilio pancréatique AP-HPGroupe Hospitalier La Pitié-SalpétrièreMedecine Sorbonne UniversitéParis 75013France Center for hIV and Retrovirology Department of Infectious DiseasesRobert Koch InstituteBerlin 13353Germany Département d'hépatologie AP-HPGroupe Hospitalier CochinUniversitéde ParisParis 75014France

BACKGROUND Liver fibrosis can result in end-stage liver failure and *** To examine human liver fibrogenesis and anti-fibrotic therapies,we evaluated the three dimensional ex vivo liver slice(LS)*** Fibrotic liver samples(F0 to F4 fibrosis stage according to the METAVIR score)were collected from patients after liver *** liver slices(hLS)were cultivated for up to 21 *** C virus(hCV)infection,alcohol(ethanol stimulation)and steatosis(palmitate stimulation)were examined in fibrotic(F2 to F4)liver slices infected(or not)with hCV.F0-F1 hLS were used as *** day 0,either ursodeoxycholic acid(choleretic and hepatoprotective properties)and/or α-tocopherol(antioxidant properties)were added to standard of care on hLS and fibrotic liver slices,infected(or not)with *** of the biomarkers of fibrosis and the triglyceride production were checked by quantitative reverse transcription polymerase chain reaction and/or enzymelinked immunosorbent *** The cultures were viable in vitro for 21 days allowing to study fibrosis inducers and to estimate the effect of anti-fibrotic *** of the biomarkers of fibrosis and the progression to steatosis(estimated by triglycerides production)was increased with the addition of hCV and/or ethanol or *** day 15 of the follow-up studies,a significant decrease of both transforming growth factorβ-1 and Procol1A1 expression and triglycerides production was observed when a combined anti-fibrotic treatment was applied on hCV infected F2-F4 LS *** These results show that the human three dimensional ex vivo model effectively reflects the in vivo processes in damaged human liver(viral,alcoholic,nonalcoholic steatohepatitis liver diseases)and provides the proof of concept that the LS examined model permits a rapid evaluation of new anti-fibrotic therapies when used alone or in combination.

关键词： human liver fibrosis hepatitis C virus Alcoholic liver disease Nonalcoholic steatohepatitis Ex vivo model Drugs

熊脱氧胆酸缓解硫唑嘌呤和皮质激素耐药的I型自身免疫性肝炎

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

世界核心医学期刊文摘（胃肠病学分册） 2006年第6期2卷 25-25页

作者： Duclos-Vallée J.-C. Di Martino V. Cazier A. 成虹 centre hépato-biliaire and upres 3541 Hpital Paul Brousse 14 avenue Paul Vaillant Couturier 94804 Villejuif

Combination therapy with steroids and azathioprine is the reference treatment for autoimmune hepatitis, but potential adverse effects are numerous and intolerance can occur. We report a patient with a well-documented type 1 autoimmune hepatitis intolerant to corticosteroids and azathioprine therapy, in whom eight years of ursodeoxycholic acid monotherapy was associated with biochemical and histological remission.

关键词： Ⅰ型自身免疫性肝炎熊脱氧胆酸硫唑嘌呤皮质激素激素耐药胆酸治疗联合疗法肝炎患者不良反应