|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Prevalence of minimal hepatic encephalopathy and quality of life evaluations in hospitalized cirrhotic patients in China显示文摘AIM:To investigate the prevalence of minimal hepatic encephalopathy(MHE)and to assess corresponding health-related quality of life(HRQoL)in hospitalized cirrhotic patients in China.METHODS:This multi-center cross-sectional study included 16 teaching hospitals,which were members of 'Hepatobiliary Cooperation Group,Society of Gastroenterology,Chinese Medical Association',from different areas of China carried out between June and October in 2011.All the eligible hospitalized cirrhotic patients(n = 538)were required to complete triplicate number connection tests combined with one digit symbol test for diagnosing MHE.Patients' clinical examination data were complemented by a modified questionnaire assessing HRQoL.Written informed consent was obtained from each patient.RESULTS:Male was predominant(68.6%)in 519 patients who met the criteria of the study,with a mean age of 49.17 ± 11.02 years.The most common cause of liver cirrhosis was chronic hepatitis B(55.9%).The prevalence of MHE was 39.9% and varied by ChildPugh-Classification score(CPC-A:24.8%,CPC-B:39.4% and CPC-C:56.1%,P < 0.01).MHE(P < 0.01)and higher CPC scores(P < 0.01)were associated with a high HRQoL scores(reflecting poorer quality of life).The prevalence of MHE was proportionate to CPC(P = 0.01)and high quality of life scores(P = 0.01).CONCLUSION:Hospitalized cirrhotic patients have a high prevalence of MHE that is proportionate to the degree of liver function and HRQoL impairment. | Ji-Yao Wang Ning-Ping Zhang Bao-Rong Chi Yu-Qing Mi Li-Na Meng Ying-Di Liu Jiang-Bin Wang Hai-Xing Jiang Jin-Hui Yang Yun Xu Xiao Li Jian-Ming Xu Guo Zhang Xin-Min Zhou Yu-Zheng Zhuge De-An Tian Jin Ye Yu-Lan Liu | 2013 | World Journal of Gastroenterology2013，19，30： | 64 |
| 2 | 伴胼胝体压部可逆性病变的轻度脑炎/脑病儿童病例一例并文献复习显示文摘目的 探讨伴胼胝体压部可逆性病变的轻度脑炎/脑病(MERS)的临床及头颅影像学特征.方法 报道1例MERS患儿临床及影像学特点.对以下数据库2000年1月至2013年6月收录的论文进行检索:中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、美国国家生物技术中心(NCBI)、生物医学文献数据库(PubMed)、万方数据知识服务平台,共收集已报道的44例MERS儿童患者临床及影像学特点,对其进行分析.结果 本例MERS发生前的基础疾病为呼吸道支原体感染,病程第2天出现脑病症状,头颅MRI为胼胝体压部、半卵圆中心及侧脑室后角病变,3周内临床及影像学完全恢复.44例MERS患儿多发生于感染性疾病过程中,临床有意识障碍、惊厥、构音障碍等表现;头颅MRI为胼胝体压部病变,除胼胝体压部受累外,还包括胼胝体膝部、半卵圆中心、额叶白质等部位,临床症状及影像多于2周内恢复正常.结论 MERS表现为在急性炎症疾病过程中出现急性轻微脑病症状,头颅MRI表现为胼胝体压部可逆性病变,短期内可完全恢复. | 赵立荣 吴晔 郭芒芒 肖江喜 姜玉武 | 2014 | 中华儿科杂志2014，52，3： | 34 |
| 3 | 新生儿窒息与缺氧缺血性脑病显示文摘缺氧缺血性脑病(Hypoxia ischemic encephalopathy以下称HIE)是围产期新生儿因缺氧引起的脑部病变,主要由宫内窒息、新生儿窒息脑缺氧所致,多见于足月儿,是围产期足月儿脑损伤的最常见原因,少数可发生在其他原因引起的脑损害。轻者通常预后良好,严重者在新生儿早期即死亡并可造成不可逆的脑损害,产生永久性神经功能缺陷,如智能低下、脑性瘫痪、痉挛、癫痫和共济失调等。新生儿窒息的本质是缺氧,轻症、早期窒息由于海豹潜水反射机制的存在产生血液重新分布、心。 | 虞人杰 | 1989 | 中国新生儿科杂志1989，14，1： | 29 |
| 4 | Effect of probiotic treatment on cirrhotic patients with minimal hepatic encephalopathy: A meta-analysis显示文摘Background: Minimal hepatic encephalopathy(MHE) is an early and reversible form of hepatic encephalopathy. The documentations on the treatment with probiotics are inconsistent. The present meta-analysis was to verify the role of probiotics in the treatment of cirrhotic patients with MHE.Data sources: Seven electronic databases were searched for relevant randomized controlled trials(RCTs)published until July 2015. The effects of probiotics on serum ammonia, endotoxin, and MHE were evaluated.Results: A total of 14 RCTs(combined n = 1132) were included in the meta-analysis. When probiotics were compared to placebo or no treatment, probiotics were more likely to reduce values in the number connection test(NCT; week 4: MD =-30.25, 95% CI:-49.85 to-10.66), improve MHE(week 4: OR = 0.18,95% CI: 0.07 to 0.47; week 12: OR = 0.15, 95% CI: 0.07 to 0.32), and prevent overt HE progression(week4: OR = 0.22, 95% CI: 0.07 to 0.67) in patients with liver cirrhosis. When probiotics was compared to lactulose, probiotics tended to reduce serum ammonia levels(week 4: MD =-0.33 μmol/L, 95% CI:-5.39 to 4.74; week 8: MD = 6.22 μmol/L, 95% CI:-24.04 to 36.48), decrease NCT(week 8: MD = 3.93, 95% CI:-0.72 to 8.58), improve MHE(week 4: OR = 0.93, 95% CI: 0.45 to 1.91; week 12: OR = 0.73, 95% CI: 0.35 to 1.51) and prevent the development of overt HE(week 4: OR = 0.96, 95% CI: 0.17 to 5.44; week 12:OR = 2.7, 95% CI: 0.50 to 14.64) in patients with liver cirrhosis. However, lactulose appears to be more effective in reducing NCT values as compared to probiotics(week 4: MD = 6.7, 95% CI: 0.58 to 12.82).Conclusion: Probiotics can decrease serum ammonia and endotoxin levels, improve MHE, and prevent overt HE development in patients with liver cirrhosis. | Qing Cao Cheng-Bo Yu Shi-Gui Yang Hong-Cui Cao Ping Chen Min Deng Lan-Juan Li | 2018 | Hepatobiliary & Pancreatic Diseases International2018，17，1： | 25 |
| 5 | Pathogenesis of pancreatic encephalopathy in severe acute pancreatitis显示文摘BACKGROUND: Pancreatic encephalopathy (PE) is a serious complication of severe acute pancreatitis (SAP). In recent years, more and more PE cases have been reported worldwide, and the onset PE in the early stage was regarded as a poor prognosis sign of SAP, but the pathogenesis of PE in SAP still has not been clarified in the past decade. The purpose of this review is to elucidate the possible pathogenesis of PE in SAP. DATA SOURCES: The English-language literature concern- ing PE in this review came from the Database of MEDLINE (period of 1991-2005), and the keywords of severe acute pancreatitis and pancreatic encephalopathy were used in the searching. RESULTS: Many factors were involved in the pathogenesis of PE in SAP. Pancreatin activation, excessive release of cytokines and oxygen free radicals, microcirculation abnormalities of hemodynamic disturbance, ET-1/NO ratio, hypoxemia, bacterial infection, water and electrolyte imbalance, and vitamin B1 deficiency participated in the development of PE in SAP. CONCLUSIONS: The pathogenesis of PE in SAP has not yet been fully understood. The development of PE in SAP may be a multi-factor process. To find out the possible inducing factor is essential to the clinical management of PE in SAP. | Zhang, Xi-Ping Tian, Hua | 2007 | Hepatobiliary & Pancreatic Diseases International2007，6，2： | 24 |
| 6 | Neuroprotection of aucubin in primary diabetic encephalopathy显示文摘Hippocampal neuronal apoptosis accompanied by impairment of cognitive function occurs in primary diabetic encephalopathy. In this study, we investigated the neuroprotective mechanism of the iridoid glycoside, aucubin, using rats (n=8). Diabetes mellitus was induced in the rats by intraperitoneal (i.p.) injection of streptozotocin (60 mg/kg body weight). After 65 d, half of the DM rats were administered aucubin (5 mg/kg; i.p.) for 15 d, yielding treatment DM+A. A third group of rats received no strepto- zotocin or aucibin, and served as controls (CON). Encephalopathy was assessed using Y-maze be- havioral testing. Rats were euthanized on Day 87, and hippocampi were excised for visual (light and transmission electron microscopic) and immunochemical (Western blot; immunohistochemical) as- sessments of the CA1 subfield for apoptosis and expression of regulatory proteins Bcl-2 and Bax. Treatment responses to all the parameters examined (body weight, plasma glucose, Y-maze error rates, pyramidal cell ultrastructure, proportions of apoptotic cells, levels of expression of Bcl-2 and Bax, and survivability of neuronal cells) were identical: there were highly significant differences between DM and CON groups (P<0.001), but the effects were significantly moderated (P<0.01) in DM+A compared with DM. These findings confirm the association of apoptosis with the encephalopathic effects of diabetes mellitus, and suggest a major role of the expression levels of Bcl-2 and Bax in the regulation of apop- totic cell death. All of the results suggest that aucubin could effectively inhibit apoptosis by modulating the expressions of Bcl-2 and Bax genes. | XUE HongYu1, JIN LiJi1,2, JIN Lei1, ZHANG Peng1, LI DanQing4, XIA YanQiu1, LU YaNan1 & XU YongPing1,3 1 Department of Bioscience and Biotechnology, Dalian University of Technology, Dalian 116024, China 2 State Key Laboratory of Fine Chemicals, Dalian University of Technology, Dalian 116024, China 3 Dalian SEM Bioengineer and Biotech Ltd., Dalian 116024, China 4 The Second Affiliated Hospital, Dalian Medical University, Dalian 116024, China | 2008 | Science China(Life Sciences)2008，51，6： | 22 |
| 7 | Targeted puncture of left branch of intrahepatic portal vein in transjugular intrahepatic portosystemic shunt to reduce hepatic encephalopathy显示文摘BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS) is currently used for the treatment of complications of portal hypertension. The incidence of hepatic encephalopathy(HE) remains a problem in TIPS placement. It has been reported that the right branch mainly receives superior mesenteric venous blood while the left branch mainly receives blood from the splenic vein. We hypothesized that targeted puncture of the left portal vein would divert the non-nutritive blood from the splenic vein into the TIPS shunt; therefore, targeted puncture of the left branch of the intrahepatic portal vein during TIPS may reduce the risk of HE.AIM To evaluate the influence of targeted puncture of left branch of portal vein in TIPS on HE.METHODS A retrospective analysis of 1244 patients with portal-hypertension-related complications of refractory ascites or variceal bleeding who underwent TIPS from January 2000 to January 2013 was performed. Patients were divided into group A(targeting left branch of portal vein, n = 937) and group B(targeting right branch of portal vein, n = 307). TIPS-related HE and clinical outcomes were analyzed.RESULTS The symptoms of ascites and variceal bleeding disappeared within a short time.By the endpoint of follow-up, recurrent bleeding and ascites did not differ significantly between groups A and B(P = 0.278, P = 0.561, respectively).Incidence of HE differed significantly between groups A and B at 1 mo(14.94% vs36.80%, χ~2 = 4.839, P = 0.028), 3 mo(12.48% vs 34.20%, χ~2 = 5.054, P = 0.025), 6 mo(10.03% vs 32.24%, χ~2 = 6.560, P = 0.010), 9 mo(9.17% vs 31.27%, χ~2 = 5.357, P =0.021), and 12 mo(8.21% vs 28.01, χ~2 = 3.848, P = 0.051). There were no significant differences between groups A and B at 3 years(6.61% vs 7.16%, χ~2 = 1.204, P =0.272) and 5 years(5.01% vs 6.18%, χ~2 = 0.072, P = 0.562). The total survival rate did not differ between groups A and B(χ~2 = 0.226, P = 0.634, log-rank test).CONCLUSION Targeted puncture of the left branch of the intrahepatic portal vein during TIPS may reduce the risk of HE but has no direct influence on prognosis of portalhypertension-related complications. | Shi-Hua Luo Jian-Guo Chu He Huang Guo-Rui Zhao Ke-Chun Yao | 2019 | World Journal of Gastroenterology2019，25，9： | 22 |
| 8 | Psychometric hepatic encephalopathy score for diagnosis of minimal hepatic encephalopathy in China显示文摘AIM:To construct normal values for the tests of the psychometric hepatic encephalopathy score(PHES)and to evaluate its usefulness in the diagnosis of minimal hepatic encephalopathy(MHE)among Chinese individuals with cirrhosis.METHODS:The five tests of PHES,number connection test-A(NCT-A),number connection test-B,serial dotting test,line tracing test and digit symbol test(DST),were administered to all enrolled subjects in a quiet room with sufficient light.Cirrhotic subjects with overt HE were excluded by the West-Haven criteria and a detailed neurological examination.Based on the nomograms of healthy volunteers,the patients were classified as having MHE when their PHES was less than-4.RESULTS:In total,146 healthy volunteers completed all the PHES tests.Age and education years were confirmed to be predictors of all five tests.In total,53patients with liver cirrhosis completed the PHES.Of the patients with liver cirrhosis,24(45.3%),22(41.5%)and 7(13.2%)had Child-Pugh grades A,B and C,respectively.MHE was diagnosed in 26 patients(49.1%).Compared with compensated cirrhotic patients(Child A),decompensated cirrhotic patients(Child B and C)had a higher proportion of MHE(65.5%vs 29.2%).No differences in age and education years were found between the MHE and non-MHE groups.NCT-A and DST were able to diagnose MHE with a sensitivity of 76.9%and a specificity of 96.3%(AUC=0.866,K=0.735).CONCLUSION:The proportion of MHE is associated with liver function.NCT-A and DST are simple tools that can be used for the diagnosis of MHE in China. | Su-Wen Li Kai Wang Yong-Qiang Yu Hai-Bao Wang Yuan-Hai Li Jian-Ming Xu | 2013 | World Journal of Gastroenterology2013，19，46： | 21 |
| 9 | 血液透析联合血液灌流治疗尿毒症脑病的疗效观察与护理显示文摘尿毒症脑病(uremic encephalopathy,UE)最突出的表现是精神活动异常,不自主运动及癫痫性抽搐发作。终末期肾病(ESRD)出现尿毒症脑病的病理生理学机制并不十分清楚,倾向于多种因素的综合作用。UE患者的脑组织并无明显的生物化学和组织学改变,ESRD并发的继发性甲旁亢及离子转运异常引起的脑组织及血液中钙离子及PTH水平增高可能是主要原因。 | 肖太玲 秦燕 | 2016 | 北京医学2016，38，1： | 20 |
| 10 | Can we further optimize therapeutic hypothermia for hypoxic-ischemic encephalopathy?显示文摘Perinatal hypoxic-ischemic encephalopathy is a leading cause of neonatal death and disability.Therapeutic hypothermia significantly reduces death and major disability associated with hypoxic-ischemic encephalopathy;however,many infants still experience lifelong disabilities to movement,sensation and cognition.Clinical guidelines,based on strong clinical and preclinical evidence,recommend therapeutic hypothermia should be started within 6 hours of birth and continued for a period of 72 hours,with a target brain temperature of 33.5 ±0.5℃ for infants with moderate to severe hypoxic-ischemic encephalopathy.The clinical guidelines also recommend that infants be re warmed at a rate of 0.5℃ per hour,but this is not based on strong evidence.There are no randomized controlled trials investigating the optimal rate of rewarming after therapeutic hypothermia for infants with hypoxic-ischemic encephalopathy.Preclinical studies of rewarming are conflicting and results were confounded by treatment with sub-optimal durations of hypothermia.In this review,we evaluate the evidence for the optimal start time,duration and depth of hypothermia,and whether the rate of rewarming after treatment affects brain injury and neurological outcomes. | Anthony Davies Guido Wassink Laura Bennet Alistair J.Gunn Joanne O.Davidson | 2019 | Neural Regeneration Research2019，14，10： | 20 |
| 11 | Chinese guidelines on management of hepatic encephalopathy in cirrhosis显示文摘The Chinese Society of Hepatology developed the current guidelines on the management of hepatic encephalopathy in cirrhosis based on the published evidence and the panelists’ consensus. The guidelines provided recommendations for the diagnosis and management of hepatic encephalopathy (HE) including minimal hepatic encephalopathy (MHE) and overt hepatic encephalopathy, emphasizing the importance on screening MHE in patients with end-stage liver diseases. The guidelines emphasized that early identification and timely treatment are the key to improve the prognosis of HE. The principles of treatment include prompt removal of the cause, recovery of acute neuropsychiatric abnormalities to baseline status, primary prevention, and secondary prevention as soon as possible. | Xiao-Yuan Xu Hui-Guo Ding Wen-Gang Li Ji-Dong Jia Lai Wei Zhong-Ping Duan Yu-Lan Liu En-Qiang Ling-Hu Hui Zhuang | 2019 | World Journal of Gastroenterology2019，25，36： | 20 |
| 12 | Current pathogenetic aspects of hepatic encephalopathy and noncirrhotic hyperammonemic encephalopathy显示文摘Hepatic encephalopathy is a medical phenomenon that is described as a neuropsychiatric manifestation of chronic or acute liver disease that is characterized by psychomotor,intellectual and cognitive abnormalities with emotional/affective and behavioral disturbances.This article focuses on the underlying mechanisms of the condition and the differences between hepatic encephalopathy and noncirrhotic hyperammonemic encephalopathy.Hepatic encephalopathy is a serious condition that can cause neurological death with brain edema and intracranial hypertension.It is assumed that approximately 60%-80% of patients with liver cirrhosis develop hepatic encephalopathy This review explores the complex mechanisms that lead to hepatic encephalopathy.However,noncirrhotic hyperammonemic encephalopathy is not associated with hepatic diseases and has a completely different etiology.Noncirrhotic hyperammonemic encephalopathy is a severe occurrence that is connected with multiple pathogeneses. | Halina Cichoz-Lach Agata Michalak | 2013 | World Journal of Gastroenterology2013，19，1： | 19 |
| 13 | 单唾液酸四己糖神经节苷脂钠对新生儿缺氧缺血性脑病疗效的探讨显示文摘新生儿缺氧缺血性脑病(hypoxic ischemic encephalopathy,HIE)是指围生期各种原因引起的缺氧和脑血流量减少或暂停而导致的新生儿脑损伤。据报道,19%新生儿的死亡可归因于新生儿窒息,即使存活下来的HIE患儿中,其高致残率亦给家庭以及社会带来较为沉重的负担。由于轻度新生儿HIE预后良好,重度患儿神经系统损伤已经难以逆转,其致死率和致残率均相当高,治疗意义较小。 | 郭俊珍 | 2016 | 山西医药杂志2016，45，8： | 18 |
| 14 | Inflammation:A novel target of current therapies for hepatic encephalopathy in liver cirrhosis显示文摘Hepatic encephalopathy(HE) is a severe neuropsychiatric syndrome that most commonly occurs in decompensated liver cirrhosis and incorporates a spectrumof manifestations that ranges from mild cognitive impairment to coma. Although the etiology of HE is not completely understood, it is believed that multiple underlying mechanisms are involved in the pathogenesis of HE, and one of the main factors is thought to be ammonia; however, the ammonia hypothesis in the pathogenesis of HE is incomplete. Recently, it has been increasingly demonstrated that inflammation, including systemic inflammation, neuroinflammation and endotoxemia, acts in concert with ammonia in the pathogenesis of HE in cirrhotic patients. Meanwhile, a good number of studies have found that current therapies for HE, such as lactulose, rifaximin, probiotics and the molecular adsorbent recirculating system, could inhibit different types of inflammation, thereby improving the neuropsychiatric manifestations and preventing the progression of HE in cirrhotic patients. The antiinflammatory effects of these current therapies provide a novel therapeutic approach for cirrhotic patients with HE. The purpose of this review is to describe the inflammatory mechanisms behind the etiology of HE in cirrhosis and discuss the current therapies that target the inflammatory pathogenesis of HE. | Ming Luo Jian-Yang Guo Wu-Kui Cao | 2015 | World Journal of Gastroenterology2015，21，41： | 17 |
| 15 | 强化认知训练对一氧化碳中毒迟发性脑病患者认知功能及日常生活活动能力影响的疗效观察显示文摘一氧化碳中毒除可造成急性中毒性脑损伤外,部分患者经过数日或数周的假愈期后,还会发生一氧化碳中毒迟发性脑病(delayed encephalopathy af-ter carbon monoxide poisoning,DEACMP),临床表现为以急性痴呆及锥体外系表现为主的精神神经功能紊乱。 | 高亚南 张颗颗 张晓强 许永利 陈雪丽 | 2017 | 北京医学2017，39，10： | 16 |
| 16 | Short and long term prognosis in perinatal asphyxia: An update显示文摘Interruption of blood flow and gas exchange to the fetus in the perinatal period, known as perinatal asphyxia, can, if significant, trigger a cascade of neuronal injury, leading on to neonatal encephalopathy(NE) and resultant long-term damage. While the majority of infants who are exposed to perinatal hypoxia-ischaemia will recover quickly and go on to have a completely normal survival, a proportion will suffer from an evolving clinical encephalopathy termed hypoxic-ischaemic encephalopathy(HIE) or NE if the diagnosis is unclear. Resultant complications of HIE/NE are wide-ranging and may affect the motor, sensory, cognitive and behavioural outcome of the child. The advent of therapeutic hypothermia as a neuroprotective treatment for those with moderate and severe encephalopathy has improved prognosis. Outcome prediction in these infants has changed, but is more important than ever, as hypothermia is a time sensitive intervention, with a very narrow therapeutic window. To identify those who will benefit from current and emerging neuroprotective therapies we must be able to establish the severity of their injury soon after birth. Currently available indicators such as blood biochemistry, clinical examination and electrophysiology are limited. Emerging biological and physiological markers have the potential to improve our ability to select those infants who will benefit most from intervention. Biomarkers identified from work in proteomics, metabolomics and transcriptomics as well as physiological markers such as heart rate variability, EEG analysis and radiological imaging when combined with neuroprotective measures have the potential to improve outcome in HIE/NE. The aim of this review is to give an overview of the literature in regards to short and longterm outcome following perinatal asphyxia, and to discuss the prediction of this outcome in the early hours after birth when intervention is most crucial; looking at both currently available tools and introducing novel markers. | Caroline E Ahearne Geraldine B Boylan Deirdre M Murray | 2016 | World Journal of Clinical Pediatrics2016，5，1： | 16 |
| 17 | Hepatic encephalopathy:An approach to its multiple pathophysiological features显示文摘Hepatic encephalopathy(HE)is a neuropsychiatric complex syndrome,ranging from subtle behavioral abnormalities to deep coma and death.Hepatic encephalopathy emerges as the major complication of acute or chronic liver failure.Multiplicity of factors are involved in its pathophysiology,such as central and neuromuscular neurotransmission disorder,alterations in sleep patterns and cognition,changes in energy metabolism leading to cell injury,an oxidative/nitrosative state and a neuroinflammatory condition.Moreover,in acute HE,a condition of imminent threat of death is present due to a deleterious astrocyte swelling.In chronic HE,changes in calcium signaling,mitochondrial membrane potential and long term potential expression,N-methyl-D-aspartate-cGMP and peripheral benzodiazepine receptors alterations,and changes in the mRNA and protein expression and redistribution in the cerebral blood flow can be observed.The main molecule indicated as responsible for all these changes in HE is ammonia.There is no doubt that ammonia,a neurotoxic molecule,triggers or at least facilitates most of these changes.Ammonia plasma levels are increased two-to three-fold in patients with mild to moderate cirrhotic HE and up to ten-fold in patients with acute liver failure. Hepatic and inter-organ trafficking of ammonia and its metabolite,glutamine(GLN),lead to hyperammonemic conditions.Removal of hepatic ammonia is a differentiated work that includes the hepatocyte,through the urea cycle,converting ammonia into GLN via glutamine synthetase.Under pathological conditions,such as liver damage or liver blood bypass,the ammonia plasma level starts to rise and the risk of HE developing is high. Knowledge of the pathophysiology of HE is rapidly expanding and identification of focally localized triggers has led the development of new possibilities for HE to be considered.This editorial will focus on issues where, to the best of our knowledge,more research is needed in order to clarify,at least partially,controversial topics. | Juan Carlos Perazzo Silvina Tallis Amalia Delfante Pablo Andrés Souto Abraham Lemberg Francisco Xavier Eizayaga Salvador Romay | 2012 | World Journal of Hepatology2012，4，3： | 16 |
| 18 | Clinical impact of microbiome in patients with decompensated cirrhosis显示文摘Cirrhosis is an increasing cause of morbidity and mortality. Recent studies are trying to clarify the role of microbiome in clinical exacerbation of patients with decompensated cirrhosis. Nowadays, it is accepted that patients with cirrhosis have altered salivary and enteric microbiome, characterized by the presence of dysbiosis. This altered microbiome along with small bowel bacterial overgrowth, through translocation across the gut, is associated with the development of decompensating complications. Studies have analyzed the correlation of certain bacterial families with the development of hepatic encephalopathy in cirrhotics. In general, stool and saliva dysbiosis with reduction of autochthonous bacteria in patients with cirrhosis incites changes in bacterial defenses and higher risk for bacterial infections, such as spontaneous bacterial peritonitis, and sepsis. Gut microbiome has even been associated with oncogenic pathways and under circumstances might promote the development of hepatocarcinogenesis. Lately, the existence of the oral-gutliver axis has been related with the development of decompensating events. This link between the liver and the oral cavity could be via the gut through impaired intestinal permeability that allows direct translocation of bacteria from the oral cavity to the systemic circulation. Overall, the contribution of the microbiome to pathogenesis becomes more pronounced with progressive disease and therefore may represent an important therapeutic target in the management of cirrhosis. | Theodora Oikonomou George V Papatheodoridis Michael Samarkos Ioannis Goulis Evangelos Cholongitas | 2018 | World Journal of Gastroenterology2018，24，34： | 16 |
| 19 | Septic encephalopathy: When cytokines interact with acetylcholine in the brain显示文摘Sepsis-associated encephalopathy(SAE) is a brain dysfunction that occurs secondary to infection in the bo characterized by alteration of consciousness, ranging from delirium to coma, seizure or focal neurological signs. S involves a number of mechanisms, including neuroinflammation, in which the interaction between cytokines a acetylcholine results in neuronal loss and alterations in cholinergic signaling. Moreover, the interaction also occurs the periphery, accelerating a type of immunosuppressive state. Although its diagnosis is not specific in biochemis and imaging tests, it could potentiate severe outcomes, including increased mortality, cognitive decline, progress immunosuppression, cholinergic anti-inflammatory deficiency, and even metabolic and hydroelectrolyte imbalan Therefore, the bilateral communication between SAE and the multiple peripheral organs and especially the immu system should be emphasized in sepsis management. | Qing-Hong Zhang Zhi-Yong Sheng Yong-Ming Yao | 2014 | Journal of Medical Colleges of PLA(China)2014，29，2： | 16 |
| 20 | Cirrhosis and its complications:Evidence based treatment显示文摘Cirrhosis results from progressive fibrosis and is the final outcome of all chronic liver disease.It is among the ten leading causes of death in United States.Cirrhosis can result in portal hypertension and/or hepatic dysfunction.Both of these either alone or in combination can lead to many complications,including ascites,varices,hepatic encephalopathy,hepatocellular carcinoma,hepatopulmonary syndrome,and coagulation disorders.Cirrhosis and its complications not only impair quality of life but also decrease survival.Managing patients with cirrhosis can be a challenge and requires an organized and systematic approach.Increasing physicians’knowledge about prevention and treatment of these potential complications is important to improve patient outcomes.A literature search of the published data was performed to provide a comprehensive review regarding the management of cirrhosis and its complications. | Salman Nusrat Muhammad S Khan Javid Fazili Mohammad F Madhoun | 2014 | World Journal of Gastroenterology2014，20，18： | 14 |
您所在的机构暂未开通此部分的功能，请联系管理员