近年来,国内外学者认为[1],胃肠功能障碍/衰竭（gastrointestinal dyfunction and failure,GIDF）是炎症反应综合征（systemic inflammatory response syndrome,SIRS）及多器官功能障碍（multiple organ dysfunction syndrome,MODS）发...近年来,国内外学者认为[1],胃肠功能障碍/衰竭（gastrointestinal dyfunction and failure,GIDF）是炎症反应综合征（systemic inflammatory response syndrome,SIRS）及多器官功能障碍（multiple organ dysfunction syndrome,MODS）发生发展的一个重要因素,是多种严重疾病和器官损伤的共同病理生理过程。而且发现,危重症患者一旦出现胃肠功能障碍,则提示病情加重或预后不良[2]。展开更多
Renal dysfunction is common in liver diseases,either as part of multiorgan involvement in acute illness or secondary to advanced liver disease.The presence of renal impairment in both groups is a poor prognostic indic...Renal dysfunction is common in liver diseases,either as part of multiorgan involvement in acute illness or secondary to advanced liver disease.The presence of renal impairment in both groups is a poor prognostic indicator.Renal failure is often multifactorial and can present as pre-renal or intrinsic renal dysfunction.Obstructive or post renal dysfunction only rarely complicates liver disease.Hepatorenal syndrome(HRS)is a unique form of renal failure associated with advanced liver disease or cirrhosis,and is characterized by functional renal impairment without significant changes in renal histology.Irrespective of the type of renal failure,renal hypoperfusion is the central pathogenetic mechanism,due either to reduced perfusion pressure or increased renal vascular resistance.Volume expansion,avoidance of precipitating factors and treatment of underlying liver disease constitute the mainstay of therapy to prevent and reverse renal impairment.Splanchnic vasoconstrictor agents,such as terlipressin,along with volume expansion,and early placement of transjugular intrahepatic portosystemic shunt(TIPS)may be effective in improving renal function in HRS.Continuous renal replacement therapy(CRRT)and molecular absorbent recirculating system(MARS)in selected patients may be life saving while awaiting liver transplantation.展开更多
To the editor We read the article entitled Cognitive impairment in heart failure patients＇ by Leto, et al. with great interest. In this review, they demonstrated pathophysiological determinants of cognitive impairmen...To the editor We read the article entitled Cognitive impairment in heart failure patients＇ by Leto, et al. with great interest. In this review, they demonstrated pathophysiological determinants of cognitive impairment in heart failure （HF） population.展开更多
Hemobilia is a rare biliary complication of liver transplantation.The predominant cause of hemobilia is iatrogenic,and it is often associated with traumatic operations,such as percutaneous liver intervention,endoscopi...Hemobilia is a rare biliary complication of liver transplantation.The predominant cause of hemobilia is iatrogenic,and it is often associated with traumatic operations,such as percutaneous liver intervention,endoscopic retrograde cholangiopancreatography,cholecystectomy,biliary tract surgery,and liver transplantation.Percutaneous transhepatic cholangiography and liver biopsy are two major causes of hemobilia in liver transplant recipients.Hemobilia may also be caused by coagulation defects.It can form intracholedochal hematomas,causing obstructive jaundice.Herein we describe a patient with an intracholedochal hematoma resulting in significant obstructive jaundice after liver transplantation for fulminant hepatic failure.Previous studies have shown that percutaneous transhepatic manipulation is a major cause of hemobilia after liver transplantation,but in our case,percutaneous transhepatic intervention was used to relieve the biliary obstruction and dissolve the biliary clot,with a good outcome.展开更多
Author＇s reply We read with great interest the letter of Yiginer, et al.regarding the influence of atrial fibrillation （AF） in the development of cognitive impairment in heart failure （HF） patients. The comment ...Author＇s reply We read with great interest the letter of Yiginer, et al.regarding the influence of atrial fibrillation （AF） in the development of cognitive impairment in heart failure （HF） patients. The comment is related to the review published in the Journal by Leto, et al. that was a systematic overview about cognition, pathophysiology of cognitive impairment in heart failure patients. In the letter, Yiginer, et al.展开更多
Peliosis hepatis is a rare pathological entity and may cause fatal hepatic hemorrhage and liver failure.Here, we present a young male patient with aplastic anemia,who had received long-term treatment with oxymetholone...Peliosis hepatis is a rare pathological entity and may cause fatal hepatic hemorrhage and liver failure.Here, we present a young male patient with aplastic anemia,who had received long-term treatment with oxymetholone.The patient suffered from sudden onset of intra-abdominal hemorrhage with profuse hemoperitoneum.The patient was treated successfully with a right hemihepatectomy and is in good health after 13 postoperative months.We suggest that peliosis hepatis be considered in patients with hepatic parenchymal hematoma,especially in patients under prolonged synthetic anabolic steroid medication.The possibility of a potentially life-threatening complication of massive intra-abdominal bleeding should also be considered.展开更多
文摘近年来,国内外学者认为[1],胃肠功能障碍/衰竭（gastrointestinal dyfunction and failure,GIDF）是炎症反应综合征（systemic inflammatory response syndrome,SIRS）及多器官功能障碍（multiple organ dysfunction syndrome,MODS）发生发展的一个重要因素,是多种严重疾病和器官损伤的共同病理生理过程。而且发现,危重症患者一旦出现胃肠功能障碍,则提示病情加重或预后不良[2]。
文摘Renal dysfunction is common in liver diseases,either as part of multiorgan involvement in acute illness or secondary to advanced liver disease.The presence of renal impairment in both groups is a poor prognostic indicator.Renal failure is often multifactorial and can present as pre-renal or intrinsic renal dysfunction.Obstructive or post renal dysfunction only rarely complicates liver disease.Hepatorenal syndrome(HRS)is a unique form of renal failure associated with advanced liver disease or cirrhosis,and is characterized by functional renal impairment without significant changes in renal histology.Irrespective of the type of renal failure,renal hypoperfusion is the central pathogenetic mechanism,due either to reduced perfusion pressure or increased renal vascular resistance.Volume expansion,avoidance of precipitating factors and treatment of underlying liver disease constitute the mainstay of therapy to prevent and reverse renal impairment.Splanchnic vasoconstrictor agents,such as terlipressin,along with volume expansion,and early placement of transjugular intrahepatic portosystemic shunt(TIPS)may be effective in improving renal function in HRS.Continuous renal replacement therapy(CRRT)and molecular absorbent recirculating system(MARS)in selected patients may be life saving while awaiting liver transplantation.
文摘To the editor We read the article entitled Cognitive impairment in heart failure patients＇ by Leto, et al. with great interest. In this review, they demonstrated pathophysiological determinants of cognitive impairment in heart failure （HF） population.
基金Supported by National Natural Science Foundation of China, No.81072029 and No.91029721Program for New Century Excellent Talents in University,Ministry of Education of China,No. NCET-09-0160
文摘Hemobilia is a rare biliary complication of liver transplantation.The predominant cause of hemobilia is iatrogenic,and it is often associated with traumatic operations,such as percutaneous liver intervention,endoscopic retrograde cholangiopancreatography,cholecystectomy,biliary tract surgery,and liver transplantation.Percutaneous transhepatic cholangiography and liver biopsy are two major causes of hemobilia in liver transplant recipients.Hemobilia may also be caused by coagulation defects.It can form intracholedochal hematomas,causing obstructive jaundice.Herein we describe a patient with an intracholedochal hematoma resulting in significant obstructive jaundice after liver transplantation for fulminant hepatic failure.Previous studies have shown that percutaneous transhepatic manipulation is a major cause of hemobilia after liver transplantation,but in our case,percutaneous transhepatic intervention was used to relieve the biliary obstruction and dissolve the biliary clot,with a good outcome.
基金This work was supported by grants from the National Natural Science FoundationQ6 of China （81273968 and 81471027）, the ministerial projects of the National Working Commission on Aging （QLB2014W002）, and the four htmdred project of 301 （YS201408）.
文摘Author＇s reply We read with great interest the letter of Yiginer, et al.regarding the influence of atrial fibrillation （AF） in the development of cognitive impairment in heart failure （HF） patients. The comment is related to the review published in the Journal by Leto, et al. that was a systematic overview about cognition, pathophysiology of cognitive impairment in heart failure patients. In the letter, Yiginer, et al.
文摘Peliosis hepatis is a rare pathological entity and may cause fatal hepatic hemorrhage and liver failure.Here, we present a young male patient with aplastic anemia,who had received long-term treatment with oxymetholone.The patient suffered from sudden onset of intra-abdominal hemorrhage with profuse hemoperitoneum.The patient was treated successfully with a right hemihepatectomy and is in good health after 13 postoperative months.We suggest that peliosis hepatis be considered in patients with hepatic parenchymal hematoma,especially in patients under prolonged synthetic anabolic steroid medication.The possibility of a potentially life-threatening complication of massive intra-abdominal bleeding should also be considered.
