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Hypoalbuminemia: an underestimated, vital characteristic of hospitalized COVID-19 positive patients?

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Hepatoma Research 2020年第6期6卷 1-10页

作者： Giuliano Ramadori clinic for Gastroenterology and Endocrinology University Medical Center GöttingenGöttingen 37075Germany

The COVID-19 pandemic has led to the greatest worldwide health crisis in *** number of infected patients with severe SARS-CoV-2(COVID-19)disease has overwhelmed the capacity of almost all health care systems around *** has now been reported in patients with severe disease seeking help in the emergency room because of COVID-19 *** the past,hypoalbuminemia was considered to be a negative prognostic marker,not only in patients with chronic liver disease,but also in patients with SARS and MERS *** is the major serum protein synthesized by the liver.A low serum albumin level is an ominous clinical *** of amino acids to a patient's diet is of fundamental importance to hepatic albumin synthesis in different clinical *** highlights the importance of nutritional support during the early phases of ***,albumin synthesis in the hepatocyte is downregulated at a pretranslational level by the direct interaction of the major acute-phase cytokines which are released into the circulation during the cytokine"storm"induced by the viral effects on the *** mechanisms contribute to severe hypoalbuminemia which,combined with massive fluid losses due to the fever,is responsible for severe hypovolemia and shock commonly observed in patients with COVID-19 in critical care settings.

关键词： Severe acute respiratory syndrome cornonavirus 2 SARS-CoV-2 COVID-19 albumin synthesis nutrition acute-phase reaction cytokines liver extrahepatic organs

Effect of cholinesterase inhibitor galanthamine on circulating tumor necrosis factor alpha in rats with lipopolysaccharideinduced peritonitis

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Chinese Medical Journal 2010年第13期123卷 1727-1730页

作者： LIU Zhi-hai MA Yue-feng WU Jun-song GAN Jian-xin XU Shao-wen JIANG Guan-yu Department of emergency Medicine Second Affiliated Hospital Zhejiang University School of Medicine and Research Institute of Emergency Medicine Hangzhou Zhejiang 310009 China

Background The nervous system, through the vagus nerve and its neurotransmitter acetylcholine, can down-regulate the systemic inflammation in vivo, and recently, a role of brain cholinergic mechanisms in activating this cholinergic anti-inflammatory pathway has been indicated. Galanthamine is a cholinesterase inhibitor and one of the centrally acting cholinergic agents available in clinic. This study aimed to evaluate the effect of galanthamine on circulating tumor necrosis factor alpha （TNF-a） in rats with lipopolysaccharide-induced peritonitis and the possible role of the vagus nerve in the action of galanthamine. Methods Rat models of lipopolysaccharide-induced peritonitis and bilateral cervical vagotomy were produced. In the experiment 1, the rats were randomly divided into control group, peritonitis group, and peritonitis groups treated with three dosages of galanthamine. In the experiment 2, the rats were randomly divided into sham group, sham plus peritonitis group, sham plus peritonitis group treated with galanthamine, vagotomy plus peritonitis group, and vagotomy plus peritonitis group treated with galanthamine. The levels of plasma TNF-α were determined in every group. Results The level of circulating TNF-α was significantly increased in rats after intraperitoneal injection of endotoxin. Galanthamine treatment decreased the level of circulating TNF-α in rats with lipopolysaccharide-induced peritonitis, and there was significant difference compared with rats with lipopolysaccharide-induced peritonitis without treatment. The 3 mg/kg dosage of galanthamine had the most significant inhibition on circulating TNF-α level at all the three tested doses. Galanthamine obviously decreased the TNF-a level in rats with lipopolysaccharide-induced peritonitis with sham operation, but could not decrease the TNF-α level in rats with lipopolysaccharide-induced peritonitis with vagotomy. Conclusion Cholinesterase inhibitor galanthamine has an inhibitory effect on TNF-α relea

关键词： cholinesterase inhibitors galanthamine tumor necrosis factor alpha vagus nerve

Acute liver failure with hemolytic anemia in children with Wilson’s disease:Genotype-phenotype correlations?

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World Journal of Hepatology 2021年第10期13卷 1428-1438页

作者： Tudor Lucian Pop Alina Grama Ana Cristina Stefanescu Claudia Willheim Peter Ferenci 2^(nd) Pediatric Discipline Department of Mother and ChildIuliu Hatieganu University of Medicine and PharmacyCluj-Napoca 400177Romania 2^(nd) Pediatric clinic Center of Expertise in Pediatric Liver Rare DisordersEmergency Clinical Hospital for ChildrenCluj-Napoca 400177Romania Department of Internal Medicine Ⅲ Gastroenterology and HepatologyMedical University of ViennaWien A-1090Austria

BACKGROUND Wilson’s disease(WD)is a rare autosomal recessive inherited disorder of copper *** liver failure(ALF)and hemolytic anemia represent the most severe presentation of WD in *** clear genotype-phenotype correlations exist in ***-truncating nonsense,frame-shift,or splice-site variants may be associated with more severe *** contrast,missense variants may be associated with late-onset,less severe disease,and more neurological ***,a gene variant(HSD17B13:TA,rs72613567)with a possible hepatic protective role against toxins was associated with a less severe hepatic phenotype in *** To analyze the possible genotype-phenotype correlations in children with WD presented with ALF and non-immune hemolytic *** The medical records of children with WD diagnosed and treated in our hospital from January 2006 to December 2020 were retrospectively *** clinical manifestations(ALF with non-immune hemolytic anemia or other less severe forms),laboratory parameters,copper metabolism,ATP7B variants,and the HSD17B13:TA(rs72613567)variant were reviewed to analyze the possible genotype-phenotype *** We analyzed the data of 51 patients with WD,26 females(50.98%),with the mean age at the diagnosis of 12.36±3.74 *** and Coombs-negative hemolytic anemia was present in 8 children(15.67%),all adolescent *** Kayser-Fleisher ring was present in 9 children(17.65%).The most frequent variants of the ATP7B gene were ***1069Gln(c.3207A>G)in 38.24% of all alleles,***1341Asp(c.4021G>A)in 26.47%,***939Cys(c.2817G>T)in 9.80%,and ***844Ter(c.2530A>T)in 4.90%.In ALF with hemolytic anemia,***939Cys(c.2817G>T)and ***844Ter(c.2530A>T)variants were more frequent than in other less severe forms,in which ***1069Gln(c.3207A>G)was more ***1341Asp(c.4021G>A)has a similar frequency in all hepatic *** 33 of the patients,the HSD17B13 genotype was *** overall HSD17B13:TA a

关键词： Wilson’s disease Children Acute liver failure Hemolytic anemia ATP7B variant Genotype-phenotype correlation

A summary of the pharmacologically tested aphrodisiac plants for sexual dysfunction

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Life Research 2019年第3期2卷 93-98页

作者： Marko Mornar Jelavic Hrvoje Pintaric Institute for Cardiovascular Prevention and Rehabilitation ZagrebCroatia School of Dental Medicine University of ZagrebZagrebCroatia University Hospital Center "Sestre milosrdnice" Clinic for Internal MedicineDepartment of Emergency MedicineZagrebCroatia

Sexual dysfunction is a disruption of normal sexual intercourse and may be a consequence of various organic and psychological disorders. It is the most frequent at patients with cardiovascular and neurological diseases, sedentary lifestyle, arterial hypertension, diabetes, obesity and metabolic syndrome, and may disrupt their emotional life. But, sexual dysfunction may occur simply because of the physical aging of the body. Physiologic changes that occur with aging will aff ect sexual function and could be exacerbated by the above-mentioned diseases. Except for the sexual counseling and standard medications (phosphodiesterase type 5 (PDE5)– inhibitors, local estrogen therapy), some of the herbal medicines (aphrodisiacs) may be helpful in the treatment of these patients making them emotionally younger and happier. In this review, we bring a list of the pharmacologically tested aphrodisiac plants. But, we have a lack of information about their mechanisms of action, drug interaction and safety profi le. Until the relevant information is collected, uses of these products may be risky to the human being and should be prescribed only in consultation with a specialist.

关键词： Sexual dysfunction Erectile dysfunction Herbal medicines Aphrodisiacs

Central retinal artery occlusion and traumatic optic neuropathy following blunt ocular trauma

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International Journal of Ophthalmology(English edition) 2018年第5期11卷 893-897页

作者： Jasmin Zvornicanin Ferenc Kuhn Meliha Halilbasic Zlatko Musanovic Department of Ophthalmology University Clinical Center Tuzla Tmovac bb Tuzla 75000 Bosnia and Herzegovina International Society of Ocular Trama Birmingham Birmingham 35200 AL USA Milos Eye clinic Belgrade 11000 Serbia Zagorskiego Eye clinic Krakow 30001 Poland

Dear Editor,We are writing to present a case report of central retinal artery occlusion（CRAO）and traumatic optic neuropathy（TON）with immediate visual loss caused by blunt facial trauma with a soccer *** is an opht... 详细信息

关键词： Central retinal artery occlusion blunt ocular trauma

Evaluation of Serum Cytokines Levels in Patients Undergoing Laparoscopic versus Conventional Cholecystectomy

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Journal of Pharmacy and Pharmacology 2016年第1期4卷 10-16页

作者： Srdjan Mijatovic Branislava Stefanovic Vasilije Jeremic Slobodan Krstic Nikola Radmanovic Tamara Alempijevic Biljana Milicic Branislav Stefanovic clinic for emergency Surgery Clinical Centre of Serbia 11000 Belgrade Serbia School of Medicine University of Belgrade 11000 Belgrade Serbia Department of A nesthesiology Clinical Centre of Serbia 11000 Belgrade Serbia clinic for gastroenterology and hepatology Clinical Center of Serbia 11000 Belgrade Serbia Institute for Medical lnformatics University of Belgrade School of Dentistry 11000 Belgrade Serbia

The aim of the study was to evaluate the influence of surgical trauma on systemic inflammation and immune response correlating preoperative and postoperative cytokine levels in patients undergoing laparotomy versus laparoscopic cholecystectomy. Seventy patients with chronic, symptomatic cholelithiasis confirmed by ultrasonography, without presence of cancer or signs of acute cholecystitis were assigned to laparoscopic cholecystectomy-LC （n = 35） and open cholecystectomy-OC （n = 35）. Blood samples were obtained preoperatively, 24 and 72 hours after surgery. Blood concentration of cytokines TNF-ct （tumor necrosis factor-a）, IL-11~ （interleukin-l）, IFN-y （interferon gamma） and IL-6 （interleukin-6）, anti-inflammatory cytokine IL-10 were measured in both groups. Although levels of TNFa were decreased on postoperative day one in LC group, the secretion in patients who underwent open laparatomy was significantly higher （/9 = 0.000）. After 72h the values raised in the OC and also in LC group compared to postoperative day one. Analyzing the values of IFN y and IL-I in our study we noticed that the values declined in the LC group after 72 hours, but significantly raised in the OC group （p = 0.000）. We observed significantly higher values of IL-6 in OC group, with the serum peak level 72 hours after procedure. In contrast, serum levels of IL-6 in patients who underwent laparascopic cholecystectomy had a decrease of values postoperativly. A similar event occurred with IL-10 in the laparoscopic group at the same *** levels of interleukins are increased and significantly higher in patients undergoing open procedures demonstrating that laparoscopic method displays less inflammatory response compared to open technique.

关键词： Cytokines laparoscopic cholecystectomy inflammatory response.

Zika virus,a pathway to new challenges

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Asian Pacific Journal of Tropical Medicine 2016年第7期9卷 606-609页

作者： Zubia Jamil Yasir Waheed Taimoor Zeb Durrani Fauji Foundation Hospital Foundation University Medical College Foundation University IslamabadDHA Phase I Liver clinic Iftikhar Eye Hospital

The current Zika outbreak is largest of its kind with 1.4 million cases in Brazil *** Health Organization declared the current outbreak as the public health emergency of international *** major route of Zika virus transmission is mosquito *** transmission and monkey bites are also observed in few *** is dire need to evaluate the other routes of transmission like blood transfusion,lactation and contact with body *** virus is infecting infants,not only causing microcephaly but also creating number of complications resulting in bad outcomes of *** Brazil alone,4 000 cases of microcephaly have observed during the current *** incidence of Guillian-Barre(GB) syndrome is also observed during the current Zika virus *** syndrome is acute medical condition leading the patients to death due to weakness of respiratory muscles or can cause the life time *** is no anti-viral drug or vaccine available for Zika *** infection can be prevented by using mosquito repellents,mosquito nets,cooling rooms by air conditions and wearing full sleeves or permethrin treated *** current outbreak of Zika has not only affected the health care but also caused great economic *** loss in Latin America and Caribbean is US$3.5 *** Nation's sustainable development goal 3.d stresses the strengthening of early warning,risk reduction and management of national and global health *** world will keep on facing new challenges in the form of Ebola or Zika;there is strong need to prepare ourselves for any disease outbreak.

关键词： Zika virus Public health emergency Microcephaly Guillian-Barre syndrome Mosquito bites

Hepatic abscess secondary to a rosemary twig migrating from the stomach into the liver

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World Journal of Gastroenterology 2007年第41期13卷 5530-5532页

作者： Aleksandar R Karamarkovic Srdjan P Djuranovic Nada N Popovic Vesna D Bumbasirevic Ana D Sijacki Ivan V Blazic Center for emergency Surgery Clinical Center of SerbiaSchool of MedicineUniversity of BelgradeBelgradeSerbia clinic for Gastroenterology and Hepatology Clinical Center of SerbiaSchool of MedicineUniversity of BelgradeBelgradeSerbia Institute of Anaesthesiology Clinical Center of SerbiaSchool of MedicineUniversity of BelgradeBelgradeSerbia

The ingestion of a foreign body that penetrates the gastric wall and migrates to the liver,where it causes an abscess is uncommon. A case of an ingested rosemary twig perforating the gastric antrum,then migrating to the liver,complicated by hepatic abscess and Staphylococcus aureus sepsis is reported. A 59-year-old man without a history of foreign body ingestion was admitted to our hospital because of sepsis and epigastralgia,which had progressively worsened. No foreign body was identified at preoperative imaging,but a rosemary twig was discovered during laparotomy. The liver abscess and sepsis were controlled successfully with surgery and antibiotics. This unusual condition should be kept in mind when dealing with cases of hepatic abscess,or even sepsis of unknown origin. Despite the improvement of non-surgical techniques such as percutaneous drainage and interventional endoscopy,surgery still remains important in the treatment of hepatic abscess caused by an ingested foreign body.

关键词： Foreign Body Gastrointestinal perforation Hepatic Abscess Ingestion Migration

High-risk factors for delirium in severely ill patients and the application of emotional nursing combined with pain nursing

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World Journal of Psychiatry 2024年第7期14卷 1027-1033页

作者： Hong-Ru Li Yu Guo emergency Intensive Care Unit The Fourth Affiliated Hospital of Soochow University(Suzhou Dushu Lake Hospital)Suzhou 215000Jiangsu ProvinceChina

BACKGROUND Delirium is a neuropsychiatric syndrome characterized by acute disturbances of consciousness with rapid onset,rapid progression,obvious fluctuations,and preventable,reversible,and other *** with delirium in the intensive care unit(ICU)are often missed or misdiagnosed and do not receive adequate *** To analyze the risk factors for delirium in ICU patients and explore the applica-tion of emotional nursing with pain nursing in the management of *** General data of 301 critically ill patients were retrospectively collected,including histories(cardiovascular and cerebrovascular diseases,hypertension,smoking,alcoholism,and diabetes),age,sex,diagnosis,whether surgery was performed,and patient origin(emergency/clinic).Additionally,the duration of sedation,Richmond Agitation Sedation Scale score,combined emotional and pain care,ven-tilator use duration,vasoactive drug use,drainage tube retention,ICU stay du-ration,C-reactive protein,procalcitonin,white blood cell count,body tempe-rature,Acute Physiology and Chronic Health Evaluation II(APACHE II)score,and Sequential Organ Failure Assessment score were recorded within 24 h after ICU *** were assessed for delirium according to confusion assessment method for the ICU,and univariate and multivariate logistic regre-ssion analyses were performed to identify the risk factors for delirium in the *** Univariate logistic regression analysis was performed on the 24 potential risk factors associated with delirium in ICU *** results showed that 16 risk factors were closely related to delirium,including combined emotional and pain care,history of diabetes,and patient *** logistic regression analysis revealed that no combined emotional and pain care,history of diabetes,emergency source,surgery,long stay in the ICU,smoking history,and high APACHE II score were independent risk factors for de-lirium in ICU *** Patients

关键词： Critical illness Delirium Risk factor Intensive care unit Emotional nursing Pain nursing