A Case of Surgical Repair for End-Stage Tricuspid Regurgitation with Severe Liver Dysfunction and Hepatic Encephalopathy / 日本心臓血管外科学会雑誌

We report the case of a patient with severe tricuspid regurgitation and severe liver dysfunction who was successfully treated by tricuspid valve repair with spiral suspension and perioperative management of high cardiac output. The patient was a 77-year-old woman who presented with chronic atrial fibrillation with bradycardia (heart rate approximately 50 bpm). She had been diagnosed with severe tricuspid valve and mitral valve regurgitation at the age of 74. As her heart failure and hepatic failure grew worse, and hepatic encephalopathy also occurred, she was admitted to the hospital. Her Child-Pugh score for liver disease was Grade C at the preoperative assessment, suggesting that she was in the high-risk category for open heart surgery. Therefore, further medical treatment was required before selecting the surgical treatment. After the implantation of a pacemaker (VVI mode, 80 bpm), the cardiac output increased with a cardiac index of 5.17 L/min/m2 compared with 2.97 L/min/m2 prior to pacemaker implantation. Furthermore, the symptoms of heart failure improved and total bilirubin decreased from 3.9 mg/dl to 1.7 mg/dl, and surgery was performed. Tricuspid regurgitation was treated with spiral suspension, and mitral regurgitation due to annular dilation was treated with annuloplasty. Following the surgery, the cardiac index was maintained from 4.3 L/min/m2 to 5.8 L/min/m2 with central venous pressure below 10 mmHg by the assistance of intra-aortic balloon pumping. The patient was extubated 30 h after surgery, and was discharged on postoperative day 54. At the time of discharge, total bilirubin was 1.5 mg/dl. At 1.5 post-operative years, the patient is New York Heart Association functional Class II and tricuspid valve regurgitation is mild.

Study various clinical manifestations and biochemical parameter for liver dysfunction in association with Plasmodium vivax malaria

Background: Malaria is a parasitic disease which is majorly caused by the bite of an infected Anopheles mosquito. It has been estimated that the most common type of malaria affecting the human race is known as Plasmodium vivax. Human malaria is a global burden with 3.4 billion people at risk over 91 endemic countries. According to the WHO, the involvement of liver dysfunction in Plasmodium vivax malaria is not an uncommon phenomenon. Aim of the research was to study various clinical manifestations and biochemical parameter for liver dysfunction in association with Plasmodium vivax malaria.Methods: It was an observational study carried out at Teerthanker Mahaveer Medical College and Research Centre, a tertiary care hospital situated in Moradabad for a period of 1 year (March 2017-Feb 2018). Total of 200 patients aged above 15 years, with either sex were part of it. All the patients having mixed malaria with dengue, pregnant women and the patients who did not give written consent for being a part of the study were excluded from the study. A detailed clinical examination was done, including all the hematological and biochemical examinations.Results: The results depicted that the number of male patients was 95, and the number of female patients was 105. The majority of the patients belonged to 15-30 years of age group. The major clinical features of the patients suffering from P. Vivax were fever and jaundice. The number of patients with serum bilirubin >3 mg/dl was 55.Conclusions: In light of the above results, it was evident that Plasmodium vivax has the capability of producing jaundice, hepatic dysfunction and anemia. The doctors must be very vigilant while treating the patients with Plasmodium vivax for any symptoms of jaundice as they are often misunderstood as hepatitis.

Retrospective analysis of voriconazole in the monitoring of therapeutic drugs in patients with liver dysfunction / 中国临床药理学与治疗学

AIM: To evaluate relationship between dosing schedules and safety of voriconazole by analyzing the monitoring results of voriconazole in patients with liver dysfunction, and to provide reference for the clinical individualized medication. METHODS: The blood concentration and safety information of voriconazole in patients with liver dysfunction was searched in PubMed, Cochrane Library, Wanfang, Weipu, and Chinese Journal Full-text Database from the establishment of the databases to December 2019, the dosing schedule and safety range of voriconazole for patients with liver dysfunction was analyzed. RESULTS: A total of 10 literatures were selected, 5 of which were multi-sample retrospective studies and 1 of which was prospective study, and the remaining 4 were case reports. In Child-Pugh grade C liver dysfunction, a maintenance dose of 100 mg q12h is more secure. The incidence of adverse reactions of voriconazole is generally within 7 days. When the target trough concentration is less than 5 mg/L or 5.3 mg/L, the incidence of adverse reactions is still high. The main adverse reactions include neurotoxicity, hallucinations, visual disturbances, gastrointestinal reactions and rash. CONCLUSION: The dose of voriconazole in patients with liver dysfunction should be reduced, and the drug concentration should be monitored in a timely manner. It is recommended that on the basis of ensuring the efficacy, trough concentration can be further reduced to reduce the occurrence of adverse reactions in patients with liver dysfunction.

Factors Affecting the Prognosis of Women with Liver Dysfunction in the Third Trimester of Pregnancy / 中山大学学报(医学科学版)

@#【Objective】To explore the effects of liver dysfunction in the third trimester of pregnancy on maternal outcomes and identify the factors affecting the maternal prognosis.【Methods】We collected the clinical data of 1 113 women with liver dysfunction in the third trimester of pregnancy （case group） and 1 113 normal pregnancies （control group） from the Third Affiliated Hospital of Sun Yat-sen University between January 2015 and December 2018. We compared the rates of cesarean section，premature delivery，placental abruption，postpartum hemorrhage and maternal mortality in the two groups，conducted the univariate and multivariate analysis for the case group and determined the prognostic risk factors by using Logistic regression. Receiver operating characteristic（ROC）curve analysis was applied to estimate the value of each independent risk factor for predicting liver dysfunction-related maternal mortality. 【Results】The rates of cesarean section，premature delivery，placental abruption，postpartum hemorrhage in the case group were higher than those in the control group（P < 0.05），and the odds ratios（ORs）were 3.59 ，7.81 ，10.68 and 2.93 ，respectively. The maternal mortality in the case group（1.2%）was higher than that in the control group（0.0%）（P < 0.05）. Logistic analysis revealed that high total bilirubin（TBIL），low prothrombin activity（PTA）and low fasting plasma glucose（FPG）were independent risk factors for liver dysfunction- related maternal mortality. The ROC curve analysis indicated that when TBIL was 235.4 μmol/L，the Youden′ s index in maximum was 0.331 with sensitivity of 0.818 and specificity of 0.513. When PTA was 20.5% ，the Youden′ s index in maximum was 0.366 with sensitivity of 0.821 and specificity of 0.545. When FPG was 3.11 mmol/L，the Youden′s index in maximum was 0.405 with sensitivity of 0.769 and specificity of 0.636.【Conclusion】Liver dysfunction in the third trimester of pregnancy has adverse effects on maternal outcomes. TBIL ，PTA and FPG are the factors affecting the maternal prognosis and may have certain predictive value for maternal death.

Analysis of Drug Use in a Patient with Brucellosis Combined with Liver Dysfunction by Clinical Pharmacists / 中国药房

OBJECTIVE：To provide reference for the selection of drug treatment plan in patients with Brucellosis combined with liver dysfunction. METHODS ：Clinical pharmacists analyzed drug treatment plan in a patient with Brucellosis combined with liver dysfunction in the First Affiliated Hospital of Medical College of Shihezi University. Referring to Brucella treatment guideline . Consensus statement by the American association of clini - HbA1c cal endocrinologists and American college of endocrinology on the comprehensive type 2 diabetes management al - and domestic and foreign clinical information ，the suggesti ons were put forward according to the change of liver dysfunction. RESULTS：The patient had chronic infection and moderate liver injury. The liver dysfunction in this patient was a common complication of Brucellosis. After consultation of doctors and pharmacists ，in consideration of the abnormal liver function ， intravenous drip of levofloxacin （0.5 g，qd）was given in the patient for anti-infection treatment. After the liver function was improved，levofloxacin was stopped ，and intravenous drip of rifampin （0.6 g，qd）and oral administration of doxycycline （100 mg，bid）were given for anti-infection treatment instead ；during the treatment period ，intravenous drip of reduced glutathione （1.8 g，qd）and diammonium glycyrrhizinate （150 mg，qd）were given for anti-inflammatory and liver protecting treatment. During the treatment，the clinical pharmacists closely monitored ADR of patients ，and carried out medication education for patients to improve the compliance. 10 d after medication ，although some of the liver function indexes of the patient did not return to normal ，but Brucellosis and liver dysfunction symptoms were improved. The patient could continue to take the same dose of rifampin and doxycycline after discharge. CONCLUSIONS ：When the patients with Brucellosis have abnormal liver function ，anti-infection treatment should be the main treatment target. The clinical pharmacists should refer to the relevant guidelines and combine with the clinical practice to help doctors adjust the treatment plan ，so as to ensure the safety and effectiveness of the patients ’medication.

The Effect of Raised Liver Enzyme in Pregnancy

Objective: The aim of this study is to detect the effect of raisedliver enzyme in pregnancy.Methods: A retrospective data analysis was performed on 100patients with abnormal liver dysfunction admitted in theobstetric unit of hospital were studied prospectively and whowere willing to participate and provide required information atAkij Ad-Din Medical College and Hospital, Khulna during theperiod 2017 to 2019.Results: 72.5% were un-booked, of low parity and belonged tolower socio-economic status; 87.5 % of pregnant womenpresented in third trimester of pregnancy. The most commonpresenting complaint was oedema (25%) followed by yellowdiscoloration of urine and visual symptoms with headache.16.75% women had liver disorder which were not specific topregnancy and consisted of infective hepatitis, malaria andsickle cell disease, whereas 83.25 % women had pregnancyspecific liver dysfunction. 37% patients had abortion followedby 15% had hepatic abscess, 14% had acute renal failure.Conclusion: From our study we can conclude that, Abnormalliver functioning enzyme is greatly affected in women duringpregnancy. If a systematic approach is adopted, the cause isoften apparent. Early and timely join care by the obstetric andmedical team can bring the best results in this so far grimsituation in the developing world.

Evaluation of hepatocellular dysfunction and its association with severity in dengue patients

Background: Dengue is a mosquito-borne infection that in recent years has become an important disease of international public health concern. Dengue virus infections and illness when symptomatic, that patients tend to present with a significantly wide variety manifestations. The aim of the study was to evaluate liver dysfunction in patients with dengue infections.Methods: The present study was undertaken as an observational cross-sectional study the period June 2017 to December 2018. The details of all patients with serologically proved dengue fever admitted in the hospital were reviewed. Data including routine blood count, liver function test (LFT), prothrombin time (PT), activated partial prothrombin time (APTT), abdominal ultrasonography was studied. Statistical analysis: Data was analyzed using SPSS version 21.0. Difference between proportions was tested by using chi square test. Pearson correlation coefficient was used to measure linear correlation between two continuous variables. A p value <0.05 was consideredstatistically significant.Results: Majority of the study participants were in the age group of 16-30 years (57.5%) and were males (64.5%). Fever, Headache and joint pain were the most common symptoms noted among the study participants. Majority of the study participants were found to have elevated levels of SGOT (75.3%), SGPT (64.2%) levels and lower levels ofserum albumin (68.6%) on evaluation. Statistically significant association was observed between elevated liver enzymes and presence of features of dengue haemorrhagic fever.Conclusions: Considerably high proportion of patients with dengue infection were found to have hepatic dysfunction in the form of deranged liver enzymes.

Liver function tests to predict the severity of dengue fever in serologically positive children below 18 years of age

Background: Dengue fever presents with a diverse clinical spectrum. Although liver is not a major target organ, hepatic dysfunction is a well-recognized feature. In this study authors attempted to study the pattern of hepatic involvement in children with dengue and its association with disease severity.Methods: This was a cross sectional study conducted at Cheluvamba hospital during the period of 1 year. Children <18 years of age with dengue Ns1 Ag and IgM positive were included in this study. After obtaining informed consent, a pre-structured proforma was used to record the relevant information from each subject. After detailed clinical examination and haematological investigation children were categorized into three groups as dengue fever with no warning signs (DNWS), dengue fever with warning signs (DWWS) and severe dengue fever (SDF) according to WHO classification. Statistical analysis was done to know the strength of association between different clinical and biochemical variables and outcome of the disease.Results: The mean age of the study population was 8.65 years with male preponderance. The mean total bilirubin, serum albumin, SGOT, SGPT, ALP, PT and INR were 0.76 mg/dl, 3.8g/dl, 233.18U/L, 118.15U/L, 200.65 U/L, 12.9s and 1.09 respectively. The mean SGOT was significantly higher than SGPT. The degree of deranged LFTs was significantly more in SDF group than DNWS and DWWS groups. Serum albumin was significantly decreased in children with SDF group correlating with disease severity, prognosis and outcome.Conclusions: Hepatic dysfunction was present in all forms of dengue infection, with SGOT rising significantly more than SGPT. All biochemical liver parameters were significantly deranged in patients with severe dengue fever indicating prolonged illness and poor prognosis.

In-vitro Plasma Protein Binding of Marbofloxacin in Healthy and Disease Condition of Buffalo Calves

Marbofloxacin is a broad-spectrum fluoroquinolone antibiotic developed for use in veterinary medicine for the treatment of skin and soft tissue infections in dogs and cats. Plasma protein binding plays a vital role in distribution, elimination and therapeutic effectiveness of drugs. In the present study we evaluated the plasma protein binding of marbofloxacin in healthy and liver dysfunctioned buffalo calves. In vitro binding of marbofloxacin to plasma proteins was determined by employing the equilibrium dialysis technique and further analyzed by High Performance Liquid Chromatography assay. The plasma protein binding for healthy calves ranges between 25.3±0.34% to 30.4±0.40% with an overall binding of 28.66 ± 0.421%. Kinetic constants (βi) and (Kβ) was 2.6±0.12×10-8 mole/g and 1.9±0.08×10-7 mole, respectively. The percentage of plasma protein binding for liver dysfunctioned buffalo calves extended from 24.5 - 30.3% with an overall mean of 28.59 ± 0.693%. The binding capacity of the drug to plasma proteins (βi) and dissociation rate constant of protein drug complex (Kβ) were 2.53±0.13 10-5 mole/g and 1.94±0.09×10-6 mole respectively. There was no significant change observed in plasma protein binding and the kinetic constant of liver dysfunctioned buffalo calves when compared to the healthy group

Safety and efficacy of citrate anticoagulation for septic patients with liver patients / 中国实用护理杂志

Objective@#To evaluate the efficacy and safety of citrate anticoagulation for continuous renal placement therapy (CRRT) in septic patients with liver dysfunction.@*Methods@#The data of septic patients who needed to CRRT and were admitted into the department of critical care medicine from January 2016 to December 2017 were enrolled in this study. Liver dysfunction was defined as Child-Turotte-Pugh (CTP) score >4. A total of fifty-six patients met the criteria. According to the patient′s actual condition, they were divided into citrate groups (29 cases) and low molecular weight heparin (LMWH) group (29 cases). Patients in LMWH group were given slow molecular weight heparin. The efficacy and safety were compared between the two groups. The filter lifetime, after treatment the activated partial thromboplastin time (APTT),hemoglobin (Hb) were compared between the two groups.@*Results@#The average filter lifetime in citrate group was (25.0±12.2) h which was longer than (13.7±4.5) h in LMWH group (t=13.17, P<0.01). The average service life of each filter was (4.2±1.9) h which was lower than (8.7±3.6) in LMWH group (t=8.395, P<0.05).@*Conclusions@#Regional Citrate anticoagulation is a safe and effective option for CRRT in septic patients with liver dysfunction, without causing electrolyte disturbance and internal environment.

Diagnosis of fever complicated with liver dysfunction / 中国实用内科杂志

A variety of causative factors can lead to diseases of liver and bile duct. The common clinical manifestations include fatigue,poor appetite, jaundice and dull pain and discomfort in liver region. Fever with liver dysfunction often indicates infectious liver diseases or inflammation of biliary duct. The diagnosis of fever with liver dysfunction can be made based on the past history, epidemiological data, clinical manifestations, laboratory examinations and imaging information. This review will make a description of the clinical characteristics of related diseases, and summarize the differential information of these diseases to help physicians to make a quick and precise diagnosis.

Liver dysfunction in malaria – An observational study

Introduction: Malaria is associated with significant mortality and morbidity in India. Hepatic dysfunction in malaria is often under-diagnosed. Early identification of hepatic dysfunction is crucial for preventing complications. Materials and methods: A prospective observational study was conducted in NRI Medical College and General Hospital, Chinakakani, Guntur District in Andhra Pradesh. A total of 50 patients with malaria were studied. Liver function tests were performed to assess the type of jaundice. The collected data was analysed. Results: The incidence was P. Vivax and P. falciparum malaria were 64% and 34% respectively. The incidence of jaundice was 26%. All of them had predominantly conjugated hyperbilirubinemia. Around 14% had mixed jaundice, and 22% had hepatic jaundice. Only one case expired which had the highest level of serum bilirubin. Conclusion: Hepatic involvement is more common among those with malaria. The incidence in vivax and falciparum malaria is comparable. Conjugated bilirubinemia with elevated liver enzymes is the most common manifestation. Early screening and identification of hepatic involvement in malaria are crucial. Initiation of treatment on time will aid in reducing mortality and morbidity

Association of valproic acid and 2-propyl-4-pentenoic acid concentrations with adverse reaction in 254 Chinese patients with epilepsy / 中南大学学报(医学版)

Objective:To investigate the correlation of the concentrations of valproic acid (VPA) and 2-propyl-4-pentenoic acid (4-ene-VPA) with their adverse reactions,and to guide the clinical safety and rational use of VPA.Methods:We collected 254 epilepsy outpatients who took long-term use of sodium valproate oral solution single or combined with other antiepileptic drugs from Xiangya Hospital.The plasma concentrations of VPA and 4-ene-VPA in patients were determined by gas chromatography-mass spectrometry (GC-MS).The double variable correlation analysis was performed to analyze the effect of plasma 4-ene-VPA and VPA concentrations on adverse reactions.Results:The correlations between the PLT level and the dosage ofVPA (P＜0.01 and P＜0.05,respectively),and the RBC level and the concentration of VPA (All P＜0.01) were significant negatively.The concentrations of 4-ene-VPA,VPA,ALT,and AST in the polytherapy group were much higher than those in the monotherapy group (All P＜0.05).In the monotherapy group,the ALT and AST levels in patients younger than or equal to 2 years old were significantly higher than those over 2 years old (P＜0.001).In the polytherapy group,the levels of AST,WBC,and PLT in patients younger than or equal to 2 years old were higher than those over 2 years old (P＜0.05).The levels of AST did not show positive correlation with the concentrations of 4-ene-VPA and VPA (r=0.031,r=0.035,all P＞0.05),and the levels of ALT also did not show positive correlation with the concentrations of 4-ene-VPA and VPA (r=-0.064,r=-0.089,all P＞0.05).Conclusion:VPA may affect blood routine indexes.Age and combination therapy with the non-enzyme-induced anti-epileptic drugs are risk factors for VPA-related liver dysfunctions and renal impairment.The determination of VPA and 4-ene VPA is not a suitable tool for early warning of the VPA-induced liver dysfunction.

Aerobic training and L-arginine supplement attenuates myocardial infarction-induced kidney and liver injury in rats via reduced oxidative stress

Introduction The aim of the present study was to determine the effect of exercise training and l-arginine supplementation on kidney and liver injury in rats with myocardial infarction (MI). Material and methods Four weeks after MI, 50 male wistar rats randomly divided into five followed groups: sham surgery without MI (Sham, n = 10), Sedentary-MI (Sed-MI, n = 10) 3: L-Arginine-MI (La-MI, n = 10) 4: Exercise training-MI (Ex-MI, n = 10) and 5: Exercise and L-arginine-MI (Ex + La-MI). Ex-MI and Ex + La-MI groups running on a treadmill for 10 weeks with moderate intensity. Rats in the L-arginine-treated groups drank water containing 4% L-arginine. Tissues oxidative stress and kidney and liver functional indices were measured after treatments. Result Urea as a kidney function indexes, increased in Sed-MI group in compared to sham group and decreased significantly in Ex-MI and Ex + La-MI groups. The level of catalase (CAT) and glutathione stimulating hormone (GSH) of kidney were significantly lower in the MI-groups compared with the Sham group and kidney Malondialdehyde (MDA) levels increased after MI and significantly decreased in response to aerobic training and L-arginine. As well as, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) as liver injury indices, increased in MI-groups and decreased by training and L-arginine. In this regards, liver MDA and CAT respectively increased and decreased in MI-groups, but aerobic training and L-arginine increased liver glutathione per-oxidase (GPx) and decreased liver MDA. Conclusion These results demonstrated that kidney and liver function impaired 14 weeks after MI and aerobic training and L-arginine supplementation synergistically ameliorated kidneys and liver injury in myocardial infarction rats through oxidative stress reduction.

Analysis of liver function, serum lipid and blood routine in patients with differentiated thyroid cancer before radioactive iodine treatment / 上海交通大学学报（医学版）

Objective·To investigate the effect of temporary hypothyroidism state to liver function, serum lipid and blood routine in patients with differentiated thyroid cancer (DTC) prepared for radioactive iodine treatment. Methods?·?A total of 182 patients with DTC undergoing radical operation of thyroid cancer and radioactive iodine treatment were collected. All these patients were divided into 3 groups by age: 26 in young group (<30 years), 112 in middle-aged group (30-54 years) and 44 in elderly group (?≥?55 years). Indicators of liver function, blood lipids and blood routine were compared before and after operation, among groups as well. Results?·?Patients under hypothyroidism state had significantly elevations in ALT, AST, LDH and serum bile acid, but a notable decrease of serum bilirubin (all P<0.05). Meanwhile they had remarkable elevations in triglyceride, cholesterol, LDL and HDL (all P<0.05). In the young group before thyroid hypothyroidism treatment, the elevation of ALT, AST, LDH and serum bile acid were more significant than those of the middle-aged and elderly patients (all P<0.05). Conclusion?·?The temporary hypothyroidism state of differentiated thyroid cancer patients could elevate liver enzymes as well as dyslipidemia.

Analysis of liver function, serum lipid and blood routine in patients with differentiated thyroid cancer before radioactive iodine treatment / 上海交通大学学报（医学版）

Objective • To investigate the effect of temporary hypothyroidism state to liver function, serum lipid and blood routine in patients with differentiated thyroid cancer (DTC) prepared for radioactive iodine treatment. Methods • A total of 182 patients with DTC undergoing radical operation of thyroid cancer and radioactive iodine treatment were collected. All these patients were divided into 3 groups by age: 26 in young group (<30 years), 112 in middle-aged group (30-54 years) and 44 in elderly group (≥ 55 years). Indicators of liver function, blood lipids and blood routine were compared before and after operation, among groups as well. Results • Patients under hypothyroidism state had significantly elevations in ALT, AST, LDH and serum bile acid, but a notable decrease of serum bilirubin (all P<0.05). Meanwhile they had remarkable elevations in triglyceride, cholesterol, LDL and HDL (all P<0.05). In the young group before thyroid hypothyroidism treatment, the elevation of ALT, AST, LDH and serum bile acid were more significant than those of the middle-aged and elderly patients (all P<0.05). Conclusion • The temporary hypothyroidism state of differentiated thyroid cancer patients could elevate liver enzymes as well as dyslipidemia.

Liver Disease: Current Perspectives On Dental Management

Liver dysfunction may be attributed to a number of causes, including lifestyle habits and other acquired infections and conditions. The patient with liver disease presents a significant management challenges for the dentist because the liver plays a vital role in metabolic functions. The purpose of this article was to review various risk factors, and the management of complications that occur in liver diseased patients while undergoing dental treatment.

Median-long term clinical analysis 96 kidney transplant from hepatitis B surface antigen positive donors to hepatitis B antigen positive recipients / 中华器官移植杂志

Objective To investigate the safety and efficacy of hepatitis B surface antigen (HBsAg) positivity of the donors on graft survival and liver complications in HBsAg (+) renal transplant recipients.Methods We retrospectively evaluated 96 HBsAg (+) patients who received HBsAg(+) donor kidney transplant fellow-up during 20～ 139 months,in order to observe the renal allograft dysfunction,liver dysfunction and others complications.Results All 96 patients underwent renal transplantation successfully in our hospital.during the follow-up period,18 cases accepted entecavir-treated,one case lost graft function,two cases died,one of them developed drug resistance and liver function failure,the other because of cancer of the liver.Twenty-three of the 78 lamivudinetreated patients (29.5％) developed drug resistance in 7～96 months,and 3 cases developed liver function failure,2 cases died and one cured,15 of the 19 cases who been salvage treated with entecavir was successful and well tolerated after 1 year,2 cases who been salvage treated with adefovir and lamivudine with HBV DNA-negative after 12 months and 23 months.The 5-year patient/graft rates of patients who been treated with lamivudine and entecavir were 88.5％/84.6％ and 88.9％/83.3％ respectively.Conclusion It is safe and feasible for renal transplantation from HBsAg(+) donors to HBsAg(+) recipients with antiviral treatment,patients would require lifelong anti-viral suppression and strictly follow-up,which is important for patient and graft survival,anti-viral drugs resistance and the liver complications should be closely monitored and treated.

Value of postoperative indocyanine green retention rate at 15 minutes combined with standard remnant liver volume in predicting liver dysfunction after hepatectomy / 中南大学学报(医学版)

Objective:To investigate the value of indocyanine green retention rate at 15 minutes (ICG R15) on postoperative day 3 combined with standard remnant liver volume (SRLV) in predicting the occurrence of liver dysfunction after hepatectomyin hepatocellular carcinoma (HCC).Methods:The clinical data of 61 HCC patients undergone hepatectomy in Xiangya Hospital of Central South University from January 2015 to February 2016 were collected and analyzed.The patients were divided into 2 groups:a normal liver function group (n=40) and a liver dysfunction group (n=21).Univariate analysis was used to evaluate the risk factors for postoperative liver dysfunction.Logistic regression was used to assess the independent risk factors for postoperative liver dysfunction,and the regression equation between independent risk factors and postoperative liver dysfunction was established,The receiver operating characteristic (ROC) curve was used to examine the regression equation and compare the value difference in predicting postoperative liver dysfunction between single and combined independent risk factors.Results:Postoperative liver dysfunction occurred in 21 of the 61 patients,with an incidence rate at 34.4％.There was no significant difference in the time of operation,time of hepatic portal occlusion,volume of tumor and volume of resected liver between the 2 groups (all P＞0.05),but there were significant differences in the ICG R15 on postoperative day 3,intraoperative blood loss and SRLV between the 2 groups (all P＜0.05).The ICG R15 on postoperative day 3,intraoperative blood loss,SRLV were the risk factors for postoperative liver dysfunction.Logistic regression analysis showed ICG R15 on postoperative day 3 and SRLV were the independent risk factors for postoperative liver dysfunction,and the regression equation between independent risk factors and postoperative liver dysfunction was as follows:logit(P)=1.277+0.140×ICG R15 on postoperative day 3-5.125×SRLV.The area under the ROC curve ofICG R15 on postoperative day 3 combined with SRLV was more than that of single ICG R15 and single SRLV.Conclusion:ICG R15 on postoperative day 3 and SRLV are the independent risk factors for postoperative liver dysfunction.The regression equation,which is established by combination of ICG R15 with SRLV,can predict the occurrence of postoperative liver dysfunction.The accuracy of ICG R15 on postoperative day 3 combined with SRLV is better than that of single ICG R15 or single SRLV.

Clinical analysis of the relationship between liver function damage and hepatitis B virus infection in patients with breast cancer after chemotherapy / 中国生化药物杂志

Objective To investigate the interrelated liver damage and hepatitis B virus infection among breast cancer patients after chemotherapy, to provide guidance for future breast reduction combined hepatitis B virus infection after chemotherapy liver damage.Methods120 cases of breast cancer patients undergoing chemotherapy combined hepatitis B carries from June 2012 to November 2016 in ningbo women and children's hospital were selected as the research object, depending on whether the infection with the hepatitis B virus into the study group and the control group, the study group HBV-DNA, HBsAg are positive, totaling 62 cases;control group, HBV-DNA, HBsAg were negative, totaling 58 cases;compare two groups of patients after chemotherapy in cases of liver damage.ResultsThe study group after chemotherapy, the incidence of liver dysfunction 48.28% in the control group after chemotherapy, the incidence of liver dysfunction 6.45 percent, the study group after chemotherapy, the incidence of liver dysfunction was significantly lower than the control group, the difference was statistically significant (P<0.05).Study group Ⅰ liver damage degree, degree Ⅱ, degree Ⅲ, degree Ⅳ of apparent higher, the difference was statistically significant (P<0.05), antiviral therapy 20 cases, no antiviral treatment in 42 cases.Antiviral therapy HBV reactivation rate and incidence of liver dysfunction were 5.0%, 20.0%;no antiretroviral therapy in HBV reactivation rate and the incidence of liver dysfunction 31.0%, 52.4% respectively;HBV antiviral therapy re-activation rate and the occurrence of liver dysfunction were significantly lower than not antiviral therapy, and the data were statistically significant (P<0.05).ConclusionThe clinical having close links between liver damage and breast cancer combined hepatitis B virus infection with hepatitis B virus are more likely to occur after infection liver dysfunction chemotherapy, and breast cancer patients after chemotherapy.