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| 1 | Microbiota and the gut-liver axis:Bacterial translocation,inflammation and infection in cirrhosis显示文摘Liver disease is associated with qualitative and quantitative changes in the intestinal microbiota.In cirrhotic patients the alteration in gut microbiota is characterized by an overgrowth of potentially pathogenic bacteria(i.e.,gram negative species)and a decrease in autochthonous familiae.Here we summarize the available literature on the risk of gut dysbiosis in liver cirrhosis and its clinical consequences.We therefore described the features of the complex interaction between gut microbiota and cirrhotic host,the so called'gut-liver axis',with a particular attention to the acquired risk of bacterial translocation,systemic inflammation and the relationship with systemic infections in the cirrhotic patient.Such knowledge might help to develop novel and innovative strategies for the prevention and therapy of gut dysbiosis and its complication in liver cirrhosis. | Valerio Giannelli Vincenza Di Gregorio Valerio Iebba Michela Giusto Serena Schippa Manuela Merli Ulrich Thalheimer | 2014 | World Journal of Gastroenterology2014，20，45： | 43 |
| 2 | Gut microbiota-related complications in cirrhosis显示文摘Gut microbiota plays an important role in cirrhosis. The liver is constantly challenged with commensal bacteria and their products arriving through the portal vein in the so-called gut-liver axis. Bacterial translocation from the intestinal lumen through the intestinal wall and to mesenteric lymph nodes is facilitated by intestinal bacterial overgrowth, impairment in the permeability of the intestinal mucosal barrier, and deficiencies in local host immune defences. Deranged clearance of endogenous bacteria from portal and systemic circulation turns the gut into the major source of bacterialrelated complications. Liver function may therefore be affected by alterations in the composition of the intestinal microbiota and a role for commensal flora has been evidenced in the pathogenesis of several complications arising in end-stage liver disease such as hepatic encephalopathy, splanchnic arterial vasodilatation and spontaneous bacterial peritonitis. The use of antibioticsis the main therapeutic pipeline in the management of these bacteria-related complications.However,other strategies aimed at preserving intestinal homeostasis through the use of pre-,pro-or symbiotic formulations are being studied in the last years.In this review,the role of intestinal microbiota in the development of the most frequent complications arising in cirrhosis and the different clinical and experimental studies conducted to prevent or improve these complications by modifying the gut microbiota composition are summarized. | Isabel Gómez-Hurtado José Such Yolanda Sanz Rubén Francés | 2014 | World Journal of Gastroenterology2014，20，42： | 12 |
| 3 | Nutritional care in hospitalized patients with chronic liver disease显示文摘AIM: To evaluate the practice of nutritional assessment and management of hospitalised patients with cirrhosis and the impact of malnutrition on their clinical outcome.METHODS: This was a retrospective cohort study on patients with liver cirrhosis consecutively admitted to the Department of Gastroenterology and Hepatology at the Royal Adelaide Hospital over 24 mo. Details were gathered related to the patients' demographics, disease severity, nutritional status and assessment, biochemistry and clinical outcomes. Nutritional status was assessed by a dietician and determined by subjective global assessment. Estimated energy and protein requirements were calculated by Simple Ratio Method. Intake was estimated from dietary history and/or food charts, and represented as a percentage of estimated daily requirements. Median duration of follow up was 14.9(0-41.4) mo. RESULTS: Of the 231 cirrhotic patients(167 male, age: 56.3 ± 0.9 years, 9% Child-Pugh A, 42% ChildPugh B and 49% Child-Pugh C), 131(57%) had formal nutritional assessment during their admission and 74(56%) were judged to have malnutrition. In-hospitalcaloric(15.6 ± 1.2 kcal/kg vs 23.7 ± 2.3 kcal/kg, P = 0.0003) and protein intake(0.65 ± 0.06 g/kg vs 1.01 ± 0.07 g/kg, P = 0.0003) was significantly reduced in patients with malnutrition. Of the malnourished cohort, 12(16%) received enteral nutrition during hospitalisation and only 6(8%) received ongoing dietetic review and assessment following discharge from hospital. The overall mortality was 51%, and was higher in patients with malnutrition compared to those without(HR = 5.29, 95%CI: 2.31-12.1; P < 0.001). CONCLUSION: Malnutrition is common in hospitalised patients with cirrhosis and is associated with higher mortality. Formal nutritional assessment, however, is inadequate. This highlights the need for meticulous nutritional evaluation and management in these patients. | Dep K Huynh Shane P Selvanderan Hugh AJ Harley Richard H Holloway Nam Q Nguyen | 2015 | World Journal of Gastroenterology2015，21，45： | 6 |
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