To evaluate if any association existed between the extent of hepatic necrosis in initial liver biopsies and patient survival.METHODSThirty-seven patients with fulminant liver failure, whose liver biopsy exhibited subs...To evaluate if any association existed between the extent of hepatic necrosis in initial liver biopsies and patient survival.METHODSThirty-seven patients with fulminant liver failure, whose liver biopsy exhibited substantial necrosis, were identified and included in the study. The histological and clinical data was then analyzed in order to assess the relationship between the extent of necrosis and patient survival, with and without liver transplantation. The patients were grouped based on the etiology of hepatic necrosis. Each of the etiology groups were then further stratified according to whether or not they had received a liver transplant post-index biopsy, and whether or not the patient survived.RESULTSThe core tissue length ranged from 5 to 44 mm with an average of 23 mm. Causes of necrosis included 14 autoimmune hepatitis, 10 drug induced liver injury (DILI), 9 hepatitis virus infection, and 4 unknown origin. Among them, 11 showed submassive (26%-75% of the parenchymal volume) and 26 massive (76%-100%) necrosis. Transplant-free survival was worse in patients with a higher extent of necrosis (40%, 71.4% and 100% in groups with necrosis of 76%-100%, 51%-75% and 26%-50%, respectively). Additionally, transplant-free survival rates were 66.7%, 57.1%, and 25.0% in groups of autoimmune hepatitis, DILI, and viral hepatitis, respectively. Even after liver transplantation, the survival rate in patients as a result of viral hepatitis remained the lowest (80%, 100%, and 40% in groups of autoimmune hepatitis, DILI, and viral hepatitis, respectively).CONCLUSIONAdequate liver biopsy with more than 75% necrosis is associated with significant transplant-free mortality that is critical in predicting survival.展开更多
As disturbing as youth and gun violence is, it is not hard to reduce the mortality rate because it is preventable. The information provided in this research will help to get policies waiting to be reviewed by legislat...As disturbing as youth and gun violence is, it is not hard to reduce the mortality rate because it is preventable. The information provided in this research will help to get policies waiting to be reviewed by legislators, and any new proposal that reaches the appropriate legislative chamber, reviewed without obstacles and will help to prevent youth violence. Upon completion of this research, the study shows that rates of youth violence have decreased based on programs implemented at the state government level with a stronger juvenile justice system holding offenders accountable to ensure public safety and reduce youth violence and victimization. The study shows that community and school involvement with law enforcement and government agencies are some of the strategies needed to help reduce gun violence and rebuild communities.展开更多
Duodenal trauma is uncommon but nowadays seen more and more frequently due to the increased automobile accidents and violent events. The management of duodenal trauma can be complicated, especially when massive injury...Duodenal trauma is uncommon but nowadays seen more and more frequently due to the increased automobile accidents and violent events. The management of duodenal trauma can be complicated, especially when massive injury to the pancreatic-duodenal-biliary complex occurs simultaneously. Even the patients receive surgeries in time, multiple postoperative complications and high mortality are common. To know and manage duodenal trauma better, we searched the recent related literature in PubMed by the keywords of duodenal trauma, therapy, diagnosis and abdomen. It shows that because the diagnosis and management are complicated and the mortality is high,duodenal trauma should be treated in time and tactfully.And application of new technology can help improve the management. In this review, we discussed the incidence,diagnosis, management, and complications as well as mortality of duodenal trauma.展开更多
文摘To evaluate if any association existed between the extent of hepatic necrosis in initial liver biopsies and patient survival.METHODSThirty-seven patients with fulminant liver failure, whose liver biopsy exhibited substantial necrosis, were identified and included in the study. The histological and clinical data was then analyzed in order to assess the relationship between the extent of necrosis and patient survival, with and without liver transplantation. The patients were grouped based on the etiology of hepatic necrosis. Each of the etiology groups were then further stratified according to whether or not they had received a liver transplant post-index biopsy, and whether or not the patient survived.RESULTSThe core tissue length ranged from 5 to 44 mm with an average of 23 mm. Causes of necrosis included 14 autoimmune hepatitis, 10 drug induced liver injury (DILI), 9 hepatitis virus infection, and 4 unknown origin. Among them, 11 showed submassive (26%-75% of the parenchymal volume) and 26 massive (76%-100%) necrosis. Transplant-free survival was worse in patients with a higher extent of necrosis (40%, 71.4% and 100% in groups with necrosis of 76%-100%, 51%-75% and 26%-50%, respectively). Additionally, transplant-free survival rates were 66.7%, 57.1%, and 25.0% in groups of autoimmune hepatitis, DILI, and viral hepatitis, respectively. Even after liver transplantation, the survival rate in patients as a result of viral hepatitis remained the lowest (80%, 100%, and 40% in groups of autoimmune hepatitis, DILI, and viral hepatitis, respectively).CONCLUSIONAdequate liver biopsy with more than 75% necrosis is associated with significant transplant-free mortality that is critical in predicting survival.
文摘As disturbing as youth and gun violence is, it is not hard to reduce the mortality rate because it is preventable. The information provided in this research will help to get policies waiting to be reviewed by legislators, and any new proposal that reaches the appropriate legislative chamber, reviewed without obstacles and will help to prevent youth violence. Upon completion of this research, the study shows that rates of youth violence have decreased based on programs implemented at the state government level with a stronger juvenile justice system holding offenders accountable to ensure public safety and reduce youth violence and victimization. The study shows that community and school involvement with law enforcement and government agencies are some of the strategies needed to help reduce gun violence and rebuild communities.
基金This research was supported by the National Natural Science Foundation of China （NSFC 30973113 NSFC 81020108023） and Chongqing Science ＆ Technology Commission （CSTC2008BA5006）.
文摘Duodenal trauma is uncommon but nowadays seen more and more frequently due to the increased automobile accidents and violent events. The management of duodenal trauma can be complicated, especially when massive injury to the pancreatic-duodenal-biliary complex occurs simultaneously. Even the patients receive surgeries in time, multiple postoperative complications and high mortality are common. To know and manage duodenal trauma better, we searched the recent related literature in PubMed by the keywords of duodenal trauma, therapy, diagnosis and abdomen. It shows that because the diagnosis and management are complicated and the mortality is high,duodenal trauma should be treated in time and tactfully.And application of new technology can help improve the management. In this review, we discussed the incidence,diagnosis, management, and complications as well as mortality of duodenal trauma.
