BACKGROUND In patients with liver failure(LF),the high rate of secondary infections,which are associated with poor prognosis,highlights the clinical significance of understanding the underlying risk factors and implem...BACKGROUND In patients with liver failure(LF),the high rate of secondary infections,which are associated with poor prognosis,highlights the clinical significance of understanding the underlying risk factors and implementing targeted intervention programs.AIM To investigate risk factors for secondary infections in patients with LF and evaluate the effectiveness of comprehensive nursing interventions.METHODS This retrospective study included 64 patients with LF,including 32 with and 32 without secondary infections.A questionnaire was used to collect data on age;laboratory parameters,including total and direct bilirubin,prothrombin time,blood ammonia,and other biochemical parameters;invasive procedures;and complications.Patients with secondary infections received comprehensive nursing intervention in addition to routine nursing care,whereas those without secondary infections received only routine nursing care to compare the effect of nursing intervention on outcomes.RESULTS The infection rate,which was not associated with age or complications,was significantly associated with biochemical parameters and invasive procedures(P<0.05).The infection rate was 61.6%in patients who had undergone invasive procedures and 32.1%in those who had not undergone invasive procedures during the hospital stay.The infection rate was also significantly associated with the type of LF(P<0.05),with the lowest rate observed in patients with acute LF and the highest rate observed in those with subacute LF.The nursing satisfaction rate was 58.3%in the uninfected group and 91.7%in the infected group,indicating significantly higher satisfaction in the infected group(P<0.05).CONCLUSION In patients with LF,the rate of secondary infections was high and associated with biochemical parameters and type of LF.Comprehensive nursing intervention can improve patient satisfaction.展开更多
Drug use during pregnancy is not common.Drug-induced liver injury(DILI)is a potential complication that is rare but can adversely affect both the mother and the fetus.Although many drugs can directly cause hepatotoxic...Drug use during pregnancy is not common.Drug-induced liver injury(DILI)is a potential complication that is rare but can adversely affect both the mother and the fetus.Although many drugs can directly cause hepatotoxicity,idiosyncratic liver injury is common in pregnancy.Underreporting of adverse drug reactions,lack of adequate literature regarding drug safety in pregnancy,and the inherent difficulty in diagnosing DILI during pregnancy make the management of this condition challenging.This review attempts to describe the existing literature regarding DILI in pregnancy,which is mainly in the form of case reports;several studies have looked at the safety of antithyroid drugs,antiretroviral drugs,and paracetamol,which have an indication for use in pregnancy;the relevant data from these studies with regard to DILI has been presented.In addition,the review describes the diagnosis of DILI,grading the disease severity,assessment of causality linking the drug to the adverse event,regulatory guidelines for evaluating the potential of drugs to cause liver injury,efforts to ensure better participation of women in clinical trials and studies in pregnant women population in particular,and the challenges involved in generating adequate research evidence.The establishment of DILI registries in various countries is an encouraging development;however,there is a need for promoting active,spontaneous reporting of adverse events during pregnancy to ensure rapid generation of evidence regarding the safety of a drug in pregnant women.展开更多
Non-steroidal anti-inflammatory drugs (NSAIDs) constitute a family of drugs, which taken as a group, represents one of the most frequently prescribed around the world. Thus, not surprisingly NSAIDs, along with antiinf...Non-steroidal anti-inflammatory drugs (NSAIDs) constitute a family of drugs, which taken as a group, represents one of the most frequently prescribed around the world. Thus, not surprisingly NSAIDs, along with antiinfectious agents, list on the top for causes of DrugInduced Liver Injury (DILI). The incidence of liver disease induced by NSAIDs reported in clinical studies is fairly uniform ranging from 0.29/100 000 [95% confidence interval (CI): 0.17-051] to 9/100 000 (95% CI: 6-15). However, compared with these results, a higher risk of liver-related hospitalizations was reported (3-23 per 100 000 patients). NSAIDs exhibit a broad spectrum of liver damage ranging from asymptomatic, transient, hyper-transaminasemia to fulminant hepatic failure. However, under-reporting of asymptomatic, mild cases, as well as of those with transient liver-tests alteration, in conjunction with reports non-compliant with pharmacovigilance criteria to ascertain DILI and flawed epidemiological studies, jeopardize the chance to ascertain the actual risk of NSAIDs hepatotoxicity. Several NSAIDs, namely bromfenac, ibufenac and benoxaprofen, have been withdrawn from the market due to hepatotoxicity; others like nimesulide were never marketed in some countries and withdrawn in others. Indeed, the contro-versy concerning the actual risk of severe liver disease persists within NSAIDs research. The present work intends (1) to provide a critical analysis of the dissimilar results currently available in the literature concerning the epidemiology of NSAIDS hepatotoxicity; and (2) to review the risk of hepatotoxicity for each one of the most commonly employed compounds of the NSAIDs family, based on past and recently published data.展开更多
Background:To observe the clinical effect of Qingre Quzhuo capsule in the treatment of non-alcoholic fatty liver disease.Methods:90 patients with non-alcoholic fatty liver disease in our hospital from January 2021 to ...Background:To observe the clinical effect of Qingre Quzhuo capsule in the treatment of non-alcoholic fatty liver disease.Methods:90 patients with non-alcoholic fatty liver disease in our hospital from January 2021 to January 2022 were randomly divided into observation group and control group,45 cases in each group.All patients received routine lifestyle intervention and the control group received oral polyene phosphatidylcholine capsules 2 capsules/time(456 mg),three times daily;45 cases in the observation group were given Qingre Quzhuo capsule(Jiyao Z2017040,0.5 g/grain)2.5 g/time,3 times/day,for 12 weeks.The clinical efficacy,liver function,liver transient elastography controlled attenuation index value,lipid metabolism,oxidation and antioxidant indexes were compared between the two groups after treatment.Results:The observation indexes of the two groups after treatment were better than those before treatment(P<0.05).After treatment,the total effective rate of the observation group was higher than that of the control group.Lipid metabolism indexes and oxidation indexes were lower than those in the control group.All antioxidant indexes were higher than control group.The decrease of liver transient elastography controlled attenuation index value was better than that of the control group and the difference was statistically significant(P<0.05).There was no significant difference in the decrease of alanine aminotransferase between the observation group and the control group after treatment.The decrease of r-glutamyltransferase was statistically significant(P<0.05).Conclusion:Qingre Quzhuo capsule in the treatment of non-alcoholic fatty liver disease can improve liver function,regulate lipid metabolism indexes of patients,improve the antioxidant capacity of liver cells and improve the controlled attenuation index value of liver transient elastography.In addition,it is superior to polyene phosphatidylcholine in regulating lipid metabolism,antioxidant capacity and controlled attenuation index value of patients with non-alcoholic fatty liver disease which is safe and worthy of promotion.展开更多
文摘BACKGROUND In patients with liver failure(LF),the high rate of secondary infections,which are associated with poor prognosis,highlights the clinical significance of understanding the underlying risk factors and implementing targeted intervention programs.AIM To investigate risk factors for secondary infections in patients with LF and evaluate the effectiveness of comprehensive nursing interventions.METHODS This retrospective study included 64 patients with LF,including 32 with and 32 without secondary infections.A questionnaire was used to collect data on age;laboratory parameters,including total and direct bilirubin,prothrombin time,blood ammonia,and other biochemical parameters;invasive procedures;and complications.Patients with secondary infections received comprehensive nursing intervention in addition to routine nursing care,whereas those without secondary infections received only routine nursing care to compare the effect of nursing intervention on outcomes.RESULTS The infection rate,which was not associated with age or complications,was significantly associated with biochemical parameters and invasive procedures(P<0.05).The infection rate was 61.6%in patients who had undergone invasive procedures and 32.1%in those who had not undergone invasive procedures during the hospital stay.The infection rate was also significantly associated with the type of LF(P<0.05),with the lowest rate observed in patients with acute LF and the highest rate observed in those with subacute LF.The nursing satisfaction rate was 58.3%in the uninfected group and 91.7%in the infected group,indicating significantly higher satisfaction in the infected group(P<0.05).CONCLUSION In patients with LF,the rate of secondary infections was high and associated with biochemical parameters and type of LF.Comprehensive nursing intervention can improve patient satisfaction.
文摘Drug use during pregnancy is not common.Drug-induced liver injury(DILI)is a potential complication that is rare but can adversely affect both the mother and the fetus.Although many drugs can directly cause hepatotoxicity,idiosyncratic liver injury is common in pregnancy.Underreporting of adverse drug reactions,lack of adequate literature regarding drug safety in pregnancy,and the inherent difficulty in diagnosing DILI during pregnancy make the management of this condition challenging.This review attempts to describe the existing literature regarding DILI in pregnancy,which is mainly in the form of case reports;several studies have looked at the safety of antithyroid drugs,antiretroviral drugs,and paracetamol,which have an indication for use in pregnancy;the relevant data from these studies with regard to DILI has been presented.In addition,the review describes the diagnosis of DILI,grading the disease severity,assessment of causality linking the drug to the adverse event,regulatory guidelines for evaluating the potential of drugs to cause liver injury,efforts to ensure better participation of women in clinical trials and studies in pregnant women population in particular,and the challenges involved in generating adequate research evidence.The establishment of DILI registries in various countries is an encouraging development;however,there is a need for promoting active,spontaneous reporting of adverse events during pregnancy to ensure rapid generation of evidence regarding the safety of a drug in pregnant women.
文摘Non-steroidal anti-inflammatory drugs (NSAIDs) constitute a family of drugs, which taken as a group, represents one of the most frequently prescribed around the world. Thus, not surprisingly NSAIDs, along with antiinfectious agents, list on the top for causes of DrugInduced Liver Injury (DILI). The incidence of liver disease induced by NSAIDs reported in clinical studies is fairly uniform ranging from 0.29/100 000 [95% confidence interval (CI): 0.17-051] to 9/100 000 (95% CI: 6-15). However, compared with these results, a higher risk of liver-related hospitalizations was reported (3-23 per 100 000 patients). NSAIDs exhibit a broad spectrum of liver damage ranging from asymptomatic, transient, hyper-transaminasemia to fulminant hepatic failure. However, under-reporting of asymptomatic, mild cases, as well as of those with transient liver-tests alteration, in conjunction with reports non-compliant with pharmacovigilance criteria to ascertain DILI and flawed epidemiological studies, jeopardize the chance to ascertain the actual risk of NSAIDs hepatotoxicity. Several NSAIDs, namely bromfenac, ibufenac and benoxaprofen, have been withdrawn from the market due to hepatotoxicity; others like nimesulide were never marketed in some countries and withdrawn in others. Indeed, the contro-versy concerning the actual risk of severe liver disease persists within NSAIDs research. The present work intends (1) to provide a critical analysis of the dissimilar results currently available in the literature concerning the epidemiology of NSAIDS hepatotoxicity; and (2) to review the risk of hepatotoxicity for each one of the most commonly employed compounds of the NSAIDs family, based on past and recently published data.
基金Project source:Hebei Provincial Planning Commission(No.20171185)Hebei Provincial Administration of Traditional Chinese Medicine(No.2018479,No.2021308)Yuan-Song Wang Heritage Studio of Famous Traditional Chinese Medicine in Hebei.
文摘Background:To observe the clinical effect of Qingre Quzhuo capsule in the treatment of non-alcoholic fatty liver disease.Methods:90 patients with non-alcoholic fatty liver disease in our hospital from January 2021 to January 2022 were randomly divided into observation group and control group,45 cases in each group.All patients received routine lifestyle intervention and the control group received oral polyene phosphatidylcholine capsules 2 capsules/time(456 mg),three times daily;45 cases in the observation group were given Qingre Quzhuo capsule(Jiyao Z2017040,0.5 g/grain)2.5 g/time,3 times/day,for 12 weeks.The clinical efficacy,liver function,liver transient elastography controlled attenuation index value,lipid metabolism,oxidation and antioxidant indexes were compared between the two groups after treatment.Results:The observation indexes of the two groups after treatment were better than those before treatment(P<0.05).After treatment,the total effective rate of the observation group was higher than that of the control group.Lipid metabolism indexes and oxidation indexes were lower than those in the control group.All antioxidant indexes were higher than control group.The decrease of liver transient elastography controlled attenuation index value was better than that of the control group and the difference was statistically significant(P<0.05).There was no significant difference in the decrease of alanine aminotransferase between the observation group and the control group after treatment.The decrease of r-glutamyltransferase was statistically significant(P<0.05).Conclusion:Qingre Quzhuo capsule in the treatment of non-alcoholic fatty liver disease can improve liver function,regulate lipid metabolism indexes of patients,improve the antioxidant capacity of liver cells and improve the controlled attenuation index value of liver transient elastography.In addition,it is superior to polyene phosphatidylcholine in regulating lipid metabolism,antioxidant capacity and controlled attenuation index value of patients with non-alcoholic fatty liver disease which is safe and worthy of promotion.
