ABSTRACT
Malnutrition is common in patients with end-stage liver disease (ESLD) and is an independent risk factor for survival, therefore it should be treated as the same important guideline as ascites and hepatic encephalopathy. However, up to now, there is no clinical nutrition guideline for patients with ESLD in China. In order to standardize the nutrition treatment, Chinese Society of Hepatology (CSH) and Chinese Society of Gastroenterology (CSGE), Chinese Medical Association(CMA) co-organized and co-developed this guideline. Recommendations on nutritional screening and assessment as well as principles of intervention and management in patients with ESLD were provided to help clinicians make rational decisions on clinical malnutrition.
Subject(s)
Humans , Ascites , China , End Stage Liver Disease , Enteral Nutrition , Reference Standards , Gastroenterology , Reference Standards , Hepatic Encephalopathy , Liver Cirrhosis , Malnutrition , Diet Therapy , Nutrition Assessment , Nutritional Status , Practice Guidelines as TopicABSTRACT
Hepatic fibrosis is a reparative response of diffuse over deposition and abnormal distribution of extracellular matrix (collagen, glycoprotein and proteoglycans) after exposure to various kinds of liver injuries, and is a key step in the developmental process of various chronic liver diseases to cirrhosis. Recently, many advances in our understanding of hepatic fibrosis have been recognized through the basic and clinical research. Therefore, we have organized the relevant domestic experts of this field to form consensus on the diagnosis and evaluation, treatment, and clinical development and application of therapy in order to better guide the diagnosis and treatment, and drug research and development.
Subject(s)
Humans , Consensus , Extracellular Matrix , Pathology , Liver , Pathology , Liver Cirrhosis , Diagnosis , TherapeuticsABSTRACT
Liver failure is a familiar clinical severe liver disease syndrome with a very high mortality rate. Over the years, scholars from around the world have been exploring the definition, etiology, classification, types, diagnosis and treatment, and prognostic judgment of liver failure. Reflecting changes, that have transpired in recent years at home and abroad relevant to clinical evidence, this guideline updates the information previously published by the Chinese Society of Infectious Diseases, Chinese Medical Association, Liver Failure and Artificial Liver Group, Severe Liver Diseases and Artificial Liver Group, Chinese Society of Hepatology, Guidelines for Diagnosis and Treatment of Liver Failure (2012 Edition).
Subject(s)
Humans , Gastroenterology , Liver Diseases , Liver Failure , Diagnosis , Therapeutics , Liver, Artificial , Practice Guidelines as Topic , PrognosisABSTRACT
Transient elastography is a noninvasive, rapid ultrasonic elastography, and assess liver fibrosis by detetcting liver stiffness. Current consensus focuses on understanding influence factors on operation and diagnosis, recommendations for clinical application on detetcting liver fibrosis of chronic liver disease and monitoring development of related complication hepatocelullar carcinoma, high risk esophageal varices, and also summarizes the potential aplication on liver disease screening and liver fibrosis regression assessment.
Subject(s)
Humans , Consensus , Elasticity Imaging Techniques , Esophageal and Gastric Varices , Liver , Liver CirrhosisABSTRACT
Current guideline developed by the Chinese Society of Hepatology on the management of hepatic encephalopathy in cirrhosis is grounded on the published evidences and panelists' consensus. This guideline presents recommendations for diagnosis and management of covert and overt hepatic encephalopathy, and underline the importance of screening minimal hepatic encephalopathy in patients with end-stage liver diseases. In addition, it also stresses that early identification and timely treatments are the means to know the prognosis. The principles of treatment are primary and secondary prevention, prompt removal of the cause, and recovery of acute neuropsychiatric abnormalities to baseline status.
Subject(s)
Humans , Consensus , Disease Management , Gastroenterology , Gastrointestinal Agents , Therapeutic Uses , Hepatic Encephalopathy , Drug Therapy , Liver Cirrhosis , Practice Guidelines as Topic , PrognosisABSTRACT
Approved direct-acting antiviral agents (DAA ) in chronic hepatitis C were introduced. Metabolism and pharmacokinetics data of DAAs were analyzed. Comorbidity and concomitant medications of chronic hepatitis C (CHC) patients were extracted from Chinese Health Insurance database. Drug-drug interactions (DDIs) were calculated by integrated above data and confirmed by using Liverpool DDI website. Based on those data, experts propose consensus on management of drug-drug interaction with direct-acting antiviral agents in chronic hepatitis C, including pre-treatment, on-treatment, and post-treatment.
ABSTRACT
The mother-to-child transmission(MTCT) of hepatitis B virus (HBV) is the dominant cause of chronic HBV infection. In order to achieve the goal of "zero" MTCT before pregnancy, during pregnancy, and after pregnancy; standardized management for hepatitis HBV infection in women of childbearing age should be regulated. The content of this consensus includes: screening and treatment of HBV in pregnant women and women of childbearing age, treatment of hepatitis B during pregnancy, preventive measures and evaluation of combined immunization of hepatitis B immunoglobulin and hepatitis B vaccine in newborns, anti-viral therapy for all pregnant women with a high HBV DNA level and post-partum period related management. In addition, 16 recommendations were formed for clinicians to standardize the clinical management of HBV infection in women of child-bearing age.