检索结果-南通市图书馆

Prognostic model for esophagogastric variceal rebleeding after endoscopic treatment in liver cirrhosis: A Chinese multicenter 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 2025年第2期31卷 85-101页

作者： Jun-Yi Zhan Jie Chen Jin-Zhong Yu Fei-Peng Xu Fei-Fei Xing De-Xin Wang Ming-Yan Yang Feng Xing Jian Wang Yong-Ping Mu Cell Biology Laboratory Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China institute of liver Diseases Shanghai Academy of Chinese MedicineShanghai 201203China Clinical Key Laboratory of Traditional Chinese Medicine of Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China Key Laboratory of liver and Kidney Disease of the Ministry of Education Shanghai University of Traditional Chinese MedicineShanghai 201203China Department of Gastroenterology and Hepatology Zhongshan Hospital Affiliated to Fudan UniversityShanghai 200032China Shanghai institute of liver Disease Fudan UniversityShanghai 200032China Evidence-Based Medicine Center Fudan UniversityShanghai 200032China Department of Gastrointestinal Endoscopy Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China Department of Hepatology Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China

BACKGROUND Rebleeding after recovery from esophagogastric variceal bleeding(EGVB)is a severe complication that is associated with high rates of both incidence and *** its clinical importance,recognized prognostic models that can effectively predict esophagogastric variceal rebleeding in patients with liver cirrhosis are *** To construct and externally validate a reliable prognostic model for predicting the occurrence of esophagogastric variceal *** This study included 477 EGVB patients across 2 cohorts:The derivation cohort(n=322)and the validation cohort(n=155).The primary outcome was rebleeding events within 1 *** least absolute shrinkage and selection operator was applied for predictor selection,and multivariate Cox regression analysis was used to construct the prognostic *** validation was performed with bootstrap *** assessed the discrimination,calibration and accuracy of the model,and performed patient risk *** Six predictors,including albumin and aspartate aminotransferase concentrations,white blood cell count,and the presence of ascites,portal vein thrombosis,and bleeding signs,were selected for the rebleeding event prediction following endoscopic treatment(REPET)*** predicting rebleeding within 1 year,the REPET model ex-hibited a concordance index of 0.775 and a Brier score of 0.143 in the derivation cohort,alongside 0.862 and 0.127 in the validation ***,the REPET model revealed a significant difference in rebleeding rates(P<0.01)between low-risk patients and intermediate-to high-risk patients in both *** We constructed and validated a new prognostic model for variceal rebleeding with excellent predictive per-formance,which will improve the clinical management of rebleeding in EGVB patients.

关键词： Esophagogastric variceal bleeding Variceal rebleeding liver cirrhosis Prognostic model Risk stratification Secondary prophylaxis

Nationwide trends and predictors of inpatient mortality in 83884 transjugular intrahepatic portosystemic shunt

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 2016年第25期22卷 5780-5789页

作者： Edward Wolfgang Lee Andrew Kuei Sammy Saab Ronald W Busuttil Francisco Durazo Steven-Huy Han Mohamed M El-Kabany Justin P Mc Williams Stephen T Kee Department of Radiology Division of Interventional Radiology Ronald Reagan Medical Center at UCLA David Geffen School of Medicine at UCLA Department of Medicine Division of Hepatology Pfleger Liver Institute University of California at Los Angeles Dumont-UCLA Transplant Center Pfleger Liver Institute Division of Liver and Pancreas Transplantation Department of Surgery David Geffen School of Medicine at University of California Los Angeles

AIM: To evaluate and validate the national trends and predictors of in-patient mortality of transjugular intrahepatic portosystemic shunt (TIPS) in 15 ***: Using the National Inpatient Sample which is a part of Health Cost and Utilization Project, we identified a discharge-weighted national estimate of 83884 TIPS procedures performed in the United States from 1998 to 2012 using international classification of diseases-9 procedural code 39.1. The demographic, hospital and co-morbility data were analyzed using a multivariant analysis. Using multi-nominal logistic regression analysis, we determined predictive factors related to increases in-hospital mortality. Comorbidity measures are in accordance to the Comorbidity Software designed by the Agency for Healthcare Research and ***: Overall, 12.3% of patients died during hospitalization with downward trend in-hospital mortality with the mean length of stay of 10.8 ± 13.1 d. Notable, African American patients (OR = 1.809 vs Caucasian patients, P < 0.001), transferred patients (OR = 1.347 vs non-transferred, P < 0.001), emergency admissions (OR = 3.032 vs elective cases, P < 0.001), patients in the Northeast region (OR = 1.449 vs West, P < 0.001) had significantly higher odds of in-hospital mortality. Number of diagnoses and number of procedures showed positive correlations with in-hospital death (OR = 1.249 per one increase in number of procedures). Patients diagnosed with acute respiratory failure (OR = 8.246), acute kidney failure (OR = 4.359), hepatic encephalopathy (OR = 2.217) and esophageal variceal bleeding (OR = 2.187) were at considerably higher odds of in-hospital death compared with ascites (OR = 0.136, P < 0.001). Comorbidity measures with the highest odds of in-hospital death were fluid and electrolyte disorders (OR = 2.823), coagulopathy (OR = 2.016), and lymphoma (OR = 1.842).CONCLUSION: The overall mortality of the TIPS procedure is stea

关键词： Transjugular intrahepatic portosystemic shunt Mortality Inpatient United States National Inpatient Sample database Health Cost and Utilization Project

Dangerous dietary supplements: Garcinia cambogia-associated hepatic failure requiring transplantation

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 2016年第45期22卷 10071-10076页

作者： Keri E Lunsford Adam S Bodzin Diego C Reino Hanlin L Wang Ronald W Busuttil the pfleger liver institute The Dumont-UCLA Liver Transplant Center Division of Liver and Pancreas Transplantation Department of Surgery David Geffen School of Medicine at UCLA University of California Los Angeles J.C Walter Jr. Center for Transplantation Sherrie and Alan Conover Center for Liver Disease and Transplantation Center for Transplantation Immunobiology Houston Methodist Hospital and Research Institute Department of Pathology and Laboratory Medicine David Geffen School of Medicine at UCLA University of California Los Angeles

Commercial dietary supplements are marketed as a panacea for the morbidly obese seeking sustainable weight-loss. Unfortunately, many claims cited by supplements are unsupported and inadequately regulated. Most concerning, how ever, are the associated harmful side effects, often unrecognized by consumers. Garcinia cambogia extract and Garcinia cambogia containing products are some of the most popular dietary supplements currently marketed for weight loss. Here, we report the first known case of fulminant hepatic failure associated with this dietary supplement. One active ingredient in this supplement is hydroxycitric acid, an active ingredient also found in weight-loss supplements banned by the Food and Drug Administration in 2009 for hepatotoxicity. Heightened awareness of the dangers of dietary supplements such as Garcinia cambogia is imperative to prevent hepatoxicity and potential fulminant hepatic failure in additional patients.

关键词： Dietary supplements Fulminant hepatic failure Drug-induced liver injury liver transplantation Hyroxycitric acid Weight-loss supplements

Serum ferritin in neonatal cholestasis: A specific and active molecule or a non-specific bystander marker?

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 2019年第2期18卷 173-180页

作者： Behairy El-Sayed Behairy Hatem Abd-Alsattar Konswa Hanaa Talaat Ahmed Dina Shehata El-Azab Nermin Mohamed Adawy Ahmad Mohamed Sira Department of Pediatric Hepatology Gastroenterology and Nutrition National Liver Institute Menofiya University Department of Pathology National Liver Institute Menofiya University

Background: Serum ferritin(SF) and consequently hepatic iron have long been considered important in liver fibrosis progression. They have been studied in different liver diseases with no previous reports in neonatal cholestasis(NC). This study aimed to measure SF in different etiologies of NC and investigate its relation to hepatic iron and fibrosis. Methods: SF was measured in 75 infants, including 50 with NC and 25 with sepsis. SF was compared between these two groups. Biochemical parameters, hepatic iron grades, and liver fibrosis and other histopathological characteristics and correlated with SF were assessed in NC group. Finally, a comparison between intrahepatic cholestasis and obstructive etiology was performed. Results: SF was elevated in NC(1598 ± 2405 ng/mL) with no significant difference from those with sepsis( P = 0.445). NC and sepsis constituted augmenting factors leading to more elevation of SF(2589 ± 3511 ng/mL). SF was significantly correlated with hepatic iron grades( r = 0.536, P liver fibrosis( P = 0.058). Conclusions: SF is non-specifically elevated in NC, with positive correlation to hepatic iron grades. SF ≥ 803.5 ng/mL can predict higher grades( ≥ grade 3) of hepatic iron. However, an active role of increased SF and hepatic iron in disease progression remains questionable.

关键词： Biliary atresia liver fibrosis Hepatic iron grade Intrahepatic cholestasis Iron

COVID-19 in liver Transplant Recipients-A Series with Successful Recovery

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

Journal of Clinical and Translational Hepatology 2020年第4期8卷 467-473页

作者： Ashok Choudhury Golamari Srinivasa Reddy Shantan Venishetty Viniyendra Pamecha Saggere Muralikrishna Shasthry Arvind Tomar Lalita Gauri Mitra Venkata Siva Tez Prasad Rajendra Prasad Mathur Debajyoti Bhattacharya Shiv Kumar Sarin Department of Hepatology and liver Transplant Institute of Liver and Biliary SciencesNew DelhiIndia Department of HPB Surgery and liver Transplant Institute of Liver and Biliary SciencesNew DelhiIndia Department of Pulmonary Medicine Institute of Liver and Biliary SciencesNew DelhiIndia Department of Critical Care Medicine Institute of Liver and Biliary SciencesNew DelhiIndia Department of Nephrology Institute of Liver and Biliary SciencesNew DelhiIndia

The severe acute respiratory syndrome corona virus-2 (referred to as SARS-CoV-2) pandemic had a great impact on public life in general as well as on populations with pre-existing disease and co-morbidities. liver transplant and immunosuppressant medication predisposes to more severe disease and is often associated with poor outcome. The clinical features, disease course, treatment and process of modulating the immunosuppression is challenging. Here, we describe the clinical presentation, treatment and outcomes in six liver transplant recipients. Out of those six patients, three had mild, one had moderate and one had severe COVID-19, and one was asymptomatic. The immunosup-pression minimization or withdrawal was done based upon the clinical severity. Consideration of tocilizumab and/or convalescent plasma as well as antivirals i.e. remdesvir done in severe cases. The routine practice of prophylactic anti-coagulation, consideration of repurposed drugs (i.e. teico-planin and doxycycline), and watchful monitoring of asymptomatic recipients helped to achieve an uneventful recovery.

关键词： liver transplant COVID-19 SARS-CoV-2 liver injury Remdesivir Convalescent plasma

Ascites and alpha-fetoprotein improve prognostic performance of Barcelona Clinic liver Cancer staging

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 2015年第18期21卷 5654-5662页

作者： Asmaa I Gomaa Alzhraa Al-Khatib Wael Abdel-Razek Mohammed Saad Hashim Imam Waked Hepatology Department National Liver Institute Menoufiya University Oncology Department National Liver Institute Menoufiya University

AIM: To assess how ascites and alpha-fetoprotein(AFP) added to the Barcelona Clinic liver Cancer(BCLC) staging predict hepatocellular carcinoma ***: The presence of underlying cirrhosis, ascites and encephalopathy, Child-Turcotte-Pugh(CTP) score, the number of nodules, and the maximum diameter of the largest nodule were determined at diagnosis for 1060 patients with hepatocellular carcinoma at a tertiary referral center for liver disease in Egypt. Demographic information, etiology of liver disease, and biochemical data(including serum bilirubin, albumin, international normalized ratio, alanine and aspartate aminotransferases, and AFP) were evaluated. Staging of the tumor was determined at the time of diagnosis using the BCLC staging system; 496 patients were stage A and 564 patients were stage B. Patients with mild ascites on initial ultrasound, computed tomography, or clinical examination, and who had a CTP score ≤ 9 were included in this analysis. All patients received therapy according to the recommended treatment based on the BCLC stage, and were monitored from the time of diagnosis to the date of death or date of data collection. The effect of the presence of ascites and AFP level on survival was ***:At the time the data were censored,123/496(24.8%)and 218/564(38.6%)patients with BCLC stages A and B,respectively,had *** mean survival of the BCLC A and B patients during a three-year follow-up period was 31 mo[95%confidence interval(95%CI):29.7-32.3]and 22.7mo(95%CI:20.7-24.8),*** presenceof ascites,multiple focal lesions,large tumor size,AFP level and CTP score were independent predictors of survival for the included patients on multivariate analysis(P<0.001).Among stage A patients,18%had ascites,33%had AFP≥200 ng/m L,and 8%had *** median survival in the presence of ascites was shorter if AFP was≥200 ng/m L(19 mo vs 24 mo),and in the absence of ascites,patients with AFP≥200 ng/m L had a shorter survival(28mo

关键词： Alpha-fetoprotein Ascites Barcelona Clinic liver Cancer Hepatocellular carcinoma Survival

Management of hepatocellular carcinoma with portal vein thrombosis

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 2015年第12期21卷 3462-3471页

作者： Matthew Quirk Yun Hwan Kim Sammy Saab Edward Wolfgang Lee Division of Inter-ventional Radiology Department of Radiology UCLA Medical Center David Geffen School of Medicine at UCLA Los Angeles Department of Radiology Korea University College of Medicine Department of Medicine Division of Hepatology Pfleger Liver Institute University of California at Los Angeles Los Angeles

Management of hepatocellular carcinoma(HCC) with portal vein thrombosis(PVT) is complex andrequires an understanding of multiple therapeutic options. PVT is present in 10%-40% of HCC at the time of diagnosis, and is an adverse prognostic factor. Management options are limited, as transplantation is generally contraindicated, and surgical resection is only rarely performed in select centers. Systemic medical therapy with sorafenib has been shown to modestly prolong survival. Transarterial chemoembolization has been performed in select cases but has shown a high incidence of complications. Emerging data on treatment of PVT with Y-90 radioembolization suggest that this modality is well-tolerated and associated with favorable overall survival. Current society guidelines do not yet specifically recommend radioembolization for patients with PVT, but this may change with the development of newer staging systems and treatment algorithms. In this comprehensive literature review, we present current and available management options with the relative advantages, disadvantages and contraindications of these treatment options with summarized data on overall survival.

关键词： Hepatocellular carcinoma Portal vein thrombosis Yt

Guidelines for diagnosis and treatment of hepatic fibrosis with integrated traditional Chinese and Western medicine(2019 edition)

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Integrative Medicine 2020年第3期18卷 203-213页

作者： Lie-ming Xu Ping Liu institute of liver Diseases Shanghai University of Traditional Chinese Medicine

In 2006, the Hepatology Committee of Chinese Association of Integrative Medicine issued the "Guidelines for the Prevention and Treatment of liver Fibrosis with Integrated Traditional Chinese and Western Medicine." In recent years, the fields of Chinese medicine, Western medicine, and integrative medicine have made rapid advances in basic and clinical research into chronic liver disease, and accumulated new evidence for the prevention and treatment of hepatic fibrosis. Therefore, in order to meet clinical needs, liver disease experts of integrated traditional Chinese and Western medicine were united to revise the previous guidelines in order to help physicians make correct and reasonable decisions in the diagnosis and treatment of hepatic fibrosis.

关键词： Hepatic fibrosis Integrated traditional Chinese and Western medicine Medicine,Chinese traditional Diagnosis Therapy Practice guideline

Ombitasvir/paritaprevir/ritonavir + dasabuvir +/-ribavirin in real world hepatitis C patients

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 2019年第18期25卷 2229-2239页

作者： Nicole Loo Eric Lawitz Naim Alkhouri Jennifer Wells Carmen Landaverde Angie Coste Rossalynn Salcido Michael Scott Fred Poordad Academic and Clinical Affairs Texas Liver Institute

BACKGROUND The hepatitis C virus(HCV) NS5A inhibitor ABT-267(ombitasvir, OBV), the HCV NS4/4A protease inhibitor ABT-450(paritaprevir, PTV), the CYP3A inhibitor ritonavir(r) and the non-nucleoside NS5B polymerase inhibitor ABT-333(dasabuvir, DSV)(OBV/PTV/r + DSV) with or without ribavirin(RBV) is a direct-acting antiviral regimen approved in the United States and other major countries for the treatment of HCV in genotype 1(GT1) infected patients. Patients with HCV who are considered "hard-to-cure" have generally been excluded from registration trials due to rigorous study inclusion criteria, presence of comorbidities and previous treatment *** To investigate the efficacy of this regimen in HCV G1-infected patients historically excluded from clinical *** Patients were ≥ 18 years old and chronically infected with HCV GT1(GT1a, GT1b or GT1a/1b). Patients were treatment-na?ve or previously failed a regimen including pegylated interferon/RBV +/-telaprevir, boceprevir, or *** hundred patients were treated with the study drug regimen, which was administered for 12 or 24 wk +/-RBV according to GT1 subtype and presence/absence of cirrhosis. Patients were evaluated every 4 wk from treatment day 1 and at 4 and 12 wk after *** Many of the patients studied had comorbidities(44.2% hypertensive, 33.7%obese, 20.2% cirrhotic) and 16% previously failed HCV treatment. Ninety-six patients completed study follow-up and 99% achieved 12-wk sustained virologic response. The majority(88.4%) of patients had undetectable HCV RNA by week 4. The most common adverse events were fatigue(12%), headache(10%),insomnia(9%) and diarrhea(8%); none led to treatment discontinuation. Physical and mental patient reported outcomes scores significantly improved after treatment. Almost all(98%) patients were treatment *** In an all-comers HCV GT1 population, 12 or 24-wk of OBV/PTV/r + DSV +/-RBV is highly effective and tolerable and results

关键词： Hepatitis C Ombitasvir Paritaprevir Ritonavir Dasabuvir Genotype 1