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Novel methionyl-tRNA synthetase gene variants/phenotypes in interstitial lung and liver disease: A case report and review of literature 被引量:4
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作者 Kuerbanjiang Abuduxikuer Jia-Yan Feng +3 位作者 Yi Lu Xin-Bao Xie Lian Chen Jian-She Wang 《World Journal of Gastroenterology》 SCIE CAS 2018年第36期4208-4216,共9页
Interstitial lung and liver disease(ILLD) is caused by biallelic mutations in the methionyl-tRNA synthetase(MARS) gene. To date, no genetic changes other than missense variants were reported in the literature. Here, w... Interstitial lung and liver disease(ILLD) is caused by biallelic mutations in the methionyl-tRNA synthetase(MARS) gene. To date, no genetic changes other than missense variants were reported in the literature. Here, we report a five-month old female infant with typical ILLD(failure to thrive, developmental delay, jaundice, diffuse interstitial lung disease, hepatomegaly with severe steatosis, anemia, and thrombocytosis) showing novel phenotypes such as kidney stones, acetabular dysplasia, prolonged fever, and extreme leukocytosis. Whole exome sequencing revealed a novel truncating variant(c.2158 C>T/p.Gln720 Stop) together with a novel tri-nucleotide insertion(c.893_894 insTCG that caused the insertion of an arginine at amino acid position 299) in the MARS gene. 展开更多
关键词 Methionyl-tRNA SYNTHETASE Infant Kidney stone Hip DYSPLASIA LEUKOCYTOSIS INTERSTITIAL lung and liver disease Methionyl-tRNA SYNTHETASE gene
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Liver cold preservation induce lung surfactant changes and acute lung injury in rat liver transplantation 被引量:2
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作者 An Jiang,Chang Liu,Liang Yu,Yi Lv,Department of Hepatobiliary Surgery,the First Affiliated Hospital,School of Medicine,Xi’an Jiaotong University,Xi’an 710061,Shannxi Province,China An Jiang,Department of VIP Clinic,The Second Affiliated Hospital,School of Medicine,Xi’an Jiaotong University,Xi’an 710004,Shannxi Province,China Feng Liu,Department of Liver Transplantation,Qianfoshan Hospital,Jinan 250014,Shandong Province,China Yu-Long Song,Department of Anesthesiology,Renmin Hospital of Shannxi Province,Xi’an 710061,Shannxi Province,China Quan-Yuan Li,Department of Transplantation,Dongfeng Hospital,Shiyan 442008,Hubei Province,China 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第4期323-330,共8页
AIM: To investigate the relationship between donor liver cold preservation, lung surfactant (LS) changes and acute lung injury (ALI) after liver transplantation. METHODS: Liver transplantation models were estab-... AIM: To investigate the relationship between donor liver cold preservation, lung surfactant (LS) changes and acute lung injury (ALI) after liver transplantation. METHODS: Liver transplantation models were estab- lished using male Wistar rats. Donor livers were pre- served in University of Wisconsin solution at 4 ℃ for different lengths of time. The effect of ammonium pyr- rolidinedithiocarbamate (PDTC) on ALI was also detect- ed. All samples were harvested after 3 h reperfusion.The severity of AU was evaluated by lung weight/body weight ratio, lung histopathological score, serum nitric oxide (NO) and endothelin (ET)-I levels, lung tumor necrosis factor (TNF)-α and interleukin (IL)-1β levels. Lung surfactants (LSs) were determined by micellar electrokinetic capillary chromatography. RESULTS: With extended donor liver cold preservation time (CPT), lung histopathological scores, serum ET-i levels, lung weight/body weight ratio and the level of TNF-α and IL-1β in lung were increased significantly in the 180-min group compared with the sham group (3.16± 0.28 vs 1.12 ± 0.21, P 〈 0.001; 343.59±53.97 vs 141.53± 48.48, P 〈 0.001; 0.00687 ±0.00037 vs 0.00557 ±0.00056, P 〈 0.001; 17.5 ± 3.0 vs 1,3 ± 0.3, P 〈 0.001; 10.8± 2.3 vs 1.8 ± 0.4, P 〈 0.001), but serum NO levels decreased remarkably (74.67 ± 10.01 vs 24.97 ± 3.18, P 〈 0.001). The expression of lung phos- phatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylinositol (PI) and phosphatidylserine (PS) increased when CPT was 〈 120 rain, and decreased when CPT was 〉 180 min (PC: 1318.89 ± 54.79 vs 1011.18± 59.99, P 〈 0.001; PE: 1504.45± 119.96 vs 1340.80±76.39, P = 0.0019; PI: 201.23 ± 34.82 vs 185.88 ± 17.04, P = 0.2265; PS: 300.43±32.95 vs 286.55± 55.55, P = 0.5054). All these ALI-associated indexes could be partially reversed by PDTC treatment. 展开更多
关键词 liver transplantation Acute lung injury Or-gan preservation lung surfactants
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Crizotinib-induced acute fatal liver failure in an Asian ALK-positive lung adenocarcinoma patient with liver metastasis: A case report 被引量:1
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作者 Ying Zhang Yan-Yan Xu +2 位作者 Yi Chen Jin-Na Li Ying Wang 《World Journal of Clinical Cases》 SCIE 2019年第9期1080-1086,共7页
BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old... BACKGROUND Crizotinib-induce hepatotoxicity is rare and non-specific, and severe hepatotoxicity can develop into fatal liver failure. Herein, we report a case of fatal crizotinib-induced liver failure in a 37-year-old Asian patient.CASE SUMMARY The patient complained of dyspnea and upper abdominal pain for a week in August 2017. He was diagnosed with anaplastic lymphoma kinase-rearranged lung adenocarcinoma combined with multiple distant metastases. Crizotinib was initiated as a first-line treatment at a dosage of 250 mg twice daily. No adverse effects were seen until day 46. On day 55, he was admitted to the hospital with elevated liver enzymes aspartate aminotransferase(AST)(402 IU/L), alanine aminotransferase(ALT)(215 IU/L) and total bilirubin(145 μmol/L) and was diagnosed with crizotinib-induced fulminant liver failure. Despite crizotinib discontinuation and intensive supportive therapy, the level of AST(1075 IU/L),ALT(240 IU/L) and total bilirubin(233 μmol/L) continued to rapidly increase,and he died on day 60.CONCLUSION Physicians should be aware of the potential fatal adverse effects of crizotinib. 展开更多
关键词 FATAL liver failure CRIZOTINIB HEPATOTOXICITY liver METASTASES ALK rearrangement lung adenocarcinoma Case report
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Surgical treatment of synchronous colorectal liver and lung metastases: the usefulness of thoracophrenolaparotomy for single stage resection 被引量:3
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作者 Daniele Del Fabbro Marco Alloisio +5 位作者 Fabio Procopio Matteo Cimino Matteo Donadon Angela Palmisano Luca Viganò Guido Torzilli 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2016年第2期216-219,共4页
When suitable, surgery still remains the therapeutic option to be preferred for patients carrier of colorectal liver and lung metastases. Since thoracophrenolaparotomy should be helpful during liver resection for some... When suitable, surgery still remains the therapeutic option to be preferred for patients carrier of colorectal liver and lung metastases. Since thoracophrenolaparotomy should be helpful during liver resection for some of these patients, simultaneous removal of right lung metastases can be proposed through this approach. Eleven consecutive patients(median age of 53 years) carrier of colorectal liver and lung metastases, underwent single session surgical resection of both liver and right lung lesions by means of J-shaped thoracophrenolaparotomy. The median number of liver metastases removed was 5(range 2-30) and of lung metastases removed was 2(range 1-3). Lung metastases were located in the upper lobe in 1 patient, in the middle lobe in 2, in the lower lobe in 6, and in the upper and lower lobe in 2. Mortality and major morbidity were nil. Two patients had a minor morbidity: one had wound infection and bile leakage treated conservatively and the other had transient fever. Mean overall survival was 24.4 months. An aggressive surgical approach should be undertaken for colorectal metastases: in case of multifocal liver disease with complex presentations, J-shaped thoracophrenolaparotomy could be considered as safe approach for combined liver and right lung metastasectomies. 展开更多
关键词 colorectal carcinoma liver metastases lung metastases thoracophrenolaparotomy
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Clinical characteristics and prognosis of non-small cell lung cancer patients with liver metastasis:A population-based study 被引量:1
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作者 Jun-Feng Wang Hong-Di Lu +3 位作者 Ying Wang Rui Zhang Xiang Li Sheng Wang 《World Journal of Clinical Cases》 SCIE 2022年第30期10882-10895,共14页
BACKGROUND The presence of liver metastasis(LM) is an independent prognostic factor for shorter survival in non-small cell lung cancer(NSCLC) patients.The median overall survival of patients with involvement of the li... BACKGROUND The presence of liver metastasis(LM) is an independent prognostic factor for shorter survival in non-small cell lung cancer(NSCLC) patients.The median overall survival of patients with involvement of the liver is less than 5 mo.At present,identifying prognostic factors and constructing survival prediction nomogram for NSCLC patients with LM(NSCLC-LM) are highly desirable.AIM To build a forecasting model to predict the survival time of NSCLC-LM patients.METHODS Data on NSCLC-LM patients were collected from the Surveillance,Epidemiology,and End Results database between 2010 and 2018.Joinpoint analysis was used to estimate the incidence trend of NSCLC-LM.Kaplan-Meier curves were constructed to assess survival time.Cox regression was applied to select the independent prognostic predictors of cancer-specific survival(CSS).A nomogram was established and its prognostic performance was evaluated.RESULTS The age-adjusted incidence of NSCLC-LM increased from 22.7 per 1000000 in 2010to 25.2 in 2013,and then declined to 22.1 in 2018.According to the multivariable Cox regression analysis of the training set,age,marital status,sex,race,histological type,T stage,metastatic pattern,and whether the patient received chemotherapy or not were identified as independent prognostic factors for CSS(P < 0.05) and were further used to construct a nomogram.The C-indices of the training and validation sets were 0.726 and 0.722,respectively.The results of decision curve analyses(DCAs) and calibration curves showed that the nomogram was well-discriminated and had great clinical utility.CONCLUSION We designed a nomogram model and further constructed a novel risk classification system based on easily accessible clinical factors which demonstrated excellent performance to predict the individual CSS of NSCLC-LM patients. 展开更多
关键词 Non-small cell lung cancer liver metastasis NOMOGRAM Risk classification system
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Surgical treatment of metachronous rectal liver and lungmetastases: A combined videolaparoscopic andvideothoracoscopic approach 被引量:1
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作者 francesco sucameli elisa francone +3 位作者 laura dova prospero magistrelli emilio falco stefano berti 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2018年第3期280-281,共2页
To the Editor:We read with tremendous interest the paper by Del Fabbroet al. [1]. In this thorough article, the authors meticulously underlinethe advantages of a modified j-shaped incision for the simultaneoustreatme... To the Editor:We read with tremendous interest the paper by Del Fabbroet al. [1]. In this thorough article, the authors meticulously underlinethe advantages of a modified j-shaped incision for the simultaneoustreatment of difficult liver colorectal metastases (CRM) and right-lung CRM, reporting their experience in a cohort of 11 patients. 展开更多
关键词 Surgical treatment of metachronous rectal liver and lung metastases:A combined videolaparoscopic and videothoracoscopic approach
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TNFR2 is a potent prognostic biomarker for post-transplant lung metastasis in patients with hepatocellular carcinoma 被引量:1
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作者 Huigang Li Zuyuan Lin +14 位作者 Jianyong Zhuo Modan Yang Wei Shen Zhihang Hu Yichen Ding Hao Chen Chiyu He Xinyu Yang Siyi Dong Xuyong Wei Beicheng Sun Shusen Zheng Ren Lang Di Lu Xiao Xu 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2023年第1期66-80,共15页
Objective:Lung metastasis is a common and fatal complication of liver transplantation for hepatocellular carcinoma(HCC).The precise prediction of post-transplant lung metastasis in the early phase is of great value.Me... Objective:Lung metastasis is a common and fatal complication of liver transplantation for hepatocellular carcinoma(HCC).The precise prediction of post-transplant lung metastasis in the early phase is of great value.Methods:The mRNA profiles of primary and paired lung metastatic lesions were analyzed to determine key signaling pathways.We enrolled 241 HCC patients who underwent liver transplantation from three centers.Tissue microarrays were used to evaluate the prognostic capacity of tumor necrosis factor(TNF),tumor necrosis factor receptor 1(TNFR1),and TNFR2,particularly for post-transplant lung metastasis.Results:Comparison of primary and lung metastatic lesions revealed that the TNF-dependent signaling pathway was related to lung metastasis of HCC.The expression of TNF was degraded in comparison to that in para-tumor tissues(P<0.001).The expression of key receptors in the TNF-dependent signaling pathway,TNFR1 and TNFR2,was higher in HCC tissues than in para-tumor tissues(P<0.001).TNF and TNFR1 showed no relationship with patients’outcomes,whereas elevated TNFR2 in tumor tissue was significantly associated with worse overall survival(OS)and increased recurrence risk(5-year OS rate:31.9%vs.62.5%,P<0.001).Notably,elevated TNFR2 levels were also associated with an increased risk of post-transplant lung metastasis(hazard ratio:1.146;P<0.001).Cox regression analysis revealed that TNFR2,Hangzhou criteria,age,and hepatitis B surface antigen were independent risk factors for post-transplant lung metastasis,and a novel nomogram was established accordingly.The nomogram achieved excellent prognostic efficiency(area under time-dependent receiver operating characteristic=0.755,concordance-index=0.779)and was superior to conventional models,such as the Milan criteria.Conclusions:TNFR2 is a potent prognostic biomarker for predicting post-transplant lung metastasis in patients with HCC.A nomogram incorporating TNFR2 deserves to be a helpful prognostic tool in liver transplantation for HCC. 展开更多
关键词 lung metastasis hepatocellular carcinoma liver transplantation NOMOGRAM
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Effect of cardiac output-guided hemodynamic management on acute lung injury in pediatric living donor liver transplantation
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作者 Xiao-Jing Dou Qing-Ping Wang +3 位作者 Wei-Hua Liu Yi-Qi Weng Ying Sun Wen-Li Yu 《World Journal of Gastrointestinal Surgery》 SCIE 2022年第9期1037-1048,共12页
BACKGROUND Acute lung injury(ALI)after liver transplantation(LT)may lead to acute respiratory distress syndrome,which is associated with adverse postoperative outcomes,such as prolonged hospital stay,high morbidity,an... BACKGROUND Acute lung injury(ALI)after liver transplantation(LT)may lead to acute respiratory distress syndrome,which is associated with adverse postoperative outcomes,such as prolonged hospital stay,high morbidity,and mortality.Therefore,it is vital to maintain hemodynamic stability and optimize fluid management.However,few studies have reported cardiac output-guided(CO-G)management in pediatric LT.AIM To investigate the effect of CO-G hemodynamic management on early postoperative ALI and hemodynamic stability during pediatric living donor LT.METHODS A total of 130 pediatric patients scheduled for elective living donor LT were enrolled as study participants and were assigned to the control group(65 cases)and CO-G group(65 cases).In the CO-G group,CO was considered the target for hemodynamic management.In the control group,hemodynamic management was based on usual perioperative care guided by central venous pressure,continuous invasive arterial pressure,urinary volume,etc.The primary outcome was early postoperative ALI.Secondary outcomes included other early postoperative pulmonary complications,readmission to the intense care unit(ICU)for pulmonary complications,ICU stay,hospital stay,and in-hospital mortality.RESULTS The incidence of early postoperative ALI was 27.7%in the CO-G group,which was significantly lower than that in the control group(44.6%)(P<0.05).During the surgery,the incidence of postreperfusion syndrome was lower in the CO-G group(P<0.05).The level of intraoperative positive fluid transfusions was lower and the rate of dobutamine use before portal vein opening was higher,while the usage and dosage of epinephrine during portal vein opening and vasoactive inotropic score after portal vein opening were lower in the CO-G group(P<0.05).Compared to the control group,serum inflammatory factors(interleukin-6 and tumor necrosis factor-α),cardiac troponin I,and N-terminal pro-brain natriuretic peptide were lower in the CO-G group after the operation(P<0.05).CONCLUSION CO-G hemodynamic management in pediatric living-donor LT decreases the incidence of early postoperative ALI due to hemodynamic stability through optimized fluid management and appropriate administration of vasopressors and inotropes. 展开更多
关键词 Cardiac output Hemodynamic management CHILD liver transplantation Acute lung injury Reperfusion injury
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Clinical Significance of a Rise in AFP in Lung Adenocarcinoma Patients with Liver Metastasis:One Case Report and Literatures Review
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作者 Yue'an Cao Nanzhan Long +4 位作者 Chaosheng Peng Ping Lu Jing Xia Wei Wang Wenxiu Xie 《Chinese Journal of Clinical Oncology》 CSCD 2008年第3期226-228,共3页
IntroductionUsually the alpha fetoprotein (AFP) concentration of patients with metastatic liver cancer is slightly raised. Most of the levels are lower than 400 ug/L. Following biopsies of lung and liver neoplasms, ... IntroductionUsually the alpha fetoprotein (AFP) concentration of patients with metastatic liver cancer is slightly raised. Most of the levels are lower than 400 ug/L. Following biopsies of lung and liver neoplasms, one patient with a clinical diagnosis of lung cancer plus liver metastasis was pathologically diagnosed having an adenocarcinoma. His serum AFP value was 100-300 times the normal value. In order to further explore the clinical significance of an elevation of the AFP level in patients with lung adenocarcinoma plus liver metastasis, and to precisely distinguish a simple liver metastasis from lung adenocarcinoma or from lung hepatoid adenocarcinoma (HAC), a clinical analysis of the patient, and a literature review was conducted. 展开更多
关键词 alpha fetoprotein adenocarcinoma of the lung metastatic liver cancer hepatoid adenocarcinoma.
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Determination of the effect of Toluene Diisocyanate on mice lung and liver cells by laser confocal microscope
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作者 Yubin JI Fanfei ZHANG +1 位作者 Lang LANG Chenfeng JI 《Chinese Journal Of Geochemistry》 EI CAS 2006年第B08期187-187,共1页
关键词 TDI 二异氰酸盐 白鼠 激光
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Reply to: Surgical treatment of metachronous rectal liver andlung metastases: A combined videolaparoscopic and videothoracoscopic approach
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作者 Daniele Del Fabbro Guido Torzilli 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2018年第3期282-282,共1页
The Author Reply:We thank Dr. Sucameli et al. for the interest toward our article[1] and for the opportunity for further discussing on this issue,providing a case report of single metastastic fore sites in the livera... The Author Reply:We thank Dr. Sucameli et al. for the interest toward our article[1] and for the opportunity for further discussing on this issue,providing a case report of single metastastic fore sites in the liverand lung both treated in a minimal access fashion. However, giventhe interest of the authors insight, it appears misleading when related to that discussed in our report which was clearly referred toother patients' profiles. Indeed, they described a case with a singleperipheral nodule in the right lung and a single liver metastasesin segment 5. This uncommon situation (less than 2% of patientsaccording to the LiverMetSurvey registry [2]), is obviouslya more than reasonable indication for a mini-invasive approach.However, our patients received surgery for complex oncological involvementof the liver: as described, this means large and/or multiplelesions, in contact or invading the hepatic veins at caval confluence.For such conditions we have introduced original surgicalapproaches [3,4]: in such conditions we would select a J-shapedthoracophrenolaparotomy for the liver per se [5]. This incision forsuch complex conditions other than allowing the liver clearance in a single operation rather than in staged approach [6], allows justin case the removal of lung nodules. Therefore, we thank again theauthors for their interest to our report, and furthermore we congratulatefor the original management of the shared clinical case.However, the condition recalled by the authors is related to a scenariooncologically and surgically at the opposite side of that discussedin our paper and for that somehow suggesting a comparisonis misleading. 展开更多
关键词 Reply to:Surgical treatment of metachronous rectal liver and lung metastases:A combined videolaparoscopic and videothoracoscopic approach
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Regression of recurrent granulosa cell tumor liver metastases following selective internal radiation therapy
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作者 Omar A Mownah John D Leahy +2 位作者 Jeffrey Summers Stephen M Gregory Nigel D Heaton 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2023年第4期406-408,共3页
Granulosa cell tumor(GCT)is the most common sex cordstromal tumor,comprising 5%of all ovarian malignancies[1].The disease course is indolent,and the majority of cases present at stage 1.However,metastases may develop ... Granulosa cell tumor(GCT)is the most common sex cordstromal tumor,comprising 5%of all ovarian malignancies[1].The disease course is indolent,and the majority of cases present at stage 1.However,metastases may develop with potential sites being peritoneum,lung,brain,liver and bone[2].Due to the rarity of the disease,published evidence for management of granulosa cell tumor liver metastases(GCTLM)is limited.Surgical resection is the optimal treatment in instances where there is a high chance of achieving complete resection[3].With regards to unresectable GCTLM there is a paucity of evidence to guide treatment strategy. 展开更多
关键词 METASTASES liver lung
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Liver fire invading the lung: Theoretical basis, identification and treatment
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作者 Xinran Chen Jian Dong +1 位作者 Tianfang Wang Lihong Zhao 《Journal of Traditional Chinese Medical Sciences》 2017年第1期16-19,共4页
Liver fire invading the lung (also called wood-fire torturing metal) is widely seen in various respiratory diseases.In order to understand this pattern well,from the perspective of the five elements theory and zang-fu... Liver fire invading the lung (also called wood-fire torturing metal) is widely seen in various respiratory diseases.In order to understand this pattern well,from the perspective of the five elements theory and zang-fu theory in Chinese Medicine,we systematically reviewed and discussed the physiological and functional characteristics of the liver and lung,the liver -lung relationship,the pathogenesis and identification of the pattern,as well as the commonly used basic formulas for the treatment of this pattern,including White-Draining Powder (Xiè Bái Sǎn,泻白散),Liver Heat-Dissolving Decoction (Huà Gān Jiān,化肝煎),Indigo and Clam Shell Powder (Dài Ge Sǎn,黛蛤散)and Hemoptysis-Relieving Formula(KéXuè Fāng,咳血方).Two examples of clinical modifications of these formulas in the treatment of hemoptysis and asthma are provided in this article.It should be noted that in the treatment of pulmonary diseases,these formulas should be used flexibly,and modified in accordance to the condition of the patient. 展开更多
关键词 liver FIRE invading the lung Wood-fire torturing the metal IDENTIFICATION and treatment
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CT 引导下细针辅助定位穿刺肺及肝内困难病灶
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作者 张建 谭中宝 +4 位作者 狄镇海 毛学群 邹容 王庆庆 韩壮 《中国介入影像与治疗学》 北大核心 2024年第8期482-485,共4页
目的观察CT引导下细针辅助定位穿刺肺及肝内困难病灶的可行性及安全性。方法回顾性纳入30例接受CT引导下22G穿刺针辅助定位穿刺的肺及肝内单发穿刺位置困难病灶或位置深在的直径0.5~2.0 cm病灶,记录辅助定位成功率、首次穿刺成功率及相... 目的观察CT引导下细针辅助定位穿刺肺及肝内困难病灶的可行性及安全性。方法回顾性纳入30例接受CT引导下22G穿刺针辅助定位穿刺的肺及肝内单发穿刺位置困难病灶或位置深在的直径0.5~2.0 cm病灶,记录辅助定位成功率、首次穿刺成功率及相关并发症等。结果30个困难病灶包括27个肺内病灶、3个肝内病灶,平均直径(1.0±0.4)cm,均于CT引导下以22G穿刺针于靶病灶边缘、病灶旁1 cm或穿刺路径中辅助定位成功,定位成功率100%,未见明显并发症。后续操作包括对14个肺结节行术前穿刺定位、对10个肺结节和3个肝内病灶行穿刺活检及对3个肺结节实施微波消融,首次穿刺成功率100%。穿刺活检后3例(3/27,11.11%)肺内困难病灶患者出现少量气胸;未见其他明显并发症。结论CT引导下以细针辅助定位经皮穿刺肺及肝内困难病灶可行且安全。 展开更多
关键词 肺疾病 肝疾病 穿刺术 放射摄影术 介入性
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驱动压导向呼气末正压通气对原位肝移植患者术中氧合和术后并发症的影响
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作者 秦晨光 方开云 +2 位作者 彭晶 何福娟 蒋泞泽 《临床麻醉学杂志》 CAS CSCD 北大核心 2024年第7期677-682,共6页
目的评价驱动压导向呼气末正压(PEEP)通气对原位肝移植术(OLT)患者术中氧合和术后并发症的影响。方法选择2020年1月至2023年9月行OLT患者118例,男89例,女29例,年龄18~70岁,BMI<28 kg/m^(2),ASAⅢ或Ⅳ级。采用随机数字表法将患者分为... 目的评价驱动压导向呼气末正压(PEEP)通气对原位肝移植术(OLT)患者术中氧合和术后并发症的影响。方法选择2020年1月至2023年9月行OLT患者118例,男89例,女29例,年龄18~70岁,BMI<28 kg/m^(2),ASAⅢ或Ⅳ级。采用随机数字表法将患者分为两组:驱动压组(D组)和固定PEEP组(P组),每组59例。两组全麻期间均采用容量控制通气,I∶E 1∶2,V_(T)6 ml/kg(理想体重),RR 10~15次/分。D组在机械通气5 min后开始PEEP滴定试验,将PEEP从2 cmH_(2)O逐渐递增到10 cmH_(2)O,选择能产生最低驱动压的PEEP,维持该PEEP直至手术结束。P组术中维持PEEP 5 cmH_(2)O。记录术中出入量、血管活性药物使用情况。记录插管后5 min(T_(1))、无肝期(T_(2))、新肝期(T_(3))、手术结束即刻(T_(4))的HR、SBP、DBP、气道峰压(Ppeak)、气道平台压(Pplat)、PEEP、血气分析结果,并计算驱动压、动态肺顺应性(Cdyn)、氧合指数(OI)、死腔率(V_(D)/V_(T))。记录术后7 d内术后肺部并发症(PPCs)的发生情况。结果与P组比较,D组晶体液输注量明显增加,去甲肾上腺素、去氧肾上腺素及肾上腺素使用率明显升高(P<0.05)。与T_(2)时比较,两组T_(1)、T_(3)、T_(4)时HR明显减慢,SBP、DBP明显升高(P<0.05)。与T_(1)时比较,两组T_(2)—T_(4)时Ppeak、Pplat、驱动压、OI明显升高,T_(3)、T_(4)时Cdyn明显降低(P<0.05)。与P组比较,D组术后7 d内PPCs发生率明显降低(P<0.05)。两组其余指标差异无统计学意义。结论驱动压导向PEEP通气可改善原位肝移植患者术中氧合,降低PPCs发生率,但术中血管活性药物的使用率升高。 展开更多
关键词 驱动压 肺保护性通气策略 肝移植 术后肺部并发症
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从“风火”论治变态反应性疾病思路
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作者 高伟 武维屏 《世界中医药》 CAS 北大核心 2024年第6期830-833,837,共5页
变态反应性疾病临床常见,其病位虽不同,但病机却有一定共性。总体而言,人体阴阳协调,则一气周流,如“春风”生养万物。一旦各种原因导致阳气郁而不升或逆而不降,疏布失常的“阳气”在人体内过度聚集,愈郁则愈欲疏泄,久积必终向外透解,... 变态反应性疾病临床常见,其病位虽不同,但病机却有一定共性。总体而言,人体阴阳协调,则一气周流,如“春风”生养万物。一旦各种原因导致阳气郁而不升或逆而不降,疏布失常的“阳气”在人体内过度聚集,愈郁则愈欲疏泄,久积必终向外透解,如“风火”之邪侵及人体各处皮肤孔窍,则会出现相关部位的过敏症状。临床诊治中,根据变态反应性疾病发作的病机,常用熄风火以缓症状、透余热以防复发、养脉络以促复原、调五脏以兼标本等治法,并坚持以辨证为先、因势利导、急缓有异、清透兼施、整体局部辨证结合等为治疗原则,取得了良好疗效。文末列举一则验案加以说明,希望帮助读者更好理解和应用。 展开更多
关键词 变态反应性疾病 过敏 风火 疏泄失常 中医思路 调肝理肺 验案
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1例克唑替尼致非小细胞肺癌患者肝损伤与腹泻的临床诊疗分析
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作者 郑爽 唐婕 《抗感染药学》 2024年第8期793-797,共5页
目的:分析1例克唑替尼致非小细胞肺癌(non-small cell lung cancer,NSCLC)患者肝损伤与腹泻的临床诊疗过程,为临床克唑替尼的用药安全提供参考。方法与结果:该患者因患NSCLC而开展化疗,其间在使用克唑替尼15 d后患者出现乏力、恶心等症... 目的:分析1例克唑替尼致非小细胞肺癌(non-small cell lung cancer,NSCLC)患者肝损伤与腹泻的临床诊疗过程,为临床克唑替尼的用药安全提供参考。方法与结果:该患者因患NSCLC而开展化疗,其间在使用克唑替尼15 d后患者出现乏力、恶心等症状,并且肝功能检查结果显示丙氨酸转氨酶和天冬氨酸转氨酶显著异常;临床药师在考察患者的病史和用药史后,认为此次肝损伤可能与克唑替尼有关,遂建议医生停用克唑替尼并予以保肝治疗,医生采纳了,1周后患者肝功能基本恢复正常;之后,患者在保肝治疗的基础上复用克唑替尼,虽未在出现肝功能异常,但2个月后出现腹泻症状,临床药师认为仍可能与克唑替尼有关,遂建议改用洛拉替尼,医生采纳了,3 d后患者腹泻症状完全缓解。结论:对于使用克唑替尼这类药物不良反应较多的抗肿瘤药物的患者,临床医生与药师应做好相关监测和用药安全提醒,以早发现、早处置,从而保障患者的用药安全。 展开更多
关键词 克唑替尼 肝损伤 腹泻 非小细胞肺癌 药物不良反应
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“龙虎回环”理论治疗失眠探析
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作者 王毅 王爱成 +3 位作者 周培娟 刘珂 和俊燕 王枳翌 《四川中医》 2024年第10期28-31,共4页
随着社会环境及心理压力的变化发展,失眠已经成为严重影响人身心健康的一个重要的亚健康或疾病因素。中医理论中将失眠囊括于不寐病证,溯其根本,多因阴阳失和,于夜卧时而鲜有倦意或精神异常兴奋难以安眠。“龙虎回环”源于古天文四象理... 随着社会环境及心理压力的变化发展,失眠已经成为严重影响人身心健康的一个重要的亚健康或疾病因素。中医理论中将失眠囊括于不寐病证,溯其根本,多因阴阳失和,于夜卧时而鲜有倦意或精神异常兴奋难以安眠。“龙虎回环”源于古天文四象理论体系,象形比类,以龙喻阳,用虎拟阴,龙虎升降有序,阴阳生克有调。本文基于“龙虎回环”理论,探讨睡眠的中医机理,以及探究失眠的治疗机制,为临床治疗失眠提供思路。 展开更多
关键词 龙虎回环 失眠 肝肺 气机升降
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清火消痈汤治疗心肝火旺及热毒内蕴型肺痈临床观察
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作者 潘延成 《中国中医药现代远程教育》 2024年第21期135-137,共3页
目的研究清火消痈汤治疗心肝火旺及热毒内蕴型肺痈的临床价值。方法以2021年1月—2021年12月为研究周期,抽取研究对象72例,采用随机数字表法分为研究组、对照组,各36例;对照组予西药治疗,研究组予清火消痈汤治疗,对比两组呼吸功能指标... 目的研究清火消痈汤治疗心肝火旺及热毒内蕴型肺痈的临床价值。方法以2021年1月—2021年12月为研究周期,抽取研究对象72例,采用随机数字表法分为研究组、对照组,各36例;对照组予西药治疗,研究组予清火消痈汤治疗,对比两组呼吸功能指标和中医证候积分。结果治疗后,研究组二氧化碳分压(PaCO_(2))水平为(41.42±3.75)mm Hg(1 mm Hg≈0.133 kPa),低于对照组的(47.59±5.88)mm Hg(P<0.05);氧分压(PaO_(2))水平为(82.99±6.75)mm Hg,高于对照组的(73.26±2.48)mm Hg(P<0.05)。治疗后,研究组主证积分为(2.44±0.68)分、次证积分为(0.65±0.11)分、总积分为(3.12±0.64)分,均低于对照组的(5.29±1.05)分、(1.89±0.62)分、(7.28±1.75)分(P<0.05)。结论清火消痈汤治疗肺痈效果显著。 展开更多
关键词 清火消痈汤 肺痈 支气管扩张 心肝火旺证 热毒内蕴证 中医药疗法
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基于《治肝三十法》探析从肝论治间质性肺疾病咳嗽 被引量:1
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作者 李睿 王玉光 《吉林中医药》 2024年第6期637-640,共4页
清代医家王旭高以肝气、肝火、肝风、肝虚为纲,总结创立了《治肝三十法》。以《治肝三十法》为立足点探析肝气、肝火、肝风、肝虚的源流及内涵,并探讨间质性肺疾病的病机变化与其相似之处,从而提出从肝论治间质性肺疾病咳嗽,分析并探索... 清代医家王旭高以肝气、肝火、肝风、肝虚为纲,总结创立了《治肝三十法》。以《治肝三十法》为立足点探析肝气、肝火、肝风、肝虚的源流及内涵,并探讨间质性肺疾病的病机变化与其相似之处,从而提出从肝论治间质性肺疾病咳嗽,分析并探索间质性肺疾病相关咳嗽的临床用药规律及有效方剂,并应用典型案例验证其临床疗效,希望能对中医辨治间质性肺疾病相关咳嗽提供新的思路及方法。 展开更多
关键词 《治肝三十法》 间质性肺疾病 久咳 辨证论治
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