AIM: To assess the role of the 13C-methacetin breath test (MBT) in patients with acute liver disease. METHODS: Fifteen patients with severe acute liver disease from diverse etiologies were followed-up with 13C-MBT dur...AIM: To assess the role of the 13C-methacetin breath test (MBT) in patients with acute liver disease. METHODS: Fifteen patients with severe acute liver disease from diverse etiologies were followed-up with 13C-MBT during the acute phase of their illnesses (range 3-116 d after treatment). Patients fasted for 8 h and ingested 75 mg of methacetin prior to the MBT. We compared results from standard clinical assessment, serum liver enzymes, synthetic function, and breath test scores. RESULTS: Thirteen patients recovered and two patients died. In patients that recovered, MBT parameters improved in parallel with improvements in lab results. Evidence of consistent improvement began on day 3 for MBT parameters and between days 7 and 9 for blood tests. Later convergence to normality occurred at an average of 9 d for MBT parameters and from 13 to 28 d for blood tests. In both patients that died, MBT parameters remained low despite fluctuating laboratory values. CONCLUSION: The 13C-MBT provides a rapid, noninvasive assessment of liver function in acute severe liver disease of diverse etiologies. The results of this pilot clinical trial suggest that the MBT may offer greater sensitivity than standard clinical tests for managing patients with severe acute liver disease.展开更多
Although a number of cases of hepatotoxicity are associated with the use of Hydroxycut weight management products, it has been alleged that their effects are primarily due to the presence of hydroxycitric acid (HCA, a...Although a number of cases of hepatotoxicity are associated with the use of Hydroxycut weight management products, it has been alleged that their effects are primarily due to the presence of hydroxycitric acid (HCA, as Super CitriMax) in the formulations. However, while these products contain up to 20 different ingredients, some do not contain HCA. Case studies reported to date have not considered in depth the literature on the numerous animal and human studies that have been conducted on the safety and effi cacy of HCA. No HCA-associated hepatotoxicity or treatment-related adverse effects have been reported in these studies, and thus it is premature to make the assumptions presented in the recent case studies regarding Hydroxycut. If it is established in well controlled studies that the use of these formulations with and/or without HCA can result in the occurrence or progression of hepatotoxicity, additional studies should be conducted to characterize the causative factor(s).展开更多
A field study was carried out on the grey disorder in fine-cured tobacco (Nicotiana tabacum L.) leaves.The results showed that low Eh and high available Fe content in the soils were responsible for the grey tobaccoand...A field study was carried out on the grey disorder in fine-cured tobacco (Nicotiana tabacum L.) leaves.The results showed that low Eh and high available Fe content in the soils were responsible for the grey tobaccoand dead roots. Grey disorder leaves produced low quality lamina, which was low in N, nicotine, reducedsugar and K contents. In this study’ soil available Mn and leaf Mn contents were in a relatively low level andshould not be an important factor in the occurrence of grey disorder in fine-cured tobacco.展开更多
Outstanding progress regarding the pathophysiology of Crohn's disease (CD) has led to the development of innovative therapeutic concepts. Numerous controlled trials have been performed in CD. This review concentra...Outstanding progress regarding the pathophysiology of Crohn's disease (CD) has led to the development of innovative therapeutic concepts. Numerous controlled trials have been performed in CD. This review concentrates on the results of randomized,placebo-controlled trials,and meta-analyses when available,that provide the highest degree of evidence. Current guidelines on the management of CD recommend a step-up approach to treatment involving the addition of more powerful therapies as the severity of disease and refractoriness to therapy increase. The advent of biological drugs has opened new therapeutic horizons for treating CD,modifying the treatment goals. However,the large majority of patients with CD will be managed through conventional therapy,even if they are a prelude to biological therapy.展开更多
Scrub typhus is an acute febrile disease caused by Orientia tsutsugamushi （0. tsutsugamushi）. We report herein the case of a woman who presented with fever and elevated serum levels of liver enzymes and who was defi...Scrub typhus is an acute febrile disease caused by Orientia tsutsugamushi （0. tsutsugamushi）. We report herein the case of a woman who presented with fever and elevated serum levels of liver enzymes and who was definitively diagnosed with scrub typhus by his- topathological examination of liver biopsy specimens, serological tests and nested polymerase chain reaction. Immunohistochemical staining using a monoclonal an- ti-O. tsutsugamushi antibody showed focally scattered positive immunoreactions in the cytoplasm of some hepatocytes. This case suggests that scrub typhus hepatitis causes mild focal inflammation due to direct liver damage without causing piecemeal necrosis or interface hepatitis. Thus, scrub typhus hepatitis differs from acute viral hepatitis secondary to liver damage due to host immune responses, which causes severe Iobular disarray with diffuse hepatocytic degeneration, necrosis and apoptosis as well as findings indicative of hepatic cholestasis, such as hepatic bile plugs or brown pigmentation of hepatocytes.展开更多
Objective： The aim of this study was to discuss HIF-la expression and vasculogenic mimicry （VM） in hepatocel- lular carcinoma （HCC） and their relationship with the clinical pathological features and clinical sign...Objective： The aim of this study was to discuss HIF-la expression and vasculogenic mimicry （VM） in hepatocel- lular carcinoma （HCC） and their relationship with the clinical pathological features and clinical significance. Methods： Two hundred and seven specimens from patients in The Affiliated Hospital of North Sichuan Medical College who received hepatic cell carcinoma resection were tested by immunohistochemistry and double staining of CD31 and PSA. Then detected the expression of HIF-la, VM, and analysed the relationship between clinical pathology. Results： The HIF-la positive rate was 71.01% and its expression was associated with liver cirrhosis, tumor size and TNM stage （P 〈 0.05）. HIF-la protein expres- sion was positively associated with the VM （y = 0.1988, P = 0.0041）. Conclusion： Hypoxia may be the reason for VM in high invasive HCC, regulating the tumor microenvironment may have great significance in inhibiting invasion and metastasis of HCC.展开更多
Introduction： The effectiveness of treatment depends on the efficacy of the therapy and the level of compliance of the patient. NF （non-specific factors） involved in treatment are all those effects that do not depe...Introduction： The effectiveness of treatment depends on the efficacy of the therapy and the level of compliance of the patient. NF （non-specific factors） involved in treatment are all those effects that do not depend on the pharmacological properties of the drug. Materials and Methods： The job lasted a year. The sample consisted of patients with mental health disorders and was divided into two groups. Treatment compliance was measured with the Morisky-Green Test. Results were compared using the chi square test and relative risk. Results and Discussion： Group A had 23 patients ending 91.3% of them and group B of 22 patients, ending the 77.27%. At the beginning of the study, we found in the group A 0.86 NF/patients while in the group B 0.82 NF/patient. At the end of the study there was a 54.65% decrease in group A while in group B the proportion remained. At the beginning of the study both groups had approximately 40% of compliant patients. Data that remained in the control group rose to 80.95% in group A at the end of the study. Conclusions： The work demonstrates the negative influence of these factors on adherence to treatment.展开更多
Hepatic encephalopathy(HE)is a reversible syndrome of impaired brain function occurring in patients with advanced liver diseases.The precise pathophysiology of HE is still under discussion;the leading hypothesis focus...Hepatic encephalopathy(HE)is a reversible syndrome of impaired brain function occurring in patients with advanced liver diseases.The precise pathophysiology of HE is still under discussion;the leading hypothesis focus on the role of neurotoxins,impaired neurotransmission due to metabolic changes in liver failure,changes in brain energy metabolism,systemic inflammatory response and alterations of the blood brain barrier.HE produces a wide spectrum of nonspecific neurological and psychiatric manifestations.Minimal HE is diagnosed by abnormal psychometric tests.Clinically overt HE includes personality changes,alterations in consciousness progressive disorientation in time and space,somnolence,stupor and,finally,coma.Except for clinical studies,no specific tests are required for diagnosis.HE is classified according to the underlying disease,the severity of manifestations,its time course and the existence of precipitating factors.Treatment of overt HE includes supportive therapies,treatment of precipitating factors,lactulose and/or rifaximin.Routine treatment for minimal HE is only recommended for selected patients.展开更多
文摘AIM: To assess the role of the 13C-methacetin breath test (MBT) in patients with acute liver disease. METHODS: Fifteen patients with severe acute liver disease from diverse etiologies were followed-up with 13C-MBT during the acute phase of their illnesses (range 3-116 d after treatment). Patients fasted for 8 h and ingested 75 mg of methacetin prior to the MBT. We compared results from standard clinical assessment, serum liver enzymes, synthetic function, and breath test scores. RESULTS: Thirteen patients recovered and two patients died. In patients that recovered, MBT parameters improved in parallel with improvements in lab results. Evidence of consistent improvement began on day 3 for MBT parameters and between days 7 and 9 for blood tests. Later convergence to normality occurred at an average of 9 d for MBT parameters and from 13 to 28 d for blood tests. In both patients that died, MBT parameters remained low despite fluctuating laboratory values. CONCLUSION: The 13C-MBT provides a rapid, noninvasive assessment of liver function in acute severe liver disease of diverse etiologies. The results of this pilot clinical trial suggest that the MBT may offer greater sensitivity than standard clinical tests for managing patients with severe acute liver disease.
文摘Although a number of cases of hepatotoxicity are associated with the use of Hydroxycut weight management products, it has been alleged that their effects are primarily due to the presence of hydroxycitric acid (HCA, as Super CitriMax) in the formulations. However, while these products contain up to 20 different ingredients, some do not contain HCA. Case studies reported to date have not considered in depth the literature on the numerous animal and human studies that have been conducted on the safety and effi cacy of HCA. No HCA-associated hepatotoxicity or treatment-related adverse effects have been reported in these studies, and thus it is premature to make the assumptions presented in the recent case studies regarding Hydroxycut. If it is established in well controlled studies that the use of these formulations with and/or without HCA can result in the occurrence or progression of hepatotoxicity, additional studies should be conducted to characterize the causative factor(s).
文摘A field study was carried out on the grey disorder in fine-cured tobacco (Nicotiana tabacum L.) leaves.The results showed that low Eh and high available Fe content in the soils were responsible for the grey tobaccoand dead roots. Grey disorder leaves produced low quality lamina, which was low in N, nicotine, reducedsugar and K contents. In this study’ soil available Mn and leaf Mn contents were in a relatively low level andshould not be an important factor in the occurrence of grey disorder in fine-cured tobacco.
文摘Outstanding progress regarding the pathophysiology of Crohn's disease (CD) has led to the development of innovative therapeutic concepts. Numerous controlled trials have been performed in CD. This review concentrates on the results of randomized,placebo-controlled trials,and meta-analyses when available,that provide the highest degree of evidence. Current guidelines on the management of CD recommend a step-up approach to treatment involving the addition of more powerful therapies as the severity of disease and refractoriness to therapy increase. The advent of biological drugs has opened new therapeutic horizons for treating CD,modifying the treatment goals. However,the large majority of patients with CD will be managed through conventional therapy,even if they are a prelude to biological therapy.
基金Supported by The Korea Science and Engineering Foundation Grant Funded by the Korean Government through the Research Center for Resistant Cells, No. R13-2003-009
文摘Scrub typhus is an acute febrile disease caused by Orientia tsutsugamushi （0. tsutsugamushi）. We report herein the case of a woman who presented with fever and elevated serum levels of liver enzymes and who was definitively diagnosed with scrub typhus by his- topathological examination of liver biopsy specimens, serological tests and nested polymerase chain reaction. Immunohistochemical staining using a monoclonal an- ti-O. tsutsugamushi antibody showed focally scattered positive immunoreactions in the cytoplasm of some hepatocytes. This case suggests that scrub typhus hepatitis causes mild focal inflammation due to direct liver damage without causing piecemeal necrosis or interface hepatitis. Thus, scrub typhus hepatitis differs from acute viral hepatitis secondary to liver damage due to host immune responses, which causes severe Iobular disarray with diffuse hepatocytic degeneration, necrosis and apoptosis as well as findings indicative of hepatic cholestasis, such as hepatic bile plugs or brown pigmentation of hepatocytes.
基金Supported by a grant from Key Breeding Project of North Sichuan Medical College(No.CBY11-A-ZP16)
文摘Objective： The aim of this study was to discuss HIF-la expression and vasculogenic mimicry （VM） in hepatocel- lular carcinoma （HCC） and their relationship with the clinical pathological features and clinical significance. Methods： Two hundred and seven specimens from patients in The Affiliated Hospital of North Sichuan Medical College who received hepatic cell carcinoma resection were tested by immunohistochemistry and double staining of CD31 and PSA. Then detected the expression of HIF-la, VM, and analysed the relationship between clinical pathology. Results： The HIF-la positive rate was 71.01% and its expression was associated with liver cirrhosis, tumor size and TNM stage （P 〈 0.05）. HIF-la protein expres- sion was positively associated with the VM （y = 0.1988, P = 0.0041）. Conclusion： Hypoxia may be the reason for VM in high invasive HCC, regulating the tumor microenvironment may have great significance in inhibiting invasion and metastasis of HCC.
文摘Introduction： The effectiveness of treatment depends on the efficacy of the therapy and the level of compliance of the patient. NF （non-specific factors） involved in treatment are all those effects that do not depend on the pharmacological properties of the drug. Materials and Methods： The job lasted a year. The sample consisted of patients with mental health disorders and was divided into two groups. Treatment compliance was measured with the Morisky-Green Test. Results were compared using the chi square test and relative risk. Results and Discussion： Group A had 23 patients ending 91.3% of them and group B of 22 patients, ending the 77.27%. At the beginning of the study, we found in the group A 0.86 NF/patients while in the group B 0.82 NF/patient. At the end of the study there was a 54.65% decrease in group A while in group B the proportion remained. At the beginning of the study both groups had approximately 40% of compliant patients. Data that remained in the control group rose to 80.95% in group A at the end of the study. Conclusions： The work demonstrates the negative influence of these factors on adherence to treatment.
文摘Hepatic encephalopathy(HE)is a reversible syndrome of impaired brain function occurring in patients with advanced liver diseases.The precise pathophysiology of HE is still under discussion;the leading hypothesis focus on the role of neurotoxins,impaired neurotransmission due to metabolic changes in liver failure,changes in brain energy metabolism,systemic inflammatory response and alterations of the blood brain barrier.HE produces a wide spectrum of nonspecific neurological and psychiatric manifestations.Minimal HE is diagnosed by abnormal psychometric tests.Clinically overt HE includes personality changes,alterations in consciousness progressive disorientation in time and space,somnolence,stupor and,finally,coma.Except for clinical studies,no specific tests are required for diagnosis.HE is classified according to the underlying disease,the severity of manifestations,its time course and the existence of precipitating factors.Treatment of overt HE includes supportive therapies,treatment of precipitating factors,lactulose and/or rifaximin.Routine treatment for minimal HE is only recommended for selected patients.
