维普中文期刊产品整合服务
1171篇 您的检索式:关键字=TRANSPLANTATION
    题名 作者 年代 出处 被引量
1Hepatocellular carcinoma: current management and recent advances显示文摘BACKGROUND: Hepatocellular carcinoma (HCC) is a major health problem worldwide. It is the fifth most common cancer in the world, and the third most common cause of cancer-related death. Without specific treatment, the prognosis is very poor. The goal of management is 'cancer control' - a reduction in its incidence and mortality as well as an improvement in the quality of life of patients with HCC and their families. This article aims to review the current management of HCC and its recent advances. DATA SOURCES: A MEDLINE database search was performed to identify relevant article using the keyworks 'hepatocellular carcinoma', 'hepatectomy', 'liver transplantation', and 'local ablative therapy'. Additional papers and book chapters were identified by a manual search of the references from the key articles. RESULTS: Liver resection and liver transplantation remain the options that give the best chance of a cure. Recent evidence suggests that local ablative therapy may offer comparable survival results in patients with small HCC, and preserved liver function. Transarterial chemoembolization (TACE) is the most promising palliative modality for unresectable HCC, but other techniques, such as transarterial radioembolization (TARE), and local ablative therapy, have also shown comparable results. CONCLUSIONS: Early diagnosis of HCC remains a key goal in improving the prognosis of patients. During the last two decades, operative mortality and surgical outcome of liver resection and liver transplantation for HCC have improved. Progress also has been made in multi-modality therapy which can increase the chance of survival and improve the quality of life for patients with advanced HCC.Wan-Yee Lau Eric C. H. Lai 2008Hepatobiliary & Pancreatic Diseases International2008,7,3:100
2Relationship between intestinal microbiota and ulcerative colitis:Mechanisms and clinical application of probiotics and fecal microbiota transplantation显示文摘Ulcerative colitis(UC) is an inflammatory disease that mainly affects the colon and rectum. It is believed that genetic factors, host immune system disorders, intestinal microbiota dysbiosis, and environmental factors contribute to the pathogenesis of UC. however, studies on the role of intestinal microbiota in the pathogenesis of UC have been inconclusive. Studies have shown that probiotics improve intestinal mucosa barrier function and immune system function and promote secretion of anti-inflammatory factors, thereby inhibiting the growth of harmful bacteria in the intestine. Fecal microbiota transplantation(FMT) can reduce bowel permeability and thus the severity of disease by increasing the production of short-chain fatty acids, especially butyrate, which help maintain the integrity of the epithelial barrier. FMT can also restore immune dysbiosis by inhibiting Th1 differentiation, activity of T cells, leukocyte adhesion, and production of inflammatory factors. Probiotics and FMT are being increasingly used to treat UC, but their use is controversial because of uncertain efficacy. Here, we briefly review the role of intestinal microbiota in thepathogenesis and treatment of UC.Zhao-hua Shen Chang-xin Zhu Yong-sheng Quan Zhen-yu Yang Shuai Wu Wei-wei Luo Bei Tan Xiao-yan Wang 2018World Journal of Gastroenterology2018,24,1:111
3Fecal microbiota transplantation for severe enterocolonic fistulizing Crohn's disease显示文摘The concept of fecal microbiota transplantation(FMT)has been used in traditional Chinese medicine at least since the 4thcentury.Evidence from recent human studies strongly supports the link between intestinal bacteria and inflammatory bowel disease.We proposed that standardized FMT might be a promising rescue therapy for refractory inflammatory bowel disease.However,there were no reports of FMT used in patients with severe Crohn’s disease(CD).Here,we report the successful treatment of standardized FMT as a rescue therapy for a case of refractory CD complicated with fistula,residual Barium sulfate and formation of intraperitoneal large inflammatory mass.As far as we know,this is the first case of severe CD treated using FMT through mid-gut.Fa-Ming Zhang Hong-Gang Wang Min Wang Bo-Ta Cui Zhi-Ning Fan Guo-Zhong Ji 2013World Journal of Gastroenterology2013,19,41:78
4Fecal microbiota transplantation broadening its application beyond intestinal disorders显示文摘Intestinal dysbiosis is now known to be a complication in a myriad of diseases.Fecal microbiota transplantation(FMT),as a microbiota-target therapy,is arguably very effective for curing Clostridium difficile infection and has good outcomes in other intestinal diseases.New insights have raised an interest in FMT for the management of extra-intestinal disorders associated with gut microbiota.This review shows that it is an exciting time in the burgeoning science of FMT application in previously unexpected areas,including metabolic diseases,neuropsychiatric disorders,autoimmune diseases,allergic disorders,and tumors.A randomized controlled trial was conducted on FMT in metabolic syndrome by infusing microbiota from lean donors or from self-collected feces,with the resultant findings showing that the lean donor feces group displayed increased insulin sensitivity,along with increased levels of butyrate-producing intestinal microbiota.Case reports of FMT have also shown favorable outcomes in Parkinson's disease,multiple sclerosis,myoclonus dystonia,chronic fatigue syndrome,and idiopathic thrombocytopenic purpura.FMT is a promising approach in the manipulation of the intestinal microbiota and has potential applications in a variety of extra-intestinal conditions associated with intestinal dysbiosis.Meng-Que Xu Hai-Long Cao Wei-Qiang Wang Shan Wang Xiao-Cang Cao Fang Yan Bang-Mao Wang 2015World Journal of Gastroenterology2015,21,1:63
5Immunomodulatory effects of mesenchymal stem cells derived from adipose tissues in a rat orthotopic liver transplantation model显示文摘BACKGROUND: Acute rejection after liver transplantation is usually treated with large doses of immunosuppressants with severe toxic and side-effects, so it is imperative to find a safe and effective method for preventing and treating rejection. This study was designed to confirm the immunomodulatory effects of rat mesenchymal stem cells (MSCs) in vitro and investigate the tolerogenic features in a rat model of allogeneic liver transplantation. METHODS: MSCs were isolated from adipose tissue of Sprague-Dawley (SD) rats and cultured. In vitro, MSCs were added into a mixed lymphocyte culture (MLC) system to study the inhibitory effects of MSCs on the proliferation of T lymphocytes in Wistar rats. By using SD and Wistar rats as liver donors and recipients, an orthotopic liver transplantation model was established and the rats were divided into a MSC-treated group and a blank control group. On postoperative day 7, all rats were sacrificed, and the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), interleukin-2 (IL-2) and interleukin-10 (IL-10) were measured. The pathological changes of liver tissue and apoptosis of hepatocytes were also assessed. RESULTS: In in vitro MLC, T lymphocyte proliferation in Wistar rats was significantly inhibited by 48.44%. In the MSC-treated group, the levels of ALT, AST, TBIL, IL-2 and IL-10 were 134.2±45.0 U/L, 162.5±30.5 U/L, 30.6± 5.4 μmol/L, 187.35±18.26 μg/L and 193.95±37.62 μg/L, and those in the blank control group were 355.6±54.3 U/L, 296.4±71.2 U/L, 145.7±28.6 μmol/L, 295.73±57.15 μg/L and 75.12±11.23 μg/L, respectively, with statistically significant differences (P<0.05). Pathological examinationrevealed that the rejection in the MSC-treated group was clearly alleviated compared with that in the blank control group. TUNEL indicated that the apoptosis of hepatocytes in the MSC-treated group was milder than that in the blank control group (P<0.05). CONCLUSION: Adipose-derived MSCs clearly inhibit recipient-derived T lymphocyte proliferation in MLC and significantly alleviate acute rejection following orthotopic liver transplantation in rats.Wan, Chi-Dan Cheng, Rui Wang, Hong-Bo Liu, Tao 2008Hepatobiliary & Pancreatic Diseases International2008,7,1:41
6Biliary complications following liver transplantation显示文摘Biliary tract complications are the most common complications after liver transplantation.These complications are encountered more commonly as a result of increased number of liver transplantations and the prolonged survival of transplant patients.Biliary complications remain a major source of morbidity in liver transplant patients,with an incidence of 5%-32%.Post liver transplantation biliary complications include strictures(anastomotic and non-anastomotic),leaks,stones,sphincter of Oddi dysfunction,and recurrence of primary biliary disease such as primary sclerosing cholangitis and primary biliary cirrhosis.The risk of occurrence of a specific biliary complication is related to the type of biliary reconstruction performed at the time of liver transplantation.In this article we seek to review the major biliary complications and their relation to the type of biliary reconstruction performed at the time of liver tranplantation.Gursimran Kochhar Jose Mari Parungao Ibrahim A Hanouneh Mansour A Parsi 2013World Journal of Gastroenterology2013,19,19:41
7Fecal microbiota transplantation as novel therapy in gastroenterology:A systematic review显示文摘AIM:To study the clinical efficacy and safety of Fecal microbiota transplantation(FMT).We systematically reviewed FMT used as clinical therapy.METHODS:We searched MEDLINE,EMBASE,the Cochrane Library and Conference proceedings from inception to July,2013.Treatment effect of FMT was calculated as the percentage of patients who achieved clinical improvement per patient category,on an intention-to-treat basis.RESULTS:We included 45 studies;34 on Clostridium difficile-infection(CDI),7 on inflammatory bowel disease,1 on metabolic syndrome,1 on constipation,1 on pouchitis and 1 on irritable bowel syndrome(IBS).In CDI 90% resolution of diarrhea in 33 case series(n = 867) was reported,and 94% resolution of diarrhea after repeated FMT in a randomized controlled trial(RCT)(n = 16).In ulcerative colitis(UC) remission rates of 0% to 68% were found(n = 106).In Crohn's disease(CD)(n = 6),no benefit was observed.In IBS,70% improvement of symptoms was found(n = 13).100% Reversal of symptoms was observed in constipation(n = 3).In pouchitis,none of the patients(n = 8) achieved remission.One RCT showed significant improvement of insulin sensitivity in metabolic syndrome(n = 10).Serious adverse events were rare.CONCLUSION:FMT is highly effective in CDI,and holds promise in UC.As for CD,chronic constipation,pouchitis and IBS data are too limited to draw conclusions.FMT increases insulin sensitivity in metabolic syndrome.Noortje G Rossen John K Mac Donald Elisabeth M de Vries Geert R D'Haens Willem M de Vos Erwin G Zoetendal Cyriel Y Ponsioen 2015World Journal of Gastroenterology2015,21,17:41
8Washed microbiota transplantation vs.manual fecal microbiota transplantation:clinical findings,animal studies and in vitro screening显示文摘Fecal microbiota transplantation(FMT)by manual preparation has been applied to treat diseases for thousands of years.However,this method still endures safety risks and challenges the psychological endurance and acceptance of doctors,patients and donors.Population evidence showed the washed microbiota preparation with microfiltration based on an automatic purification system followed by repeated centrifugation plus suspension for three times significantly reduced FMT-related adverse events.This washing preparation makes delivering a precise dose of the enriched microbiota feasible,instead of using the weight of stool.Intraperitoneal injection in mice with the fecal microbiota supernatant obtained after repeated centrifugation plus suspension for three times induced less toxic reaction than that by the first centrifugation following the microfiltration.The toxic reactions that include death,the change in the level of peripheral white blood cells,and the proliferation of germinal center in secondary lymphoid follicles in spleen were noted.The metagenomic next-generation sequencing(NGS)indicated the increasing types and amount of viruses could be washed out during the washing process.Metabolomics analysis indicated metabolites with pro-inflammatory effects in the fecal microbiota supernatant such as leukotriene B4,corticosterone,and prostaglandin G2 could be removed by repeated washing.Near-infrared absorption spectroscopy could be served as a rapid detection method to control the quality of the washingprocess.In conclusion,this study for the first time provides evidence linking clinical findings and animal experiments to support that washed microbiota transplantation(WMT)is safer,more precise and more quality-controllable than the crude FMT by manual.Ting Zhang Gaochen Lu Zhe Zhao Yafei Liu Quan Shen Pan Li Yaoyao Chen Haoran Yin Huiquan Wang Cicilia Marcella Bota Cui Lei Cheng Guozhong Ji Faming Zhang 2020Protein & Cell2020,11,4:44
9Treatment options for alcoholic and non-alcoholic fatty liver disease: A review显示文摘Alcoholic liver disease(ALD)and non-alcoholic fatty liver disease(NAFLD)are serious health problems worldwide.These two diseases have similar pathological spectra,ranging from simple steatosis to hepatitis to cirrhosis and hepatocellular carcinoma.Although most people with excessive alcohol or calorie intake display abnormal fat accumulation in the liver(simple steatosis),a small percentage develops progressive liver disease.Despite extensive research on understanding the pathophysiology of both these diseases there are still no targeted therapies available.The treatment for ALD remains as it was 50 years ago:abstinence,nutritional support and corticosteroids(or pentoxifylline as an alternative if steroids are contraindicated).As for NAFLD,the treatment modality is mainly directed toward weight loss and co-morbidity management.Therefore,new pathophysiology directed therapies are urgently needed.However,the involvement of several inter-related pathways in the pathogenesis of these diseases suggests that a single therapeutic agent is unlikely to be an effective treatment strategy.Hence,a combination therapy towards multiple targets would eventually be required.In this review,we delineate the treatment options in ALD and NAFLD,including various new targeted therapies that are currently under investigation.We hope that soon we will be having an effective multi-therapeutic regimen for each disease.Sukhpreet Singh Natalia A Osna Kusum K Kharbanda 2017World Journal of Gastroenterology2017,23,36:45
10Blood loss,predictors of bleeding,transfusion practice and strategies of blood cell salvaging during liver transplantation显示文摘Blood loss during liver transplantation (OLTx) is a common consequence of pre-existing abnormalities of the hemostatic system,portal hypertension with multiple collateral vessels,portal vein thrombosis,previous abdominal surgery,splenomegaly,and poor 'functional' recovery of the new liver.The intrinsic coagulopathic features of end stage cirrhosis along with surgical technical difficulties make transfusion-free liver transplantation a major challenge,and,despite the improvements in understanding of intraoperative coagulation profiles and strategies to control blood loss,the requirements for blood or blood products remains high.The impact of blood transfusion has been shown to be significant and independent of other well-known predictors of posttransplant-outcome.Negative effects on immunomodulation and an increased risk of postoperative complications and mortality have been repeatedly demonstrated.Isovolemic hemodilution,the extensive utilization of thromboelastogram and the use of autotransfusion devices are among the commonly adopted procedures to limit the amount of blood transfusion.The use of intraoperative blood salvage and autologous blood transfusion should still be considered an important method to reduce the need for allogenic blood and the associated complications.In this article we report on the common preoperative and intraoperative factors contributing to blood loss,intraoperative transfusion practices,anesthesiologic and surgical strategies to prevent blood loss,and on intraoperative blood salvaging techniques and autologous blood transfusion.Even though the advances in surgical technique and anesthetic management,as well as a better understanding of the risk factors,have resulted in a steady decrease in intraoperative bleeding,most patients still bleed extensively.Blood transfusion therapy is still a critical feature during OLTx and various studies have shown a large variability in the use of blood products among different centers and even among individual anesthesiologists within the same center.Unfortunately,despite the large number of OLTx performed each year,there is still paucity of large randomized,multicentre,and controlled studies which indicate how to prevent bleeding,the transfusion needs and thresholds,and the 'evidence based' perioperative strategies to reduce the amount of transfusion.Feltracco Paolo Brezzi Marialuisa Barbieri Stefania Galligioni Helmut Milevoj Moira Carollo Cristiana Ori Carlo 2013World Journal of Hepatology2013,5,1:37
11Changes of gut bacteria and immune parameters in liver transplant recipients显示文摘BACKGROUND: Liver transplantation is one of the most effective therapeutic options for patients with end-stage liver diseases, and gut microbiota is actively involved in potential infections in pretransplant and posttransplant patients. However, the diversity of gut microbiota and its relationship with the immune parameter of liver transplantation recipients are not well understood. METHODS: We collected fresh feces and blood samples from 190 participants in China from November 2004 to May 2008, including 28 healthy volunteers, 51 cirrhotic patients and 111 liver-transplanted patients. Six interesting gut bacteria, plasma endotoxin, serum cytokines (i.e., tumor necrosis factor alpha and interleukin-6) and fecal secretory IgA (SIgA) were investigated by real-time quantitative PCR, chromogenic limulus amoebocyte assay, sandwich-type enzyme-linked immunosorbent assay and radioimmunoassay, respectively. RESULTS: All Eubacteria, Bifidobacterium spp., Faecalibacterium prausnitzii and Lactobacillus spp. were significantly lower in the liver transplantation recipients while Enterobacteriaceae and Enterococcus spp. were significantly higher (P<0.05). Except for Enterococcus spp., other bacteria showed a tendency to restore to normal level along with the time after liver transplantation. Plasma endotoxin, interleukin-6 and fecal SIgA in cirrhotic patients increased significantly, but not in liver transplantation recipients. Plasma endotoxin and interleukin-6 were negatively correlated with all Eubacteria and the Bacteroides-Prevotella group, while tumor necrosis factor alpha was not significantly correlated with these six gut bacteria in cirrhotic patients.CONCLUSIONS: Our study demonstrates that abundant gut bacteria were altered significantly in both cirrhotic and liver transplantation patients, while plasma endotoxin and interleukin-6 increased remarkably in cirrhotic patients, showing significant correlations with gut microbiota. Interestingly, our data show a tendency for these gut bacteria to restore to normal levels in liver transplantation recipients.Zhong-Wen Wu, Zong-Xin Ling, Hai-Feng Lu, Jian Zuo, Ji-Fang Sheng, Shu-Sen Zheng and Lan-Juan Li State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases Key Lab of Combined Multiorgan Transplantation, Ministry of Public Health, Key Lab of Organ Transplantation and Department of Hepatobiliary and Pancreatic Surgery , First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China 2012Hepatobiliary & Pancreatic Diseases International2012,11,1:37
12Antiviral therapy for hepatitis B virus associated hepatic failure显示文摘BACKGROUND:Chronic hepatitis B virus(HBV)infection remains a major global health issue,and the prognosis of patients with HBV-associated fulminant hepatic failure is extremely poor.The application of antiviral therapies has led to significant improvements in patient outcomes.This article aimed to review the current strategies in antiviral treatment of HBV-associated fulminant hepatic failure. DATA SOURCES:Literature search was conducted using PubMed on the related subjects.Part of the data was from the most recent work of the authors’laboratory. RESULTS:Hepatitis B immunoglobulin in prevention of recurrent HBV infection after orthotopic liver transplantation(OLT)has been proven effective.However, its cost is high,and significant side effects have been found to induce viral mutations.Lamivudine has a potent suppression for HBV replication and an excellent safety profile in decompensated cirrhotic patients,but its major drawback is the high rate of drug-resistance.Adefovir is effective for lamivudine-resistance strains in the post- OLT situation,and its drug-resistance rate is relatively low. Combination therapies such as hepatitis B immunoglobulin combined with lamivudine and lamivudine combined with adefovir have been widely adopted for prophylaxis against HBV recurrence of infection after OLT.Entecavir, telbivudine,tenofovir and other newer agents have been widely used in antiviral therapy. CONCLUSIONS:The prognosis of HBV-associated ful- minant hepatic failure is being transformed by developments in antiviral therapy.However,it should be noticed that HBV is controlled but never eliminated,and drug-resistance still remains a major issue.Hopefully,newer strategies may help to solve these problems.Wang, Yu-Ming Tang, Ying-Zi 2009Hepatobiliary & Pancreatic Diseases International2009,8,1:36
13Bacterial infection after liver transplantation显示文摘Infectious complications are major causes of morbidity and mortality after liver transplantation,despite recent advances in the transplant field.Bacteria,fungi,viruses and parasites can cause infection before and after transplantation.Among them,bacterial infections are predominant during the first two months posttransplantation and affect patient and graft survival.They might cause surgical site infections,including deep intra-abdominal infections,bacteremia,pneumonia,catheter-related infections and urinary tract infections.The risk factors for bacterial infections differ between the periods after transplant,and between centers.Recently,the emergence of multi-drug resistant bacteria is great concern in liver transplant(LT)patients.The instructive data about effects of infections with extended-spectrum beta lactamase producing bacteria,carbapenem-resistant gram-negative bacteria,and glycopeptide-resistant gram-positive bacteria were reported on a center-by-center basis.To prevent posttransplant bacterial infections,proper strategies need to be established based upon center-specific data and evidence from well-controlled studies.This article reviewed the recent epidemiological data,risk factors for each type of infections and important clinical issues in bacterial infection after LT.Sang Il Kim 2014World Journal of Gastroenterology2014,20,20:38
14Early respiratory complications after liver transplantation显示文摘The poor clinical conditions associated with end-stage cirrhosis,pre-existing pulmonary abnormalities,and high comorbidity rates in patients with high Model for End-Stage Liver Disease scores are all well-recognized factors that increase the risk of pulmonary complications after orthotopic liver transplantation(OLT)surgery.Many intraoperative and postoperative events,such as fluid overload,massive transfusion of blood products,hemodynamic instability,unexpected coagulation abnormalities,renal dysfunction,and serious adverse effects of reperfusion syndrome,are other factors that predispose an individual to postoperative respiratory disorders.Despite advances in surgical techniques and anesthesiological management,the lung may still suffer throughout the perioperative period from various types of injury and ventilatory impairment,with different clinical outcomes.Pulmonary complications after OLT can be classified as infectious or non-infectious.Pleural effusion,atelectasis,pulmonary edema,respiratory distress syndrome,and pneumonia may contribute considerably to early morbidity and mortality in liver transplant patients.It is of paramount importance to accurately identify lung disorders because infectious pulmonary complications warrant speedy and aggressive treatment to prevent diffuse lung injury and the risk of evolution into multisystem organ failure.This review discusses the most common perioperative factors that predispose an individual to postoperative pulmonary complications and these complications’early clinical manifestations after OLT and influence on patient outcome.Paolo Feltracco Cristiana Carollo Stefania Barbieri Tommaso Pettenuzzo Carlo Ori 2013World Journal of Gastroenterology2013,19,48:32
15Liver transplantation for hepatocellular carcinoma beyond the Milan criteria: A review显示文摘Liver transplantation(LT) has been accepted as an effective therapy for hepatocellular carcinoma(HCC). The Milan criteria(MC) are widely used across the world to select LT candidates in HCC patients. However, the MC may be too strict because a substantial subset of patients who have HCC exceed the MC and who would benefit from LT may be unnecessarily excluded from the waiting list. In recent years, many extended criteria beyond the MC were raised, which were proved to be able to yield similar outcomes compared with those patients meeting the MC. Because the simple use of tumor size and number was insufficient to indicate HCC biological features and to predict the risk of tumor recurrence, some biological markers such as Alphafetoprotein, Des-Gamma-carboxy prothrombin and the neutrophil-to-lymphocyte ratio were useful in selecting LT candidates in HCC patients beyond the MC. For patients with advanced HCC, downstaging therapy is an effective way to reduce the tumor stage to fulfill the MC by using liver-directed therapy such as transarterial chemoembolization, radiofrequency ablation and percutaneous ethanol injection. This article reviews the recent advances in LT for HCC beyond the MC.Dong-Wei Xu Ping Wan Qiang Xia 2016World Journal of Gastroenterology2016,22,12:31
16Targeted migration of mesenchymal stem cells modified with CXCR4 to acute failing liver improves liver regeneration显示文摘AIM:To improve the colonization rate of transplanted mesenchymal stem cells(MSCs)in the liver and effect of MSC transplantation for acute liver failure(ALF).METHODS:MSC was modified with the chemokine CXC receptor 4(CXCR4)gene(CXCR4-MSC)or not(Null-MSC)through lentiviral transduction.The characteristics of CXCR4-MSCs and Null-MSCs were determined by real-time quantitative polymerase chain reaction,Western blotting and flow cytometry.CXCR4-MSCs and Null-MSCs were infused intravenously 24 h after administration of CCl4 in nude mice.The distribution of the MSCs,survival rates,liver function,hepatocyte regeneration and growth factors of the recipient micewere analyzed.RESULTS:In vitro,CXCR4-MSCs showed better migration capability toward stromal cell-derived factor-1αand a protective effect against thioacetamide in hepatocytes.In vivo imaging showed that CXCR4-MSCs migrated to the liver in larger numbers than Null-MSCs1 and 5 d after ALF.Higher colonization led to a longer lifetime and better liver function.Either CXCR4-MSCs or Null-MSCs exhibited a paracrine effect through secreting hepatocyte growth factor and vascular endothelial growth factor.Immunohistochemical analysis of Ki-67showed increased cell proliferation in the damaged liver of CXCR4-MSC-treated animals.CONCLUSION:Genetically modified MSCs expressing CXCR4 showed greater colonization and conferred better functional recovery in damaged liver.Hu-Cheng Ma Xiao-Lei Shi Hao-Zhen Ren Xian-Wen Yuan Yi-Tao Ding 2014World Journal of Gastroenterology2014,20,40:29
17Hepatocellular carcinoma: From diagnosis to treatment显示文摘Hepatocellular carcinoma(HCC) is the sixth most prevalent malignancy worldwide and is a rising cause of cancer related mortality. Risk factors for HCC are well documented and effective surveillance and early diagnosis allow for curative therapies. The majority of HCC appears to be caused by cirrhosis from chronic hepatitis B and hepatitis C virus. Preventive strategies include vaccination programs and anti-viral treatments.Surveillance with ultrasonography detects early stage disease and improves survival rates. Many treatment options exist for individuals with HCC and are determined by stage of presentation. Liver transplantation is offered to patients who are within the Milan criteria and are not candidates for hepatic resection. In patients with advanced stage disease, sorafenib shows some survival benefit.Abhijeet Waghray Arvind R Murali KV Narayanan Menon 2015World Journal of Hepatology2015,7,8:27
18Surgical strategy for bile duct cancer:Advances and current limitations显示文摘The aim of this review is to describe recent advances and topics in the surgical management of bile duct cancer.Radical resection with a microscopically negative margin(R0)is the only way to cure cholangiocarcinoma and is associated with marked survival advantages compared to margin-positive resections.Complete resection of the tumor is the surgeon’s ultimate aim,and several advances in the surgical treatment for bile duct cancer have been made within the last two decades.Multidetector row computed tomography has emerged as an indispensable diagnostic modality for the precise preoperative evaluation of bile duct cancer,in terms of both longitudinal and vertical tumor invasion.Many meticulous operative procedures have been established,especially extended hepatectomy for hilar cholangiocarcinoma,to achieve a negative resection margin,which is the only prognostic factor under the control of the surgeon.A complete caudate lobectomy and resection of the inferior part of Couinaud’s segmentⅣcoupled with right or left hemihepatectomy has become the standard surgical procedure for hilar cholangiocarcinoma,and pyloruspreserving pancreaticoduodenectomy is the first choice for distal bile duct cancer.Limited resection for middle bile duct cancer is indicated for only strictly selected cases.Preoperative treatments including biliary drainage and portal vein embolization are also indicated for only selected patients,especially jaundiced patients anticipating major hepatectomy.Liver transplantation seems ideal for complete resection of bile duct cancer,but the high recurrence rate and decreased patient survival after liver transplant preclude it from being considered standard treatment.Adjuvant chemotherapy and radiotherapy have a potentially crucial role in prolonging survival and controlling local recurrence,but no definite regimen has been established to date.Further evidence is needed to fully define the role of liver transplantation and adjuvant chemo-radiotherapy.Nobuhisa Akamatsu Yasuhiko Sugawara Daijo Hashimoto 2011World Journal of Clinical Oncology2011,2,2:27
19Mesenchymal stem cells alleviate TNBS-induced colitis by modulating inflammatory and autoimmune responses显示文摘AIM: To investigate the potential therapeutic effects of mesenchymal stem cells (MSCs) in inflammatory bowel disease (IBD), we transplanted MSCs into an experimental model of IBD. METHODS: A rectal enema of trinitrobenzene sulfonic acid (TNBS) (100 mg/kg body weight) was administered to female BALB/c mice. Bone marrow mesenchymal stem cells (BMSCs) were derived from male green fluorescent protein (GFP) transgenic mice and were transplanted intravenously into the experimental animals after disease onset. Clinical activity scores and histological changes were evaluated. GFP and Sex determining region Y gene (SRY ) expression were used for cell tracking. Ki67 positive cells and Lgr5-expressing cells were determined to measure proliferative activity. Inflammatory response was determined by mea-suring the levels of different inflammatory mediators in the colon and serum. The inflammatory cytokines included tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), interleukin-2 (IL-2), IL-6, IL-17, IL-4, IL-10, and transforming growth factor (TGF-β). Master regulators of Th1 cells (T-box expressed in T cells, T-bet), Th17 cells (retinoid related orphan receptor gamma(t), RORγt), Th2 cells (GATA family of transcription factors 3, GATA3) and regulatory T cells (forkhead box P3, Foxp3) were also determined. RESULTS: Systemic infusion of GFP-BMSCs ameliorated the clinical and histopathologic severity of colitis, including body weight loss, diarrhea and inflammation, and increased survival (P < 0.05). The cell tracking study showed that MSCs homed to the injured colon. MSCs promoted proliferation of intestinal epithelial cells and differentiation of intestinal stem cells (P < 0.01). This therapeutic effect was mainly mediated by downregulation of both Th1-Th17-driven autoimmune and inflammatory responses (IL-2, TNF-α, IFN-γ, T-bet; IL-6, IL-17, RORγt), and by up-regulation of Th2 activities (IL-4, IL-10, GATA-3) (P < 0.05). MSCs also induced activated CD4 + CD25 + Foxp3 + regulatory T cells (TGF-β, IL-10, Foxp3) with a suppressive capacity on Th1-Th17 effecter responses and promoted Th2 differentiation in vivo (P < 0.05). CONCLUSION: MSCs are key regulators of immune and inflammatory responses and may be an attractive candidate for cell-based therapy of IBD.Qian-Qian Chen Li Yan Chang-Zheng Wang Wei-Hua Wang Hui Shi Bin-Bin Su Qing-Huan Zeng Hai-Tao Du Jun Wan 2013World Journal of Gastroenterology2013,19,29:25
20Endoscopic management of biliary complications after liver transplantation: An evidence-based review显示文摘Biliary tract diseases are the most common complications following liver transplantation(LT) and usually include biliary leaks, strictures, and stone disease. Compared to deceased donor liver transplantation in adults, living donor liver transplantation is plagued by a higher rate of biliary complications. These may be promoted by multiple risk factors related to recipient, graft, operative factors and post-operative course. Magnetic resonance cholangiopancreatography is the first-choice examination when a biliary complication is suspected following LT, in order to diagnose and to plan the optimal therapy; its limitations include a low sensitivity for the detection of biliary sludge. For treating anastomotic strictures, balloon dilatation complemented with the temporary placement of multiple simultaneous plastic stents has become the standard of care and results in stricture resolution with no relapse in > 90% of cases. Temporary placement of fully covered self-expanding metal stents(FCSEMSs) has not been demonstrated to be superior(except in a pilot randomized controlled trial that used a special design of FCSEMSs), mostly because of the high migration rate of current FCSEMSs models. The endoscopic approach of non-anastomotic strictures is technically more difficult than that of anastomotic strictures due to the intrahepatic and/or hilar location of strictures, and the results are less satisfactory. For treating biliary leaks, biliary sphincterotomy and transpapillary stenting is the standard approach and results in leak resolution in more than 85% of patients. Deep enteroscopy is a rapidly evolving technique that has allowed successful treatment of patients who were not previously amenable to endoscopic therapy. As a result, the percutaneous and surgical approaches are currently required in a minority of patients.Carlos Macías-Gómez Jean-Marc Dumonceau 2015World Journal of Gastrointestinal Endoscopy2015,7,6:25
返回顶部 每页显示:
共59页 首页 上一页 第1页 下一页 末页 /59 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