检索结果-南通市图书馆

Management of portopulmonary hypertension:New perspectives

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 2013年第45期19卷 8252-8257页

作者： Luigi Mancuso Francesca Scordato Michela Pieri eliana Valerio Andrea Mancuso Department of cardiologia Ospedale Cervello90100 Palermo Italy cardiologia Clinica Candela 90100 Palermo Italy epatologia e Gastroenterologia Ospedale Niguarda Cà Granda Milano 20162 Milano Italy Medicina Interna 1 ARNAS Civico 90100 Palermo Italy

Portopulmonary hypertension(PPHTN)is a known complication of cirrhosis.Moderate-to-severe PPHTN implies an extremely poor prognosis.It occurs in 5%-10%of patients referred for liver transplantation(LT),and probably with an higher incidence in patients with large portosystemic shunts.Patients with moderate-tosevere pulmonary hypertension have been previously excluded from LT because of the extremely high surgical risk and since the post-transplant outcome reported was poor.Recently,new perspectives in the management of patients with portopulmonary hypertension are emerging.In fact,some pulmonary vasoactive drugs have become routine in the treatment of patients with idiopathic pulmonary hypertension.These drugs,particularly epoprostenol,have been recently introduced in the treatment of patients with PPHTN,and have been shown to be effective in reducing pulmonary artery pressure as well as pulmonary vascular resistances.Furthermore,recent studies seem to demonstrate that treatment with pulmonary vasoactive drugs could allow liver transplantation with acceptable surgical risks and excellent survival.Although there are not large series nor prospective studies addressing this topic,the clinical scenario of patients with PPHTN seems to be positively changing.

关键词： Portopulmonary hypertension Cirrhosis Liver transplantation Management epoprostenol

Dynamic carbon 13 breath tests for the study of liver function and gastric emptying

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Gastroenterology Report 2015年第1期3卷 12-21页

作者： Leonilde Bonfrate Ignazio Grattagliano Giuseppe Palasciano Piero Portincasa Department of Biomedical Sciences and Human Oncology Clinica Medica‘A.Murri’University of Bari Medical SchoolBariItaly Italian College of General Practitioners Florence and BariItaly

In gastroenterological practice,breath tests(BTs)are diagnostic tools used for indirect,non-invasive assessment of several pathophysiological metabolic processes,by monitoring the appearance in breath of a metabolite of a specific substrate.Labelled substrates originally employed radioactive carbon 14(^(14)C)and,more recently,the stable carbon 13 isotope(^(13)C)has been introduced to label specific substrates.The ingested^(13)C-substrate is metabolized,and exhaled^(13)CO_(2)is measured by mass spectrometry or infrared spectroscopy.Some^(13)C-BTs evaluate specific(microsomal,cytosolic,and mitochondrial)hepatic metabolic pathways and can be employed in liver diseases(i.***.simple liver steatosis,non-alcoholic steato-hepatitis,liver fibrosis,cirrhosis,hepatocellular carcinoma,drug and alcohol effects).Another field of clinical application for^(13)C-BTs is the assessment of gastric emptying kinetics in response to liquids(^(13)C-acetate)or solids(^(13)C-octanoic acid in egg yolk or in a pre-packed muffin or the^(13)C-Spirulina platensis given with a meal or a biscuit).Studies have shown that^(13)C-BTs,used for gastric emptying studies,yield results that are comparable to scintigraphy and can be useful in detecting either delayed-(gastroparesis)or accelerated gastric emptying or changes of gastric kinetics due to pharmacological effects.Thus,^(13)C-BTs represent an indirect,cost-effective and easy method of evaluating dynamic liver function and gastric kinetics in health and disease,and several other potential applications are being studied.

关键词： breath tests stable isotope hepatic metabolism gastric motility scintigraphy

Low utility of plasma Nociceptin/orphanin FQ in the diagnosis of hepatocellular carcinoma

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 2006年第29期12卷 4716-4720页

作者： Aldo Spadaro Antonino Ajello Carmelo Luigiano Carmela Morace Maria Letizia Resta Grazia Berlinghieri Salvatore Campo Claudio Scisca Angela Alibrandi Graziella D'arrigo Nunziata Alessi Oscar Ferraù Maria Antonietta Freni Dipartimento Clinico Sperimentale di Medicina e Farmacologia clinica medica Pad.CAOUVia Consolare Valeria No.1Messina 98125Italy

瞄准：在肝细胞癌(HCC ) 的察觉的浆液 alpha-fetoprotein (alpha-FP ) 的用途是可疑的。nociceptin/orphanin FQ (N/OFQ ) 的很高的传播层次，为新奇 opioid 受体的 ligand，最近在 HCC 被报导了。这研究的目的是在与肝肝硬化在病人产... 详细信息

瞄准：在肝细胞癌(HCC ) 的察觉的浆液 alpha-fetoprotein (alpha-FP ) 的用途是可疑的。nociceptin/orphanin FQ (N/OFQ ) 的很高的传播层次，为新奇 opioid 受体的 ligand，最近在 HCC 被报导了。这研究的目的是在与肝肝硬化在病人产生的 HCC 的诊断估计血浆 N/OFQ 的角色。方法：血浆 N/OFQ 层次被 eLISA 在 58 个病人(28 HCC 和 30 肝肝硬化) 并且在 25 健康控制测量。价值被相关与临床并且实验室特征包括 alpha-FP。枪兵索引，寒风伊朗的银币相关系数，非参量的联合(NPC ) 测试和判别式逐步的分析被用于数据的统计评估。结果：nociceptin 的上面的正常限度是 122 pg/mL。在这上面的血浆层次截止与 HCC 在 21.4% 病人被发现，在 23.3% 那些与肝硬化并且在 8% 健康题目。200 ng/mL 与肝硬化那些与 HCC 并且在没有在 46.4% 病人被发现的 alpha-FP 浆液层次 > 。没有关联在 N/OFQ 层次和任何东西之间被发现临床并且实验室特征，包括 alpha-FP。由 NPC 测试， HCC 和肝脏硬化症的病人关于 alpha-FP 是不同的(P = 0.000 ) 然而并非以 nociceptin (P = 0.595 ) 。由点寒风伊朗的银币关联， HCC 存在断然与 alpha-FP 被相关(rpb = 0.52， P = 0.000 ) 然而并非与 N/OFQ (rpb = 0.16， P = 0.157 ) 。在判别式分析， alpha-FP 在 Wilks 测试是重要的(Y =-0.709 + 0.03 alpha-FP ) 并且适当地分类 81% 所有病人和 61% HCC。N/OFQ 比 alpha-FP 有更低的敏感，特性和预兆的价值。结论：Nociceptin 与长期的肝疾病在病人被增加，独立于 HCC 的存在，尽管内在的机制还得被澄清。我们断定它不是为 HCC 的一个有用标记。

关键词：等离子体诊断方法肝细胞癌病理机制

Adalimumab efficacy in enteropathic spondyloarthritis: A 12-mo observational multidisciplinary study

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 2017年第39期23卷 7139-7149页

作者： Michele Maria Luchetti Devis Benfaremo Francesco Ciccia Laura Bolognini Monia Ciferri Alessia Farinelli Matteo Rossini Piergiorgio Mosca Giovanni Triolo Armando Gabrielli Dipartimento Scienze Cliniche e Molecolari Clinica MedicaUniversità Politecnica delle Marche Dipartimento Biomedico di Medicina Interna e Specialistica Sezione di Reumatologia Università degli Studi di Palermo Dipartimento Gastro-enterologico e dei Trapianti Polo Ospedaliero--Universitario 'Umberto I-G.M. Lancisi- G. Salesi'

AIM To report adalimumab(Ada) efficacy on articulargastrointestinal disease and health-related quality of life(HRQo L) in patients with enteropathic spondyloarthritis(eS).MeTHODS A cohort of 52 patients with eS was evaluated in the departments of gastroenterology and internal medicine. At baseline, all patients underwent assessment by an integrated gastro-rheumatologic evaluation of articular and gastrointestinal activity, as well patient reported outcomes(PROs) of the HRQo L questionnaires. After this integrated evaluation and following a specific working flowchart, the Ada anti-tumor necrosis factor(TNF)-inhibitor was assigned to a cohort of 30 patients and its clinical efficacy was evaluated at baseline and after 6-mo and 12-mo treatment by the following tests:(1) Ankylosing Spondylitis Disease Activity ScoreC-Reactive Protein(ASDAS-CRP); Bath Ankylosing Spondylitis Disease Activity Index(BASDAI), Bath Ankylosing Spondylitis Functional Index(BASFI) and Bath Ankylosing Spondylitis Metrology Index(BASMI) for articular activity;(2) Inflammatory Bowel Disease Questionnaire(IBDQ), Crohn's Disease Activity Index(CDAI) and partial Mayo(p Mayo) score for gastrointestinal symptoms and activity; and(3) Health Assessment Questionnaire(HAQ), Patient Global Assessment(PGA) and Short Form-36 health survey(SF-36) questionnaires for PROs of the HRQo L.ReSULTS Integrated evaluation and management of the patients affected by eS, carried out simultaneously by a gastroenterologist and a rheumatologist, allowed clinicians to choose the optimal therapeutic strategy. In a cohort of 30 eS patients affected by active articular and gastrointestinal disease, or axial active articular inflammation, Ada led to fast and sustained improvement of both articular and gastrointestinal disease activities. In fact, all the clinimetric evaluation tests exploring articular or gastrointestinal activity, as well as all the HRQo L scores, showed a significant improvement having been achieved at the earliest(6-mo) assessment. This important clinical im

关键词： Clinimetric 评价耐心的报导结果煽动性的肠疾病 enteropathic spondyloarthritis 肿瘤坏死因素禁止者多学科的评估

Biochemical mechanisms in drug-induced liver injury:Certainties and doubts

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 2009年第39期15卷 4865-4876页

作者： Ignazio Grattagliano Leonilde Bonfrate Catia V Diogo Helen H Wang David QH Wang Piero Portincasa clinica medica "A.Murri" Dipartimento di Medicina Interna e Medicina PubblicaUniversity of Bari Medical School Department of Zoology Center for Neurosciences and Cell BiologyUniversity of Coimbra Department of Medicine Liver Center and Gastroenterology DivisionBeth Israel Deaconess Medical CenterHarvard Medical School and Harvard Digestive Diseases Center

Drug-induced liver injury is a significant and still unresolved clinical problem.Limitations to knowledge about the mechanisms of toxicity render incomplete the detection of hepatotoxic potential during preclinical development.Several xenobiotics are lipophilic substances and their transformation into hydrophilic compounds by the cytochrome P-450 system results in production of toxic metabolites.Aging,preexisting liver disease,enzyme induction or inhibition,genetic variances,local O2 supply and,above all,the intrinsic molecular properties of the drug may affect this process.Necrotic death follows antioxidant consumption and oxidation of intracellular proteins,which determine increased permeability of mitochondrial membranes,loss of potential,decreased ATP synthesis,inhibition of Ca2+-dependent ATPase,reduced capability to sequester Ca2+ within mitochondria,and membrane bleb formation.Conversely,activation of nucleases and energetic participation of mitochondria are the main intracellular mechanisms that lead to apoptosis.Non-parenchymal hepatic cells are inducers of hepatocellular injury and targets for damage.Activation of the immune system promotes idiosyncratic reactions that result in hepatic necrosis or cholestasis,in which different HLA genotypes might play a major role.This review focuses on current knowledge of the mechanisms of drug-induced liver injury and recent advances on newly discovered mechanisms of liver damage.Future perspectives including new frontiers for research are discussed.

关键词：生化机制肝损伤药物性免疫系统激活肝细胞损伤毒性机制肝脏疾病抗氧化剂

慢性乙型肝炎患儿e抗原清除后调查:一项29年的纵向研究

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9期2卷 49-50页

作者： Bortolotti F. Guido M. Bartolacci S. 王铮 clinica medica V Via Giustiniani 235100 PadovaItaly

Chronic hepatitis B is usually a benign disease in Caucasian children;however,the long-term prognosis remains unsettled.This report describes the results of a 29-year longitudinal study including 99 white children with chronic hepatitis B,mainly acquired horizontally:91 were hepatitis B e antigen(HBeAg)-positive(4 had cirrhosis),and 8 were HBeAg negative at presentation.Of the 91 HBeAg-positive children,89 underwent HBeAg seroconversion after a mean period of 5.2 ±4.0 years and were included in the study.Of the 85 children without cirrhosis,one had HBeAg-negative hepatitis and the other 84 became inactive carriers.During a mean follow-up of 14.5 ±6.1 years after HBeAg seroclearance,4 carriers experienced reactivation,and 3 of them had HBeAg-negative hepatitis at the last follow-up.Of the 8 initially HBeAg-negative children,2 had HBeAg-negative hepatitis,and 6 were inactive carriers.Of the 4 children with cirrhosis,2 had hepatocellular carcinoma(HCC)and remained alive and 2 lost the histological features of cirrhosis in adulthood.Two patients with HBeAg-negative hepatitis and 1 with cirrhosis had experienced drug abuse.At the end of follow-up,15 of the 89 initially HBeAg-positive patients and 2 of 8 initially HBeAg-negative children had cleared hepatitis B surface antigen.In conclusion,the overall prognosis for chronic hepatitis B in horizontally infected Caucasian children is favorable;however,some patients progress to HCC and HBeAg-negative hepatitis.Long-term monitoring is important,as is counseling on cofactors of liver damage,such as alcohol and drug abuse.

关键词：慢性乙型肝炎 e抗原患儿 HBeAg阴性 HBeAg血清转换 HBeAg阳性清除后随访观察

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

儿科肾移植患者中的氧化应激与移植后高血压

世界核心医学期刊文摘（儿科学分册） 2006年第12期2卷 39-40页

作者： CalòL.A. Dall'Amico R. Pagnin e. 朱新菊 clinical and experimental Medicine Clinica Medica 4Pediatric Nephrology University of PadovaItaly Dr.

Objective:To test the hypothesis that oxidative stress signaling contributes to post-transplant endothelial dysfunction and hypertension in pediatric post-transplant hypertension. Study design:This study evaluated in 16 pediatric renal transplant patients,divided in two groups based on the presence of post transplant hypertension,the oxidative stress status measuring the gene expression (reverse transcription-polymerase chain reaction)of two major oxidative stress-related proteins,p22phox and heme oxygenase-1(HO-1). Total plasma antioxidant power(eLISA)was also evaluated. Results:Mononuclear cell p22phoxgene expression was higher in hypertensive patients compared with the normotensive group (0.91 ±0.06 vs 0.79 ±0.08 densitometric units,P ereas HO-1 RNA production and total plasma antioxidant power were higher in the normotensive group (0.38 ±0.04 vs 0.20 ±0.11 d.u.,P espectively).Conclusions:Oxidative stress is associated with post-transplant hypertension in hypertensive pediatric kidney-transplant patients,who therefore are at risk of oxidative stress-induced organ damage. They might benefit from treatments addressing not only hypertension but also oxidant-related complications.

关键词：氧化应激血压正常组内皮功能紊乱血红素加氧酶抗氧化力基因表达脏器损害研究设计

Post-transplantation hepatocellular carcinoma recurrence: Patterns and relation between vascularity and differentiation degree

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 Hepatology 2015年第2期7卷 276-284页

作者： Annarita Pecchi Giulia Besutti Mario De Santis Cinzia Del Giovane Sofia Nosseir Giuseppe Tarantino Fabrizio Di Benedetto Pietro Torricelli Dipartimento di Diagnostica per Immagini Azienda Ospedaliero-Universitaria Policlinico di Modena Unità di Statistica medica Dipartimento di Medicina Diagnostica Clinica e Sanità Pubblica Università di Modena e Reggio Emilia Dipartimento dei Laboratori Anatomia Patologica e Medicina Legale Università degli studi di Modena e Reggio Emilia Dipartimento Chirurgico Medico Odontoiatrico e di Scienze Morfologiche con interesse Trapiantologico Oncologico e di Medicina Rigenerativa Università di Modena e Reggio Emilia

AIM: To evaluate the relationship between hepatocellular carcinoma(HCC) vascularity and grade; to describe patterns and vascular/histopathological variations of post-transplantation recurrence.MeTHODS: This retrospective study included 165 patients(143 men, 22 women; median age 56.8 years, range 28-70.4 years) transplanted for HCC who had a follow-up period longer than 2 mo. Pre-transplantation dynamic computed tomography or magnetic resonance examinations were retrospectively reviewed, classifying HCC imaging enhancement pattern into hypervascular and hypovascular based on presence of wash-in during arterial phase. All pathologic reports of the explanted livers were reviewed, collecting data about HCC differentiation degree. The association between imaging vascular pattern and pathological grade was estimated using the Fisher exact test. All follow-up clinical and imaging data were reviewed for evidence of recurrence. Recurrence rate was calculated and imaging features of recurrent tumor were collected, classifying early and late recurrences based on timing(ears after transplantation) and intrahepatic, extrahepatic and both intrahepatic and extrahepatic recurrences based onlocation. All intrahepatic recurrences were classified as hypervascular or hypovascular and the differentiation degree was collected where available. The presence of variations in imaging enhancement pattern and pathological grade between the primary tumor and the intrahepatic recurrence was evaluated and the association between imaging and histopatholgical variations was estimated by using the χ2 test. ReSULTS: Of the 163 patients with imaging evidence of viable tumor, 156(95.7%) had hypervascular and 7(4.3%) hypovascular HCC. Among the 125 patients with evidence of viable tumor in the explanted liver, 19(15.2%) had grade 1, 56(44.8%) grade 2, 40(32%) grade 3 and 4(3.2%) grade 4 HCC, while the differentiation degree was not assessable for 6 patients(4.8%). A significant association was found between imaging vascularity and pathologi

关键词： Contrast media Hepatocellular carcinoma Liver transplantation Cell differentiation Recurrence

Predictors of survival in patients with established cirrhosis and hepatocellular carcinoma treated with sorafenib

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 2014年第3期20卷 786-794页

作者： Andrea L Inghilesi Donatella Gallori Lorenzo Antonuzzo Paolo Forte Daniela Tomcikova Umberto Arena Stefano Colagrande Silvia Pradella Bernardo Fani elena Gianni Luca Boni Giacomo Laffi Francesco Di Costanzo Fabio Marra Dipartimento di Medicina Sperimentale e clinica Università degli Studi di Firenze Oncologia medica Azienda Ospedaliero-Universitaria Careggi Gastroenterologia 2 Azienda Ospedaliero-Universitaria Careggi Centro per il Coordinamento delle Sperimentazioni Cliniche Istituto Toscano Tumoriand Azienda Ospedaliero-Universitaria Careggi Dipartimento di Scienze Biomediche Sperimentali e ClinicheUniversità degli Studi di Firenze

AIM:To investigate in greater detail the efficacy and safety of sorafenib for the treatment of hepatocellular carcinoma(HCC)in patients with established cirrhosis.MeTHODS:From October 2009 to July 2012 patients with an established diagnosis of cirrhosis and HCC treated with sorafenib were consecutively enrolled.According to the Barcelona Clinic Liver Cancer(BCLC)classification,patients were in the advanced stage(BCLC-C)or in the intermediate stage(BCLC-B)but unfit or unresponsive to other therapeutic strategies.Treatment was evaluated performing a 4-phase computed tomography or magnetic resonance imaging scan every 2-3 mo,and analyzed according to the modified Response evaluation Criteria in Solid Tumors.Sorafenib was administered at 800 mg/d,until radiological progression or occurrence of unacceptable adverse events(Aes).Univariate and multivariate analyses identified predictors of 16-wk clinical benefit and overall survival.ReSULTS:Forty-four patients were enrolled,15 had intermediate HCC and 14 a Child-Pugh score of B7.Aes caused treatment interruption in 19 patients(43%),and median treatment duration was shorter in this subset(5 wk vs 19 wk,Pe BCLC-C subgroup(13 wk vs 40 wk,P=0.015).No significant differences in the reason for treatment interruption or in treatment duration were found comparing patients in Child-Pugh class A vs B or in patients older or younger than 70 years.After 16 wk of treatment,18 patients(41%)had stable disease or partial response.Patients with viral infection or BCLC-C were at higher risk of disease progression.eCOG,extrahepatic spread,macrovascular invasion,alpha-fetoprotein or alkaline phosphatase levels at admission were independent predictors of overall survival.CONCLUSION:In patients with cirrhosis and HCC treated with sorafenib,Aes are a common cause of early treatment withdrawal.Vascular invasion and extrahepatic spread condition early response to treatment and survival.Baseline biochemical parameters may be helpful to identify patients at higher risk of shorter

关键词： Hepatocellular carcinoma Sorafenib Cirrhosis Adver