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1.
Säo Paulo med. j ; 140(2): 213-221, Jan.-Feb. 2022. tab
Article in English | LILACS | ID: biblio-1366050

ABSTRACT

Abstract BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) has become a public health problem worldwide. Neck circumference (NC) is a simple anthropometric adiposity parameter that has been correlated with cardiometabolic disorders like NAFLD. OBJECTIVES: To investigate the association between NC and NAFLD, considering their obesity-modifying effect, among participants from the Longitudinal Study of Adult Health (ELSA-Brasil) baseline study. DESIGN AND SETTINGS: Cross-sectional study at the ELSA-Brasil centers of six public research institutions. METHODS: This analysis was conducted on 5,187 women and 4,270 men of mean age 51.8 (± 9.2) years. Anthropometric indexes (NC, waist circumference [WC] and body mass index [BMI]), biochemical and clinical parameters (diabetes, hypertension and dyslipidemia) and hepatic ultrasound were measured. The association between NC and NAFLD was estimated using multinomial logistic regression, considering potential confounding effects (age, WC, diabetes, hypertension and dyslipidemia). Effect modification was investigated by including the interaction term NC x BMI in the final model. RESULTS: The frequency of NAFLD and mean value of NC were 33.6% and 33.9 (± 2.5) cm in women, and 45.8% and 39.4 (± 2.8) cm in men, respectively. Even after all adjustments, larger NC was associated with a greater chance of moderate/severe NAFLD (1.16; 95% confidence interval [CI] for women; 1.05, 95% CI for men; P < 0.001). Presence of multiplicative interaction between NC and BMI (P < 0.001) was also observed. CONCLUSION: NC was positively associated with NAFLD in both sexes, regardless of traditional adiposity indexes such as BMI and WC. The magnitude of the association was more pronounced among women.


Subject(s)
Humans , Male , Female , Adult , Non-alcoholic Fatty Liver Disease/epidemiology , Non-alcoholic Fatty Liver Disease/diagnostic imaging , Body Mass Index , Cross-Sectional Studies , Risk Factors , Longitudinal Studies , Waist Circumference , Middle Aged , Neck
2.
Journal of Clinical Hepatology ; (12): 471-476, 2022.
Article in Chinese | WPRIM | ID: wpr-920916

ABSTRACT

Hepatic ischemia-reperfusion injury (HIRI) is a very common complication of liver transplantation, liver resection, and shock. At present, many studies have been conducted on HIRI, but there is still a lack of drugs for radical treatment in clinical practice. Many factors, such as related cells, molecular mechanisms and signaling pathways, reactive oxygen species and oxidative stress response, nitric oxide, and mitochondria, mediate the development and progression of HIRI, which leads to the decline of patients' quality of life and even endangers their life safety. Based on the pathogenesis of HIRI and related articles, this article summarizes the research advances in the prevention and treatment of HIRI with traditional Chinese medicine components, so as to provide theoretical support for basic research and clinical research on HIRI.

3.
Journal of Clinical Hepatology ; (12): 392-396, 2022.
Article in Chinese | WPRIM | ID: wpr-920890

ABSTRACT

Objective To investigate the effect of the mitochondria-targeted antioxidant SS-31 on acute liver injury in a mouse model of sepsis. Methods A total of 24 adult male C57BL/6J mice were randomly divided into control group, control+SS-31 group, lipopolysaccharide (LPS) group, and LPS+SS-31 group, with 6 mice in each group. The mice were given intraperitoneal injection of LPS (10 mg/kg) to establish a model of sepsis and acute liver injury, followed by intraperitoneal injection of SS-31 (10 mg/kg) for treatment, and the mice in the control group were given intraperitoneal injection of an equal volume of PBS solution, followed by intraperitoneal injection of an equal volume of normal saline. After 12 hours, ELISA was used to measure the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), reactive oxygen species (ROS), superoxide dismutase (SOD), tumor necrosis factor-α (TNFα), interleukin-1β(IL-1β), and interleukin-6 (IL-6), and HE staining was used to observe liver histopathological changes. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups. Results Compared with the LPS group, the LPS+SS-31 group had significant reductions in the serum levels of ALT (140.05±12.22 U/L vs 102.64±8.75 U/L, P < 0.05) and AST (80.22±4.71 U/L vs 69.26±5.37 U/L, P < 0.05) and the levels of ROS (1 030.21±115.87 pg/mL vs 847.84±63.65 pg/mL, P < 0.05), TNFα (767.18±60.60 ng/mL vs 698.89±16.99 ng/mL, P < 0.05), IL-1β (29.97±1.37 ng/mL vs 26.70±3.09 ng/mL, P < 0.05), and IL-6 (59.13±7.09 pg/mL vs 49.29±3.41 pg/mL, P < 0.05) in liver tissue. Compared with the control group based on HE staining, the LPS group showed destruction of hepatic lobular structure, inflammatory cell infiltration, ambiguous intercellular space, and hepatocyte swelling, while the LPS+SS-31 group showed alleviation of inflammatory cell infiltration and hepatocyte swelling. Conclusion The mitochondria-targeted antioxidant SS-31 can reduce the production of ROS, downregulate the highly expressed inflammatory factors in sepsis, and alleviate sepsis-related acute liver injury in mice.

4.
Journal of Clinical Hepatology ; (12): 387-391, 2022.
Article in Chinese | WPRIM | ID: wpr-920889

ABSTRACT

Objective To establish the intelligent identification method for the big data of liver injury-related adverse drug reaction (ADR) based on the construction of text database. Methods With the keywords including "drug-induced liver injury" and "abnormal liver function" and a search time of January 1, 2012 to December 31, 2016, 5% (4152 cases) of the case reports of liver injury-related ADR were retrieved and extracted from the China Adverse Drug Reaction Monitoring System, and then based on clinical reevaluation by physicians, these cases were classified into "negative cases", "suspected cases", and "confirmed cases". On this basis, key elements (including ADR name, biochemical parameter, and clinical symptoms) were identified. An intelligent identification method for liver injury-related ADR was established based on the correlation analysis between key elements and clinical reevaluation and the receiver operating characteristic (ROC) curve for determining cut-off values, and the method of cross validation was used to evaluate the performance of this intelligent identification method. Results The formula for the evaluation and identification of liver injury-related ADR was as follows: total score (M)=symptom score+index score+ADR name score. This formula showed the best discriminatory ability to distinguish "negative case" from "suspected case" or "confirmed case" at M=5 (area under the ROC curve [AUC]=0.97), with a sensitivity of 99.57% and a specificity of 84.61%, and it showed the best discriminatory ability to distinguish "confirmed case" from "suspected case" or "negative case" at M=12 (AUC=0.938), with a sensitivity of 87.93% and a specificity of 85.98%. Conclusion This method provides reference and basis for intelligent identification and evaluation of big data on liver injury-related ADR and is expected to effectively reduce the burden of manual processing of ADR big data and provide effective tools and methodological demonstration for early risk signal identification and warning of liver injury-related ADR.

5.
Journal of Clinical Hepatology ; (12): 311-317, 2022.
Article in Chinese | WPRIM | ID: wpr-920874

ABSTRACT

The prognosis of severe liver disease combined with invasive fungal infection (IFI) is poor, and the clinical manifestations are often atypical. Moreover, most of the antifungal drugs are metabolized in the liver, with severe toxicities and side effects, making clinical diagnosis and treatment difficult. The Professional Committee for Hepatology, the Chinese Research Hospital Association and the Hepatology Branch of China Medical Association organized relevant experts to formulate an expert consensus based on the characteristics of patients with severe liver disease combined with IFI, in order to provide reference for medical personnel in making decisions on the diagnosis and treatment.

6.
Journal of Clinical Hepatology ; (12): 224-227, 2022.
Article in Chinese | WPRIM | ID: wpr-913148

ABSTRACT

As a member of the transient receptor potential ion channel family, transient receptor potential vanilloid 4 (TRPV4) is a non-selective cation channel and is widely distributed in a variety of tissues and organs. In recent years, more and more studies have shown that TRPV4 channel proteins are closely associated with liver diseases such as liver fibrosis, liver cancer, and polycystic liver disease. This article analyzes the articles on TRPV4 and liver disease and summarizes the exact signaling pathways and possible potential mechanism between TRPV4 and liver disease, so as to provide new ideas for clinical application and further studies.

7.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(2): 321-326, set 29, 2021. tab
Article in English | LILACS | ID: biblio-1354620

ABSTRACT

Introdution: Chronic liver diseases are characterized by inflammatory and fibrotic lesions of the liver that cause systemic complications. These complications can negatively interfere with the respiratory muscle strength and exercise capacity of developing children and adolescents. Objectives: to compare respiratory muscle strength and exercise capacity in children and adolescents with chronic hepatopathy, using predicted values from healthy individuals of the same age. Methodology: a cross-sectional study was performed. Children and adolescents from 6 to 16 years old with chronic hepatopathies were included. For the evaluation of respiratory muscle strength, the maximal respiratory pressures were measured through manovacuometry. A six-minute walk test was used to assess exercise capacity. The Wilcoxon test was used to verify the difference between the evaluated and predicted values of the distance traveled. Results: In total, 40 subjects were analyzed; 57.5% of the subjects were female, and the subjects had a mean age of 11.68±2.82 years. In the comparison between the measured and predicted maximal respiratory pressures, a median (IQR) difference of -21,47 (33-95) cmH2O (p< 0.001) was found for the maximal inspiratory pressure, and a mean difference of 30.68±17,16 cmH2O (p< 0.001) was found for the maximal expiratory pressure. Regarding exercise capacity, the measured average distance traveled was 346.46±49.21 m, which was 185.54±63,90 m (p< 0.001) less than the predicted value. Conclusion: Children and adolescents with chronic liver disease have reduced respiratory muscle function and exercise capacity.


Introdução: as doenças hepáticas crônicas são caracterizadas por lesões inflamatórias e fibróticas do fígado que causam complicações sistêmicas. Essas complicações podem interferir negativamente na força muscular respiratória e na capacidade de exercício de crianças e adolescentes em desenvolvimento. Objetivo: comparar a força muscular respiratória e a capacidade de exercício em crianças e adolescentes com hepatopatia crônica, utilizando valores preditos de indivíduos saudáveis da mesma idade. Metodologia: trata-se de um estudo transversal. Foram incluídas crianças e adolescentes de 6 a 16 anos com hepatopatias crônicas. Para a avaliação da força muscular respiratória, as pressões respiratórias máximas foram medidas por meio da manovacuometria. Teste de caminhada de seis minutos foi usado para avaliar a capacidade de exercício. O teste de Wilcoxon foi utilizado para verificar a diferença entre os valores avaliados e previstos da distância percorrida. Resultados: no total, 40 sujeitos foram analisados; 57,5% dos sujeitos eram do sexo feminino, idade média de 11,68±2,82 anos. Na comparação entre as pressões respiratórias máximas medidas e previstas, foi encontrada diferença mediana (IQ) de -21,47 (33-95) cmH2O (p<0,001) para a pressão inspiratória máxima e diferença média de 30,68±17,16 cmH2O (p<0,001) para a pressão expiratória máxima. Em relação à capacidade de exercício, a distância média percorrida foi 346,46±49,21 m, média 185,54±63,90 m (p<0,001) inferior ao valor previsto. Conclusão: crianças e adolescentes com doença hepática crônica apresentam redução da função muscular respiratória e da capacidade de exercício.


Subject(s)
Humans , Male , Female , Child , Adolescent , Chronic Disease , Walk Test , Maximal Respiratory Pressures , Liver Diseases , Cross-Sectional Studies , Statistics, Nonparametric
8.
Radiol. bras ; 54(3): 165-170, May-June 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1250652

ABSTRACT

Abstract Objective: To evaluate variables affecting the need for analgesia after ultrasound-guided percutaneous liver biopsy performed on an outpatient basis. Materials and Methods: This was a retrospective analysis of 1,042 liver biopsies performed between 2012 and 2018. The data collected included the age and sex of the patient, as well as self-reported pain in the recovery room, the pain treatment used, the indication for the biopsy, and the lobe punctured. As per the protocol of our institution, physicians would re-evaluate patients with mild pain (1-3 on a visual analog scale), prescribe analgesics for those with moderate pain (4-6 on the visual analog scale), and prescribe opioids for those with severe pain (7-10 on the visual analog scale). Results: The main indications for biopsy were related to diffuse disease (in 89.9%), including the follow-up of hepatitis C (in 47.0%) and suspicion of nonalcoholic steatohepatitis (in 38.0%). Pain requiring analgesia occurred in 8.0% of procedures. Of the 485 female patients, 51 (10.5%) needed analgesia, compared with 33 (5.9%) of the 557 male patients (p < 0.05). The need for analgesia did not differ in relation to patient age, the lobe punctured, or the indication for biopsy (nodular or diffuse disease). The analgesic most commonly used was dipyrone (in 75.9%), followed by paracetamol alone (16.4%) and their combination with opioids (7.6%). Conclusion: Ultrasound-guided percutaneous liver biopsy is safe and well tolerated. Postprocedural pain does not correlate with the lobe punctured, patient age, or the indication for biopsy and appears to affect more women than men.


Resumo Objetivo: Avaliar variáveis que afetam a necessidade de analgesia após biópsia hepática guiada por ultrassonografia. Materiais e Métodos: Análise retrospectiva de 1042 biópsias hepáticas realizadas entre 2012 e 2018. Os dados coletados incluíram dor detectada na sala de recuperação, analgesia utilizada, indicação, lobo puncionado, idade e sexo do paciente. O protocolo institucional indicava orientações e reavaliação para dor leve (1-3, segundo a escala visual analógica), analgésicos simples para dor moderada (4-6, segundo a escala visual analógica) e opioides para dor importante (7-10, segundo a escala visual analógica). Resultados: As indicações foram principalmente doença difusa (89,9%), particularmente no seguimento de hepatite C (47,0%) e suspeita de esteato-hepatite não alcoólica (38,0%). Dor com necessidade de analgesia ocorreu em 8,0% dos procedimentos. Mulheres demandaram analgesia em 10,5% das vezes e homens demandaram em 5,9% (p < 0,05). Não houve diferença estatisticamente significante na necessidade de analgesia em relação a idade, lobo hepático puncionado ou indicação por doença nodular versus difusa. O analgésico mais utilizado foi dipirona (75,9%), seguido de paracetamol (16,4%) e associação com opioides (7,6%). Conclusão: Este é um procedimento seguro e bem tolerado. Dor pós-procedimento não se correlaciona com lateralidade da biópsia, idade ou doença nodular versus difusa e parece afetar mais mulheres que homens.

9.
Article in Chinese | WPRIM | ID: wpr-908112

ABSTRACT

Objective:To explore the effect of alcohol abstinence intervention based on timing theory on patients with alcoholic liver disease.Methods:A total of 106 patients with alcoholic liver disease hospitalized in the Department of liver disease of Taian Medical District, 960th Hospital of Chinese PLA from July 2018 to June 2019 were selected by convenience sampling method and divided into observation group and control group by random digits table method, 53 cases in each group. The control group received routine nursing, and through the improvement of patients' cognition and support system, implemented short abstinence intervention during hospitalization; the observation group received abstinence intervention based on timing theory on the basis of the control group intervention. At 1 month and 6 months after discharge, the differences of rehydration rate, alcohol dependence and physical and mental status between the two groups were compared.Results:Finally, 49 cases in the control group completed the study, and 51 cases in the observation group completed the study. The rehydration rates of the observation group were 21.57%(11/51) and 15.69%(8/51) respectively at 1 month and 6 months after discharge, while those of the control group were 40.82%(20/49) and 36.73%(18/49) respectively at 1 month and 6 months after discharge. The difference was statistically significant ( χ2 values were 4.328, 5.754, P<0.05). The alcohol dependence scores were 0(2,3), 0(1,2) in the observation group and 2(0,3), 3(1,4) in the control group at 1 month and 6 months after discharge, and the difference was statistically significant ( Z values were -6.719, -7.345, P<0.01). There was no significant difference in the score of Symptom Checklist-90(SCL-90) before intervention and 1 month after discharge between the two groups ( P>0.05). Six months after discharge, the score of SCL-90 was 8.26 ± 1.37 in the observation group and 10.11 ± 1.68 in the control group, and the difference was statistically significant( t value was 6.046, P<0.01). Conclusions:The application of timing theory in alcohol abstinence of patients with alcoholic liver disease can significantly reduce the relapse rate and the degree of alcohol dependence of patients with alcoholic liver disease, improve the physical and mental state of patients.

10.
Journal of Clinical Hepatology ; (12): 2976-2980, 2021.
Article in Chinese | WPRIM | ID: wpr-906902

ABSTRACT

Pyroptosis is a pattern of cell death to eliminate endogenous and exogenous harmful stimuli. GSDMD and GSDME, members of the Gasdermin protein family, are the main executors of pyroptosis, and after being cut by activated caspases, they can induce pyroptosis by perforating the cell membrane, and causing the release of intracellular inflammatory factors such as IL-18 and IL-1β. Recent studies have found that pyroptosis is involved and plays a "double-edged sword" role in the development and progression of liver diseases. This article elaborates on the molecular mechanism of pyroptosis and the research advances in the role of pyroptosis in the development and progression of liver diseases, so as to provide new targets and ideas for the prevention and treatment of liver diseases.

11.
Journal of Clinical Hepatology ; (12): 2874-2877, 2021.
Article in Chinese | WPRIM | ID: wpr-906878

ABSTRACT

Objective To investigate the application value of transjugular liver biopsy (TJLB) in the diagnosis and treatment of complicated and severe liver diseases. Methods A retrospective analysis was performed for the clinical data of 31 patients who underwent TJLB in The Fifth Medical Center of Chinese PLA General Hospital, including indication for puncture, success rate, and final diagnosis. Results Among the 31 patients, there were 15 male patients and 16 female patients. Percutaneous liver biopsy was unsuitable for 8 patients with liver failure and disturbances of blood coagulation, 13 with liver cirrhosis and ascites, and 10 with liver cirrhosis and thrombocytopenia (< 50×10 9 /L), which were the indications for TJLB. The success rate of TJLB puncture was 100%, with 2-4 passes for puncture. No serious adverse event was observed. Of all 31 patients, 26 (83.87%) had a definite diagnosis at discharge, among whom there were 5 patients with idiopathic portal hypertension, 9 patients with drug-induced liver failure or liver cirrhosis, 5 patients with autoimmune liver disease, and 7 patients with liver cirrhosis or liver failure due to other causes, and 5 patients had unknown etiology. In addition, 3 patients underwent biopsy to confirm the diagnosis and decision of whether liver transplantation should be performed. Conclusion TJLB plays an important role in the diagnosis and treatment of complicated and severe liver diseases and still has certain limitations, and therefore, suitable patients should be selected in clinical practice.

12.
Article in Chinese | WPRIM | ID: wpr-905979

ABSTRACT

Pyroptosis, also known as cell inflammatory necrosis, is different from apoptosis, necrosis, and other forms of cell death in morphological characteristics, occurrence, and regulatory mechanism. It is a new type of programmed cell death dependent on Caspase, which has been discovered and confirmed in recent years. Studies have shown that pyroptosis is closely related to the occurrence of liver diseases, and is critical in alcoholic liver disease (ALD), non-alcoholic fatty liver disease (NAFLD), liver fibrosis, and liver cancer. Pyroptosis causes inflammatory injury of hepatocytes to promote the occurrence and development of liver diseases by activating Caspase-1, cleaving the effector gasdermin-D (GSDMD), and releasing pro-inflammatory cytokines, such as interleukin-18 (IL-18) and interleukin-1β (IL-1β) mainly through the classical NOD-like receptor protein 3 (NLRP3) inflammasome pathway. Clinically, Chinese medicine in the treatment of liver diseases has unique efficacy and low side effects. In the intervention on liver diseases, Chinese medicine blocks the pyroptosis signaling pathway to relieve the liver inflammation by inhibiting the assembly and activation of NLRP3 inflammasome multiprotein complex, blunting the activity of Caspase-1 or Caspase-4/Caspase-5/Caspase-11, and inhibiting the cleavage of GSDMD to reduce the release of pro-inflammatory cytokines such as IL-18 and IL-1β. Therefore, in-depth investigation of pyroptosis facilitates unveiling its role in the occurrence, development, and prognosis of liver diseases, and the enhancement or inhibition of pyroptosis may provide a new strategy for the prevention and treatment of liver diseases by Chinese medicine. At present, NLRP3 inflammasome, a key protein in the classic pyroptosis signaling pathway, has become an anti-liver disease target of Chinese medicine. This study briefly summarized the relationship between pyroptosis and liver diseases and reviewed the intervention of monomers, compound prescriptions, effective fractions and extracts of Chinese medicine in recent years to provide important guidance for further exploring the pathogenic mechanism of pyroptosis and the treatment of liver diseases with Chinese medicine.

13.
Journal of Clinical Hepatology ; (12): 2719-2722, 2021.
Article in Chinese | WPRIM | ID: wpr-905029

ABSTRACT

N 6 -methyladenosine (m6A) is a chemical modification that exists in a variety of RNAs and is most commonly observed in mRNA. The liver is a vital metabolic and digestive organ in human body, and m6A methylation plays an important role in the physiological and pathological processes of the liver. This article reviews the biological role and potential application value of m6A methylation in liver physiology and liver diseases such as viral hepatitis, nonalcoholic fatty liver disease, liver fibrosis, and hepatocellular carcinoma, and it is pointed out that m6A methylation can regulate related factors and is involved in the development and progression of liver diseases, which provides new ideas and targets for clinical diagnosis and treatment.

14.
Journal of Clinical Hepatology ; (12): 2488-2492, 2021.
Article in Chinese | WPRIM | ID: wpr-904977

ABSTRACT

Absent in melanoma 2 (AIM2) is a cytoplasmic double-stranded DNA (dsDNA) sensing protein that can recognize the dsDNA released during cell disturbance and pathogen invasion and trigger the activation of inflammasome cascade. Activation of inflammasomes leads to the maturation and release of inflammatory cytokines (interleukin-1β and interleukin-18), induces pyroptosis, and initiate innate immune response. Among these inflammasomes, AIM2 and its mechanism of action and clinical significance in liver diseases has become a research hotspot at present. This article summarizes and discusses the importance of AIM2 in the pathogenesis of various liver diseases including nonalcoholic fatty liver disease, hepatitis B virus infection, liver fibrosis, liver cirrhosis, and hepatocellular carcinoma, so as to provide new ideas and a reference for clinical treatment.

15.
Journal of Clinical Hepatology ; (12): 2478-2481, 2021.
Article in Chinese | WPRIM | ID: wpr-904975

ABSTRACT

With the increasing incidence rates of metabolic diseases such as obesity and type 2 diabetes, the incidence rate of nonalcoholic fatty liver disease (NAFLD) has also gradually increased year by year. NAFLD has complex underlying pathogeneses which have not yet been fully clarified. As the carrier of intercellular communication, exosomes play an important role in the development and progression of liver diseases. This article summarizes the mechanism of action of exosomes in the pathogenesis of NAFLD and their effect on lipid metabolism, insulin resistance, liver inflammation, and fibrosis, and it is pointed out that exosomes have great potential in the diagnosis and treatment of diseases, which will be the focus of future research.

16.
Journal of Clinical Hepatology ; (12): 2488-2492, 2021.
Article in Chinese | WPRIM | ID: wpr-904927

ABSTRACT

Absent in melanoma 2 (AIM2) is a cytoplasmic double-stranded DNA (dsDNA) sensing protein that can recognize the dsDNA released during cell disturbance and pathogen invasion and trigger the activation of inflammasome cascade. Activation of inflammasomes leads to the maturation and release of inflammatory cytokines (interleukin-1β and interleukin-18), induces pyroptosis, and initiate innate immune response. Among these inflammasomes, AIM2 and its mechanism of action and clinical significance in liver diseases has become a research hotspot at present. This article summarizes and discusses the importance of AIM2 in the pathogenesis of various liver diseases including nonalcoholic fatty liver disease, hepatitis B virus infection, liver fibrosis, liver cirrhosis, and hepatocellular carcinoma, so as to provide new ideas and a reference for clinical treatment.

17.
Journal of Clinical Hepatology ; (12): 2478-2481, 2021.
Article in Chinese | WPRIM | ID: wpr-904925

ABSTRACT

With the increasing incidence rates of metabolic diseases such as obesity and type 2 diabetes, the incidence rate of nonalcoholic fatty liver disease (NAFLD) has also gradually increased year by year. NAFLD has complex underlying pathogeneses which have not yet been fully clarified. As the carrier of intercellular communication, exosomes play an important role in the development and progression of liver diseases. This article summarizes the mechanism of action of exosomes in the pathogenesis of NAFLD and their effect on lipid metabolism, insulin resistance, liver inflammation, and fibrosis, and it is pointed out that exosomes have great potential in the diagnosis and treatment of diseases, which will be the focus of future research.

18.
Journal of Clinical Hepatology ; (12): 2167-2170, 2021.
Article in Chinese | WPRIM | ID: wpr-904861

ABSTRACT

Objective To investigate the influence of the concept of collaborative innovation on the construction of a scientific research system for regional liver pathology center from multiple perspectives, and to explore its application significance. Methods A total of 1246 liver biopsy specimens which were examined in Department of Pathology in Wuxi Second People's Hospital and Wuxi Fifth People's Hospital from January 2014 to September 2020 were collected, among which the specimens examined before the founding of the regional liver pathology center were collected as nI group, and those examined after the founding of the center were collected as nII group. According to the examination time of the first, second, or third year after founding, the nII group was further divided into nIIa group, nIIb group, and nIIc group. A multi-perspective analysis was performed based on five indices, i.e., number of liver biopsy specimens, growth rate of liver biopsy specimens, growth rate of internal collaborative departments, growth rate of external collaborative units, and evaluation of the collaborative and innovative scientific research system. Results The growth rate of liver biopsy specimens in the nI group was 15.51%; after the founding of the regional liver pathology center, the highest growth rate of 187.76% was observed in the nIIa group, and a relatively stable growth rate of 76.35% was observed in the nIIb group. There was a gradual increase in the number of specimens in internal collaborative departments, with a growth rate of 50% in the nIIa group and 83.33% in the nIIb group, while the number of external collaborative units increased steadily, with a growth rate of 100% in the nIIa group and 50% in the nIIb group. The nII group showed a diversified increasing trend in the evaluation indices of the scientific research system. Conclusion It is a new perspective for the construction of regional disciplinary scientific research system to grasp the opportunity of policy-supported development and innovate the effective cooperation mode between internal departments and external units under the concept of collaborative innovation.

19.
Article in Chinese | WPRIM | ID: wpr-910607

ABSTRACT

Liver disease is one of the main causes of human deaths in the world. Orthotopic liver transplantation is the most effective treatment for severe liver diseases, such as liver cirrhosis, hepatocellular carcinoma, etc. However, liver transplantation was limited because of donors shortage, and immunological. In recent years, stem cell therapy with the ability of multi-directional differentiation has potential application value in the treatment of patients with liver diseases. However, the mechanisms of stem cell therapy have not yet been fully understood. Stem cells can be detected under in vivo cell imaging. It can noninvasively trace the distribution, migration, proliferation and differentiation of stem cells, and it is an important link to study the mechanism of stem cells in the treatment of liver diseases. Therefore, this review briefly introduces the latest research progress of stem cell in vivo imaging techniques in the field of stem cell diagnosis and treatment of liver diseases.

20.
Journal of Clinical Hepatology ; (12): 1888-1893., 2021.
Article in Chinese | WPRIM | ID: wpr-886344

ABSTRACT

ObjectiveTo investigate the accuracy of three laparoscopic liver resection (LLR) difficulty score systems (DSSs) in evaluating surgical difficulty and predicting short-term postoperative outcome. MethodsThe retrospective cohort study was conducted for 142 patients who underwent LLR in The First Hospital of Lanzhou University from June 2015 to May 2020, and their preoperative, intraoperative, and postoperative clinical data were collected. According to preoperative clinical data, DSS-B score, Hasegawa score, and Halls score were used to determine the difficulty score of surgery for each patient, and then the patients were divided into low, medium, and high difficulty groups. Intraoperative data were compared between the three groups to verify the accuracy of the three DSSs, and postoperative clinical data were used to evaluate the ability of DSSs to predict short-term postoperative outcome. An analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple or two groups. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups, and the Bonferroni method was used for correction of P values between two groups. The receiver operating characteristic (ROC) curve was plotted and the area under the ROC curve (AUC) was calculated to evaluate the efficiency of each DSS in predicting postoperative complications. ResultsAmong the 142 patients, there were 37 patients in the low difficulty group, 56 in the medium difficulty group, and 49 in the high difficulty group based on DSS-B score; there were 70 patients in the low difficulty group, 47 in the medium difficulty group, and 25 in the high difficulty group based on Hasegawa score; there were 46 patients in the low difficulty group, 62 in the medium difficulty group, and 34 in the high difficulty group based on Halls score. For the low, medium, and high difficulty groups based on DSS-B score, Hasegawa score, or Halls score, time of operation, intraoperative blood loss, and rate of hepatic portal occlusion increased with the increase in difficulty score (all P<0.001); there was a significant difference in intraoperative blood transfusion rate between the medium and high difficulty groups based on DSS-B score (P<0.017), between the low and high difficulty groups based on Halls score (P<0.017), and between the low, medium, and high difficulty groups based on Hasegawa score (P<0.017). There was a significant difference in the rate of conversion to laparotomy between the medium and high difficulty groups based on DSS-B score (P<0.017), and Hasegawa score and Halls score identified the difference between the low and high difficulty groups (P<0.017). For the length of postoperative hospital stay, DSS-B score and Halls score only identified the difference between the low and high difficulty groups (P<0.05), while Hasegawa score identified the difference between the low difficulty group and the medium/high difficulty groups (P<0.05); for the incidence rate of postoperative complications, only Hasegawa score effectively identified the difference between the high difficulty group and the low/medium difficulty groups (P<0.017). DSS-B score, Halls score, and Hasegawa score had an AUC of 0.636 (95% confidence interval [CI]: 0.515-0.758), 0.557 (95% CI: 0.442-0.673), and 0.760 (95% CI: 0.654-0.866), respectively, in predicting postoperative complications, among which Hasegawa score had the highest predictive efficiency. ConclusionDSS-B score and Hasegawa score can better assess the difficulty of LLR, and Hasegawa score has an advantage in predicting short-term postoperative outcome.

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