维普中文期刊产品整合服务
980篇 您的检索式:关键字=CHRONIC
    题名 作者 年代 出处 被引量
1Animal experiment and clinical study of effect of gamma-interferon on hepatic fibrosis显示文摘AIM To evaluate the antifibrotic effect ofdifferent doses of recombinant human Gamma-Interferon (IFN-γ) intwo rat models of hepaticfibrosis, and to observe its effect on moderatechronic hepatitis B virus fibrosis.METNODS Hepatic fibrosis was successfullyinduced in 150 and 196 rats by subcutaneousinjection of carbon tetrachloride (CCl4) andintraperitoneal injection of dimethylnitrosamine(DMN), respectively. Each of the two modeldose IFN-γ group (15 MU/kg per day, i.m. for 8group (1.67 MU/kg daily, i.m. for 8 weeks).Another group of 10 rats without any treatmentwas used as normal controls. At the end of theexperiment, semi-quantitative histopathologicalscores of inflammation and fibrosis, liver (αsmooth muscle actin (α-SMA) expression level,liver hydroxyl proline content and serumhyaluronic acid levels were compared. And 47medium chronic hepatitis B viral fibrosispatients were studied. They were given IFN-γtreatment, 100MU/day i.m. for the first threemonths and 100MU qod i.m. for the next sixmonths. Semi-quantitative pathological scoresof inflammation and fibrosis and serum hepaticfibrosis indices were compared within the 9months.RESULTS In animal experiment, thepathological fibrosis scores and liver hydroxylproline content were found to be significantlylower in rats treated with different doses of IFN-γ as compared with rats in fibrotic model groupinduced by either CCI4 or DMN, in a dose-dependent manner. For CCI4-induced model,pathological fibrosis scores in high, medium andIow doses IFN-γ groups were 5.10 ± 2.88, 7.70 ±3.53 and 8.00 ± 3.30, respectively, but the scorewas 14.60 ± 7.82 in fibrotic model group.Hydroxyl proline contents were 2.83 ± 1.18, 3.59± 1.22 and 4.80 ± 1.62, in the three IFN-γgroups, and 10.01 ± 3.23 in fibrotic model group.The difference was statistically significant(P<0.01). Similar results were found in DMN-induced model. Pathological fibrosis scoreswere 6.30±0.48, 8.10 ±2.72 and 8.30 ±2.58, inhigh, medium and Iow doses IFN-γ groups, and12.60 ± 3.57 in fibrotic model group. Hydroxylproline contents were 2.72 ± 0.58, 3.14 ± 0.71and 3.62 ± 1.02, in the three IFN-γ groups, and12.79 ± 1.54 in fibrotic model group. Thedifference was statistically significant(P<0.01). Serum hepatic fibrosis indicesdecreased significantly in the 47 patients afterIFN-γ treatment (HA: 433.38 ± 373.00 vs 281.57± 220.48; LN: 161.22± 41.02 vs 146.35 ± 44.67;PCⅢ: 192.59 ± 89.95 vs 156.98 ± 49.22; C-Ⅳ:156.30 ± 44.01 vs 139.14 ± 34.47) and thedifferences between the four indices weresignificant (P<0.05). Thirty-three patientsCONCLUSION All the three doses of IFN-γ areeffective in treating rat liver fibrosis induced byeither CCl4 or DMN, the higher the dose, thebetter the effect. And IFN-γ is effective forpatients with moderate chronic hepatitis B viralfibrosis.Hong Lei Weng Wei Min Cai Rong Hua Liu Institute of Infectious Diseases, First Affiliated Hospital. Medical School. Zhejiang University, Hangzhou 310003, Zhejiang Province. China 2001World Journal of Gastroenterology2001,7,1:53
2中医药辨证治疗急性加重期慢性阻塞性肺疾病随机对照试验疗效评价指标的系统评价显示文摘目的:在系统评价中医药辨证治疗急性加重期慢性阻塞性肺疾病(AECOPD)随机对照试验临床疗效基础上探讨其疗效评价指标的选择和使用。方法:计算机检索CBM、CNKI、VIP、万方数据库、Cochrane图书馆、PubMed和Embase数据库,收集公开发表中医药辨证治疗AECOPD随机对照试验的临床研究,由两位研究者按照纳入标准独立筛选文献、提取资料后,应用RevMan5.1软件进行Meta分析。结果:共纳入73篇相关文献,Meta分析结果显示中医辨证治疗能提高AECOPD患者的临床疗效和中医证候疗效,改善临床症状、肺功能,提高氧分压,降低二氧化碳分压,降低白细胞计数和CRP水平;疗效评价指标使用较多的有临床疗效、证候疗效、肺功能、血气分析、血常规、C反应蛋白、临床症状体征、中医证候积分等,其余如生活质量、影像学评价、住院时间和6 min步行距离等则相对较少。结论:中医药辨证治疗AECOPD具有较好的临床疗效,但由于纳入研究的质量不高,仍需开展大样本、多中心、方法科学的高质量临床试验;临床疗效评价指标的选用仍不规范,疗效指标的选择应根据临床研究的目的不同而有所侧重,另外还应体现中医药的临床特点。张海龙 王明航 李风雷 王海峰 余学庆 李建生 2013中医学报2013,28,6:53
3Prognostic value of red blood cell distribution width for severe acute pancreatitis显示文摘BACKGROUND Severe acute pancreatitis(SAP)is a common condition in the intensive care unit(ICU)and has a high mortality.Early evaluation of the severity and prognosis is very important for SAP therapy.Recently,red blood cell distribution(RDW)was associated with mortality of sepsis patients and could be used as a predictor of prognosis.Similarly,RDW may be associated with the prognosis of SAP patients and be used as a prognostic indicator for SAP patients.AIM To investigate the prognostic value of RDW for SAP patients.METHODS We retrospectively enrolled SAP patients admitted to the ICU of the First Affiliated Hospital of China Medical University from June 2015 to June 2017.According to the prognosis at 90 d,SAP patients were divided into a survival group and a non-survival group.RDW was extracted from a routine blood test.Demographic parameters and RDW were recorded and compared between the two groups.The receiver operator characteristic(ROC)curve was constructed and Cox regression analysis was performed to investigate the prognostic value of RDW for SAP patients.RESULTS In this retrospective cohort study,42 SAP patients were enrolled,of whom 22 survived(survival group)and 20 died(non-survival group).The baseline parameters were comparable between the two groups.The coefficient of variation of RDW(RDW-CV),standard deviation of RDW(RDW-SD),Acute Physiology and Chronic Health Evaluation II(APACHE II)score,and Sequential Organ Failure Assessment(SOFA)score were significantly higher in the non-survival group than in the survival group(P<0.05).The RDW-CV and RDW-SD were significantly correlated with the APACHE II score and SOFA score,respectively.The areas under the ROC curves(AUCs)of RDW-CV and RDW-SD were all greater than those of the APACHE II score and SOFA score,among which,the AUC of RDW-SD was the greatest.The results demonstrated that RDW had better prognostic value for predicting the mortality of SAP patients.When the RDW-SD was greater than 45.5,the sensitivity for predicting prognosis was 77.8%and the specificity was 70.8%.Both RDW-CV and RDW-SD could be used as independent risk factors to predict the mortality of SAP patients in multivariate logistic regression analysis and univariate Cox proportional hazards regression analysis,similar to the APACHE II and SOFA scores.CONCLUSION The RDW is greater in the non-surviving SAP patients than in the surviving patients.RDW is significantly correlated with the APACHE II and SOFA scores.RDW has better prognostic value for SAP patients than the APACHE II and SOFA scores and could easily be used by clinicians for the treatment of SAP patients.Fang-Xiao Zhang Zhi-Liang Li Zhi-Dan Zhang Xiao-Chun Ma 2019World Journal of Gastroenterology2019,25,32:50
4Hepatitis B virus genotypes:Global distribution and clinical importance显示文摘At least 600000 individuals worldwide annually die of hepatitis B virus(HBV)-related diseases,such as chronic hepatitis B(CHB),liver cirrhosis(LC),and hepatocellular carcinoma(HCC).Many viral factors,such as viral load,genotype,and specific viral mutations,are known to affect disease progression.HBV reverse transcriptase does not have a proofreading function,therefore,many HBV genotypes,sub-genotypes,mutants,and recombinants emerge.Differences between genotypes in response to antiviral treatment have been determined.To date,10 HBV genotypes,scattered across different geographical regions,have been identified.For example,genotype A has a tendency for chronicity,whereas viral mutations are frequently encountered in genotype C.Both chronicity and mutation frequency are common in genotype D.LC and progression to HCC are more commonly encountered with genotypes C and D than the other genotypes.Pathogenic differences between HBV genotypes explain disease intensity,progression to LC,and HCC.In conclusion,genotype determination in CHB infection is important in estimating disease progression and planning optimal antiviral treatment.Mustafa Sunbul 2014World Journal of Gastroenterology2014,20,18:42
5Management of chronic hepatitis B infection: Current treatment guidelines, challenges, and new developments显示文摘Chronic hepatitis B(CHB)virus infection is a global public health problem,affecting more than 400 million people worldwide.The clinical spectrum is wide,ranging from a subclinical inactive carrier state,to progressive chronic hepatitis,cirrhosis,decompensation,and hepatocellular carcinoma.However,complications of hepatitis B virus(HBV)-related chronic liver disease may be reduced by viral suppression.Current international guidelines recommend first-line treatment of CHB infection with pegylated interferon,entecavir,or tenofovir,but the optimal treatment for an individualpatient is controversial.The indications for treatment are contentious,and increasing evidence suggests that HBV genotyping,as well as serial on-treatment measurements of hepatitis B surface antigen and HBV DNA kinetics should be used to predict antiviral treatment response.The likelihood of achieving a sustained virological response is also increased by extending treatment duration,and using combination therapy.Hence the paradigm for treatment of CHB is constantly evolving.This article summarizes the different indications for treatment,and systematically reviews the evidence for the efficacy of various antiviral agents.It further discusses the shortcomings of current guidelines,use of rescue therapy in drug-resistant strains of HBV,and highlights the promising clinical trials for emerging therapies in the pipeline.This concise overview presents an updated practical approach to guide the clinical management of CHB.Ceen-Ming Tang Tung On Yau Jun Yu 2014World Journal of Gastroenterology2014,20,20:41
6De novo combined lamivudine and adefovir dipivoxil therapy vs entecavir monotherapy for hepatitis B virus-related decompensated cirrhosis显示文摘AIM:To compare efficacy of combined lamivudine(LAM)and adefovir dipivoxil(ADV)therapy with that of entecavir(ETV)monotherapy for hepatitis B virus(HBV)-related decompensated liver cirrhosis.METHODS:A total of 120 na ve patients with HBVrelated decompensated cirrhosis participated in this study.Sixty patients were treated with combined LAM and ADV therapy(LAM+ADV group),while the other60 were treated with ETV monotherapy(ETV group)for two years.Tests for liver and kidney function,alpha-fetoprotein,HBV serum markers,HBV DNA load,prothrombin time(PT),and ultrasonography or computed tomography scan of the liver were performed every1 to 3 mo.Repeated measure ANOVA and theχ2test were performed to compare the efficacy,side effects,and the cumulative survival rates at 48 and 96 wk.RESULTS:Forty-five patients in each group were observed for 96 wk.No significant differences in HBV DNA negative rates and alanine aminotransferase(ALT)normalization rates at weeks 48(χ2=2.12 and 2.88)and96(χ2=3.21 and 3.24)between the two groups were observed.Hepatitis B e antigen seroconversion rate in the LAM+ADV group at week 96 was significantly higher in the ETV group(43.5%vs 36.4%,χ2=4.09,P<0.05).Viral breakthrough occurred in 2 cases(4.4%)by week 48 and in 3 cases(6.7%)by week 96 in the LAM+ADV group,and no viral mutation was detected.In the ETV group,viral breakthrough occurred in 1 case(2.2%)at the end of week 96.An increase in albumin(F=18.9 and 17.3),decrease in total bilirubin and in ALT(F=16.5,17.1 and 23.7,24.8),reduced PT(F=22.7 and 24.5),and improved Child-Turcotte-Pugh and the model for end-stage liver disease scores(F=18.5,17.8,and 24.2,23.8)were observed in both groups.The cumulative rates of mortality and liver transplantation were 16.7%(10/60)and 18.3%(11/60)in the LAM+ADV and ETV groups,respectively.CONCLUSION:Both LAM+ADV combination therapy and ETV monotherapy can effectively inhibit HBV replication,improve liver function,and decrease mortality.Jiang-Shan Lian Lin-Yan Zeng Jian-Yang Chen Hong-Yu Jia Yi-Min Zhang Dai-Rong Xiang Liang Yu Jian-Hua Hu Ying-Feng Lu Ling Zheng Lan-Juan Li Yi-Da Yang 2013World Journal of Gastroenterology2013,19,37:36
7A study on relationship of nitric oxide,oxidation,peroxidation,lipoperoxidation with chronic cholecystitis显示文摘AIM To study relationship of injury induced bynitric oxide,oxidation,peroxidation,lipoperoxidation with chronic cholecystitis.METHODS The values of plasma nitric oxide(P-NO),plasma vitamin C(P-VC),plasma vitamin E(P-VE),plasma β-carotene(P-β-CAR),plasmalipoperoxides(P-LPO),erythrocyte superoxidedismutase(E-SOD),erythrocyte catalase(E-CAT),erythrocyte glutathione peroxidase(E-GSH-Px)activities and erythrocyte lipoperoxides(E-LPO)level in 77 patients with chronic cholecystitisand 80 healthy control subjects were determined,differences of the above average values betweenthe patient group and the control group anddifferences of the average values betweenpreoperative and postoperative patients wereanalyzed and compared,linear regression andcorrelation of the disease course with the abovedetermination values as well as the stepwiseregression and correlation of the course with thevalues were analyzed.RESULTS Compared with the control group,theaverage values of P-NO,P-LPO,E-LPO weresignificantly increased(P<0.01),and of P-VC, P-VE,P-β-CAR,E-SOD,E-CAT and E-GSH-Pxdecreased(P<0.01)in the patient group.Theanalysis of the linear regression and correlationshowed that with prolonging of the course,thevalues of P-NO,P-LPO and E-LPO in the patientswere gradually ascended and the values of P-VC,P-VE,P-β-CAR,E-SOD,E-CAT and E-GSH-Pxdescended(P<0.01).The analysis of thestepwise regression and correlation indicated thatthe correlation of the course with P-NO,P-VE andP-β-CAR values was the closest.Compared withthe preoperative patients,the average values of P-NO,P-LPO and E-LPO were significantlydecreased(P<0.01)and the average values of P-VC,E-SOD,E-CAT and E-GSH-Px in postoperativepatients increased(P<0.01)in postoperativepatients.But there was no significant difference inthe average values of P-VE,P-β-CAR preoperativeand postoperative patients.CONCLUSION Chronic cholecystitis could inducethe increase of nitric oxide,oxidation,peroxidation and lipoperoxidation.Jun Fu Zhou Dong Cai You Gen Zhu Jin Lu Yang Cheng Hong Peng Yang Hai Yu 2000World Journal of Gastroenterology2000,6,4:36
8Portal hypertensive gastropathy:A systematic review of thepathophysiology,clinical presentation,natural history andtherapy显示文摘AIM: To describe the pathophysiology, clinical presentation, natural history, and therapy of portal hypertensive gastropathy(PHG) based on a systematic literature review.METHODS: Computerized search of the literature was performed via Pub Med using the following medical subject headings or keywords: 'portal' and 'gastropathy'; or 'portal' and 'hypertensive'; or 'congestive' and 'gastropathy'; or 'congestive' and 'gastroenteropathy'. The following criteria were applied for study inclusion: Publication in peer-reviewed journals, and publication since 1980. Articles were independently evaluated by each author and selected for inclusion by consensus after discussion based on the following criteria: Well-designed, prospective trials; recent studies; large study populations; and study emphasis on PHG. RESULTS: PHG is diagnosed by characteristic endoscopic findings of small polygonal areas of variable erythema surrounded by a pale, reticular border in a mosaic pattern in the gastric fundus/body in a patient with cirrhotic or non-cirrhotic portal hypertension. Histologic findings include capillary and venule dilatation, congestion, and tortuosity, without vascular fibrin thrombi or inflammatory cells in gastric submucosa. PHG is differentiated from gastric antral vascular ectasia by a different endoscopic appearance. The etiology of PHG is inadequately understood. Portal hypertension is necessary but insufficient to develop PHG because many patients have portal hypertension without PHG.PHG increases in frequency with more severe portal hypertension, advanced liver disease, longer liver disease duration, presence of esophageal varices, and endoscopic variceal obliteration. PHG pathogenesis is related to a hyperdynamic circulation, induced by portal hypertension, characterized by increased intrahepatic resistance to flow, increased splanchnic flow, increased total gastric flow, and most likely decreased gastric mucosal flow. Gastric mucosa in PHG shows increased susceptibility to gastrotoxic chemicals and poor wound healing. Nitrous oxide, free radicals, tumor necrosis factor-alpha, and glucagon may contribute to PHG development. Acute and chronic gastrointestinal bleeding are the only clinical complications. Bleeding is typically mild-to-moderate. Endoscopic therapy is rarely useful because the bleeding is typically diffuse. Acute bleeding is primarily treated with octreotide, often with concomitant proton pump inhibitor therapy, or secondarily treated with vasopressin or terlipressin. Nonselective β-adrenergic receptor antagonists, particularly propranolol, are used to prevent bleeding after an acute episode or for chronic bleeding. Iron deficiency anemia from chronic bleeding may require iron replacement therapy. Transjugular-intrahepaticportosystemic-shunt or liver transplantation is highly successful ultimate therapies because they reduce the underlying portal hypertension.CONCLUSION: PHG is important to recognize in patients with cirrhotic or non-cirrhotic portal hypertension because it can cause acute or chronic GI bleeding that often requires pharmacologic therapy.Mihajlo Gjeorgjievski Mitchell S Cappell 2016World Journal of Hepatology2016,8,4:38
9Characteristics of general distribution of hepatitis B virus genotypes in China显示文摘BACKGROUND:Based on differences in the virus nucleotide sequence,hepatitis B virus(HBV)genotypes are presently divided into genotypes A-H.The geographic distributions of HBV genotypes differ in countries and regions.To determine the general characteristics of their distributions in the mainland of China,we reviewed articles on HBV genotypes published in China. METHODS:The Wanfang Database and the CNKI Database were searched for original articles involving HBV in China,and then the data from the articles were classified according to genotype and latitude and analyzed using SPSS 11.0. RESULTS:The main HBV genotypes were C,B and BC, and their rates were 50.99%,35.58%,6.07%,respectively; other genotypes were rare.There was a negative correlation between latitude and the rate of genotype B (r=-0.782,P<0.01),while a positive correlation existed between latitude and the rate of genotype C(r=0.646, P<0.01).No correlation was observed between latitude and the rates of other genotypes(r=0.294,P>0.05). CONCLUSIONS:In China,HBV genotype C predominates, followed by genotype C and mixed genotype BC;genotypes A,D and others are rare.With an increasing latitude,the distribution of genotype B decreases gradually,while that of genotype C tends to increase.The other genotypes do not show any changes.Zhu, Chang-Tai Dong, Chun-Lei 2009Hepatobiliary & Pancreatic Diseases International2009,8,4:32
10Short-term entecavir therapy of chronic severe hepatitis B显示文摘BACKGROUND:Chronic severe hepatitis B patients often have limited survival.This investigation aimed to evaluate the short-term effects of nucleoside analog therapy on chronic severe hepatitis B. METHODS:We retrospectively,randomly collected the data of 129 chronic severe hepatitis B patients:55 were treated with entecavir,and the remaining 74 were not treated with nucleoside analogues. RESULTS:No significant difference in short-term survival rate was found between the group treated with entecavir and that treated without nucleoside analogues.Although entecavir greatly reduced HBV replication in different periods of therapy(P<0.001),the model for end-stage liver disease(MELD)score and liver function(alanine aminotransferase,albumin,bilirubin,prothrombin time) showed no significant change.No significant differences were found in MELD scores and liver function in patients with different HBV DNA levels(≤104copies/ml,>10 4 to<10 6 copies/ml,≥10 6 copies/ml).Nor correlation was observed between HBV DNA levels and MELD scores in different periods of therapy(P>0.05).The HBV DNA levels of patients who survived for over 3 months or less than 3 months were not significantly different either.However, the MELD score and parameters of liver function(albumin, bilirubin,prothrombin time)were different between the two groups(P<0.05).CONCLUSION:These results suggest that short-term suppression of HBV replication may not slow down the progression of liver failure in patients with chronic severe hepatitis B.Chen, Jun Han, Jian-Hua Liu, Chun Yu, Ren-He Li, Fa-Zhao Li, Qun-Fang Gong, Guo-Zhong 2009Hepatobiliary & Pancreatic Diseases International2009,8,3:31
11Chronic hepatitis B infection in pregnancy显示文摘There are no standard guidelines to follow when a patient with chronic hepatitis B infection becomes pregnant or desires pregnancy. Topics to consider include which patients to treat, when to start treatment, what treatment to use and when to stop treatment. Without any prophylaxis or antiviral therapy, a hepatitis B surface antigen and E antigen positive mother has up to a 90% likelihood of vertical transmission of hepatitis B virus(HBV) to child. Standard of care in the United States to prevent perinatal transmission consists of administration of hepatitis B immune globulin and HBV vaccination to the infant. The two strongest risk factors of mother to child transmission(MTCT) of HBV infection despite immunoprophylaxis are high maternal HBV viral load and high activity of viral replication. The goal is to prevent transmission of HBV at birth by decreasing viral load and/or decreasing activity of the virus. Although it is still somewhat controversial, most evidence shows that starting antivirals in the third trimester is effective in decreasing MTCT without affecting fetal development. There is a growing body of literature supporting the safety and efficacy of antiviral therapies to reduce MTCT of hepatitis B. There are no formal recommendations regarding which agent to choose. Tenofovir, lamivudine and telbivudine have all been proven efficacious in decreasing viral load at birth without known birth defects, but final decision of which antiviral medication to use will have to be determined by physician and patient. The antivirals may be discontinued immediately if patient is breastfeeding, or within first four weeks if infant is being formula fed.Jennifer R Lamberth Sheila C Reddy Jen-Jung Pan Kevin J Dasher 2015World Journal of Hepatology2015,7,9:32
12HCV-RNA positivity in peripheral blood mononuclear cells of patients with chronic HCV-infection: does it really mean viral replication?显示文摘AIM To analyze the association of HCV-RNA with peripheral blood mononuclear cells (PBMC)and to answer the question whether HCV-RNA positivity in PBMC is due to viral replication,METHODS HCV-RNA was monitored in serumand PBMC preparations from 15 patients with chronic HCV infection before, during and after an IFN-α therapy using a nested RT/ PCRtechnique. In a second approach, PBMC from healthy donors were incubated in HCV positive plasma.RESULTS In the IFN-α responding patients,HCV-RNA disappeared first from total RNApreparations of PBMC and then from serum. In contrast, in relapsing patients, HCV-RNAreappeared first in serum and then in PBMC. A quantitative analysis of the HCV-RNAconcentration in serum was performed before and after transition from detectable to nondetectable HCV-RNA in PBMC-RNA and vice versa. When HCV-RNA was detectable in PBMCpreparations, the HCV concentration in serum was significantly higher than the serum HCV-RNA concentration when HCV-RNA in PBMC was not detectable. Furthermore, at no time during the observation period was HCV specific RNA observed in PBMC, if HCV-RNA in serum was under the detection limit. Incubation of PBMCfrom healthy donors with several dilutions of HCV positive plasma for two hours showed a concentration-dependent PCR-positivity for HCV-RNA in reisolated PBMC.CONCLUSION The detectability of HCV-RNA in total RNA from PBMC seems to depend on the HCV concentration in serum. Contamination or passive adsorption by circulating virus could be the reason for detection of HCV-RNA in PBMCpreparations of chronically infected patients.Volker Meier Sabine Mihm Perdita Wietzke-Braun Guliano Ramadori 2001World Journal of Gastroenterology2001,7,2:29
13Non-invasive diagnosis of hepatitis B virus-related cirrhosis显示文摘Chronic hepatitis B(CHB)infection is a major public health problem associated with significant morbidity and mortality worldwide.Twenty-three percent of patients with CHB progress naturally to liver cirrhosis,which was earlier thought to be irreversible.However,it is now known that cirrhosis can in fact be reversed by treatment with oral anti-nucleotide drugs.Thus,early and accurate diagnosis of cirrhosis is important to allow an appropriate treatment strategy to be chosen and to predict the prognosis of patients with CHB.Liver biopsy is the reference standard for assessment of liver fibrosis.However,the method is invasive,and is associated with pain and complications that can be fatal.In addition,intra-and inter-observer variability compromises the accuracy of liver biopsy data.Only small tissue samples are obtained and fibrosis is heterogeneous in such samples.This confounds the two types of observer variability mentioned above.Such limitations have encouraged development of non-invasive methods for assessment of fibrosis.These include measurements of serum biomarkers of fibrosis;and assessment of liver stiffness via transient elastography,acoustic radiation force impulse imaging,real-time elastography,or magnetic resonance elastography.Although significant advances have been made,most work to date has addressed the diagnostic utility of these techniques in the context of cirrhosis caused by chronic hepatitis C infection.In the present review,we examine the advantages afforded by use of non-invasive methods to diagnose cirrhosis in patients with CHB infections and the utility of such methods in clinical practice.Sangheun Lee Do Young Kim 2014World Journal of Gastroenterology2014,20,2:29
14Early warning and clinical outcome prediction of acute-onchronic hepatitis B liver failure显示文摘Hepatitis B virus(HBV) associated acute-on-chronic liver failure(ACLF) is an increasingly recognized fatal liver disease encompassing a severe acute exacerbation of liver function in patients with chronic hepatitis B(CHB). Despite the introduction of an artificial liver support system and antiviral therapy, the short-term prognosis of HBV-ACLF is still extremely poor unless emergency liver transplantation is performed. In such a situation, stopping or slowing the progression of CHB to ACLF at an early stage is the most effective way of reducing the morbidity and mortality of HBV-ACLF. It is well-known that the occurrence and progression of HBV-ACLF is associated with many factors, and the outcomes of HBV-ACLF patients can be significantly improved if timely and appropriate interventions are provided. In this review, we highlight recent developments in early warning and clinical outcome prediction in patients with HBV-ACLF and provide an outlook for future research in this field.En-Qiang Chen Fan Zeng Ling-Yun Zhou Hong Tang 2015World Journal of Gastroenterology2015,21,42:30
15A randomized double-blind placebo-controlled study of lamivudine in the treatment of patients with chronic hepatitis B virus infection显示文摘ObjectiveToevaluatetheefectoflamivudineonthelossofserumhepatitisBvirus(HBV)DNA,HBeAg/antiHBeseroconversionandALTlevelsinchron...姚光弼 王宝恩 崔振宇 姚集鲁 曾民德 1999Chinese Medical Journal1999,,5:28
16Add-on pegylated interferon augments hepatitis B surface antigen clearance vs continuous nucleos(t)ide analog monotherapy in Chinese patients with chronic hepatitis B and hepatitis B surface antigen≤1500 IU/mL:An observational study显示文摘BACKGROUND Nucleos(t)ide analog(NA)has shown limited effectiveness against hepatitis B surface antigen(HBsAg)clearance in chronic hepatitis B(CHB)patients.AIM To evaluate the efficacy and safety of add-on peginterferonα-2a(peg-IFNα-2a)to an ongoing NA regimen in CHB patients.METHODS In this observational study,195 CHB patients with HBsAg≤1500 IU/m L,hepatitis B e antigen(HBeAg)-negative(including HBeAg-negative patients or HBeAg-positive patients who achieved HBeAg-negative after antiviral treatment with NA)and hepatitis B virus-deoxyribonucleic acid<1.0×10^2 IU/mL after over 1 year of NA therapy were enrolled between November 2015 and December2018 at the Second Affiliated Hospital of Xi'an Jiaotong University,China.Patients were given the choice between receiving either peg-IFNα-2a add-on therapy to an ongoing NA regimen(add-on group,n=91)or continuous NA monotherapy(monotherapy group,n=104)after being informed of the benefits and risks of the peg-IFNα-2a therapy.Total therapy duration of peg-IFNα-2a was 48 wk.All patients were followed-up to week 72(24 wk after discontinuation of peg-IFNα-2a).The primary endpoint was the proportion of patients with HBsAg clearance at week 72.RESULTS Demographic and baseline characteristics were comparable between the two groups.Intention-to-treatment analysis showed that the HBsAg clearance rate in the add-on group and monotherapy group was 37.4%(34/91)and 1.9%(2/104)at week 72,respectively.The HBsAg seroconversion rate in the add-on group was 29.7%(27/91)at week 72,and no patient in the monotherapy group achieved HBsAg seroconversion at week 72.The HBsAg clearance and seroconversion rates in the add-on group were significantly higher than in the monotherapy group at week 72(P<0.001).Younger patients,lower baseline HBsAg concentration,lower HBsAg concentrations at weeks 12 and 24,greater HBsAg decline from baseline to weeks 12 and 24 and the alanine aminotransferase≥2×upper limit of normal during the first 12 wk of therapy were strong predictors of HBsAg clearance in patients with peg-IFNα-2a add-on treatment.Regarding the safety of the treatment,4.4%(4/91)of patients in the add-on group discontinued peg-IFNα-2a due to adverse events.No severe adverse events were noted.CONCLUSION Peg-IFNα-2a as an add-on therapy augments HBsAg clearance in HBeAg-negative CHB patients with HBsAg≤1500 IU/m L after over 1 year of NA therapy.Feng-Ping Wu Ying Yang Mei Li Yi-Xin Liu Ya-Ping Li Wen-Jun Wang Juan-Juan Shi Xin Zhang Xiao-Li Jia Shuang-Suo Dang 2020World Journal of Gastroenterology2020,26,13:27
17Acute recurrent pancreatitis:Etiopathogenesis, diagnosis and treatment显示文摘Acute recurrent pancreatitis(ARP)refers to a clinical entity characterized by episodes of acute pancreatitis which occurs on more than one occasion.Recurrence of pancreatitis generally occurs in a setting of normal morpho-functional gland,however,an established chronic disease may be found either on the occasion of the first episode of pancreatitis or during the follow-up.The aetiology of ARP can be identified in the majority of patients.Most common causes include common bile duct stones or sludge and bile crystals;sphincter of oddi dysfunction;anatomical ductal variants interfering with pancreatic juice outflow;obstruction of the main pancreatic duct or pancreatico-biliary junction;genetic mutations;alcohol consumption.However,despite diagnostic technologies,the aetiology of ARP still remains unknown in up to 30%of cases:in these cases the term'idiopathic'is used.Because occult bile stone disease and sphincter of oddi dysfunction account for the majority of cases,cholecystectomy,and eventually the endoscopic biliary and/or pancreatic sphincterotomy are curative in most of cases.Endoscopic biliary sphincterotomy appeared to be a curative procedure per se in about 80%of patients.Ursodeoxycholic acid oral treatment alone has also been reported effective for treatment of biliary sludge.In uncertain cases toxinbotulin injection may help in identifying some sphincter of oddi dysfunction,but this treatment is not widely used.In the last twenty years,pancreatic endotherapy has been proven effective in cases of recurrent pancreatitis depending on pancreatic ductal obstruction,independently from the cause of obstruction,and has been widely used instead of more aggressive approaches.Pier Alberto Testoni 2014World Journal of Gastroenterology2014,20,45:27
18Recombinant bovine basic fibroblast growth factor accelerates wound healing in patients with burns, donor sites and chronic dermal ulcers显示文摘Objective To evaluate the effect of recombinant bovine basic fibroblast growth factor(rbFGF) on accelerating healing of burn wounds, donor sites and chronic dermal ulcers in multicenters Methods One thousand and twenty four patients with burns, donor sites and chronic dermal ulcers were recruited for this prospective and multicenter clinical trial and another 641 patients with the similar wounds were used as controls All patients were divided into three groups: burn group, donor site group, and chronic dermal ulcer group In the burn group, 654 patients with superficial second degree burns( superficial Ⅱ ) or deep second degree burns( deep Ⅱ ) were treated topically with either recombinant bovine basic fibroblast growth factor (rbFGF plus vehicle, rbFGF 150 ?AU/cm 2/day, 330 patients) or placebo (vehicle without rbFGF, 324 patients) In the donor site group, 509 patients were treated with rbFGF and 317 patients with placebo in a similar way as described elsewhere In the chronic dermal ulcer group, 185 patients were treated with rbFGF and the controls were themselves Photography, histological evaluation and clinical examination were used to evaluate the results of wound healing Results All of superficial second degree burns, deep second degree burns and the donor sites treated with recombinant bovine basic fibroblast growth factor had an accelerated rate of granulation tissue formation and epidermal regeneration as compared with that in the controls Superficial second degree burns and deep second degree burns treated with recombinant bovine basic fibroblast growth factor healed in 9 89±2 45 and 17 04±4 56 days, respectively, whereas the average healing time in those receiving placebo was 12 35±2 74 and 21 21±4 88 days The donor sites treated with rbFGF or placebo healed in 10 68±4 55 and 14 74±6 46 days, respectively All chronic dermal ulcers except 12 patients treated with rbFGF healed within 6 weeks Histological evaluation of punch biopsy specimens from the burn wounds, donor sites and chronic dermal ulcers seven days after treatment supported the impression of accelerated wound healing after rbFGF treatment Conclusions rbFGF is effective in shortening the wound healing time and improving the wound healing quality Accelerating wound healing is of clinical benefit in reducing the length of hospitalization, costs and emotional burden of the付小兵 沈祖尧 陈玉林 谢君鹤 郭振荣 张明良 盛志勇 2000Chinese Medical Journal2000,,4:26
19Efficacy and safety of tenofovir disoproxil fumarate in pregnancy for the prevention of vertical transmission of HBV infection显示文摘AIM:To evaluate the effects of tenofovir disoproxil fumarate(TDF)use during late pregnancy to reduce hepatitis B virus(HBV)transmission in highly viremic mothers.METHODS:This retrospective study included 45 pregnant patients with hepatitis B e antigen(+)chronic hepatitis B and HBV DNA levels>107copies/mL who received TDF 300 mg/d from week 18 to 27 of gestation(n=21).Untreated pregnant patients served as controls(n =24).All infants received 200 IU of hepatitis B immune globulin(HBIG)within 24 h postpartum and 20μg of recombinant HBV vaccine at 4,8,and 24 wk.Perinatal transmission rate was determined by hepatitis B surface antigen and HBV DNA results in infants at week 28.RESULTS:At week 28,none of the infants of TDFtreated mothers had immunoprophylaxis failure,whereas2(8.3%)of the infants of control mothers had immunoprophylaxis failure(P=0.022).There were no differences between the groups in terms of adverse events in mothers or congenital deformities,gestational age,height,or weight in infants.At postpartum week 28,significantly more TDF-treated mothers had levels of HBV DNA<250 copies/mL and normalized alanine aminotransferase compared with controls(62%vs none,P<0.001;82%vs 61%,P=0.012,respectively).CONCLUSION:TDF therapy during the second or third trimester reduced perinatal transmission rates of HBV and no adverse events were observed in mothers or infants.Mustafa Kemal Celen Duygu Mert Müzeyyen Ay Tuba Dal Safak Kaya Necmettin Yildirim Serda Gulsun Tunga Barcin Sevgi Kalkanli Mehmet Sinan Dal Celal Ayaz 2013World Journal of Gastroenterology2013,19,48:26
20Enhanced recovery after surgery protocols in functional endoscopic sinus surgery for patients with chronic rhinosinusitis with nasal polyps: a randomized clinical trial显示文摘Background:Enhanced recovery after surgery (ERAS) protocols are a series of perioperative care to optimize preoperative preparation, prevent postoperative complications, minimize stress, and speed up recovery. This study aimed to assess the impact of ERAS protocols for functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).Methods:One hundred and two patients with CRSwNP undergoing FESS were randomly divided into the ERAS group and the control group. The outcomes of the Self-Rating Anxiety Scale (SAS), Visual Analogue Scale (VAS), Medical Outcomes Study Sleep Scale (MOS-SS) and Kolcaba Comfort Scale Questionnaire (GCQ) were determined in both groups. The serum levels of C-reactive protein (CRP) were compared preoperatively and 24 hours postoperatively.Results:The ERAS group had a significantly better SAS scores than did the control group (28 [24, 35] vs. 43 [42, 47], Z=5.968, P<0.001). The rhinalgia and headache scores at 2, 24 and 48 hours postoperatively were lower in the ERAS group than that in the control group (all P < 0.001). The outcomes of the MOS-SS (43 [42, 39] vs. 28 [22, 35], Z= 7.071, P < 0.001) and GCQ (76 [68, 87] vs. 64 [50, 75], Z= 4.806, P < 0.001) were significantly different between the two groups. No significant difference was found in the preoperative CRP levels between the two groups (1.3 [0.6, 2.8] vs. 0.5 [0.5, 1.2], Z = 3.049, P > 0.05);However, the CRP level in 24 hours postoperatively was significantly lower in the ERAS group than that in the control group (2.5 [1.4, 3.9] vs. 6.6 [3.8, 9.0], Z = 5.027, P < 0.001). The incidence rates of complications, such as nausea/emesis (χ^2=0.343, P>0.05), hemorrhage, aspiration and tumble, were not increased in the ERAS group compared with those in the control group. The ERAS group had a significantly shorter length of hospital stay (5 [4, 5] days vs. 8 [8,9] days, Z=8.939, P<0.001) and hospitalization expenses ($ 2670 [2375, 2740] vs. $3129 [3116, 3456], Z=8.514, P<0.001).Conclusions:ERAS protocols might optimize FESS for patients with CRSwNP by reducing psychological and physical stress, shortening the length of hospital stay and lowering hospitalization expenses without increasing postoperative complications.Xi-Fu Wu Wei-Feng Kong Wei-Hao Wang Lian-Xiong Yuan Hui-Qing Xu Min Qi Shao-Li Zhou Qin-Tai Yang 2019Chinese Medical Journal2019,,3:26
返回顶部 每页显示:
共49页 首页 上一页 第1页 下一页 末页 /49 跳转

网站首页 | 关于我们 | 联系我们 | 产品服务 | 客服中心 | 广告服务 | 版权声明 | 网站联盟 | 友情链接 | 售卡网点

版权所有© 渝B2-20050021-1 渝公网安备 50019002500403号 违法和不良信息举报中心

互联网出版许可证 新出网证(渝)字10号 全国400电话 - 免长途话费