简介：Splanchniccirculationistheprimarymechanismthatregulatesvolumesofcirculatingbloodandsystemicbloodpressureinpatientswithcirrhosisaccompaniedbyportalhypertension.Recently,interesthasbeenexpressedinmodulatingsplanchniccirculationinpatientswithlivercirrhosis,becausethiscapabilitymightproducebeneficialeffectsincirrhoticpatientsundergoingalivertransplant.Pharmacologicmodulationofsplanchniccirculationbyuseofvasoconstrictorsmightminimizevenouscongestion,replenishcentralbloodflow,andthusoptimizemanagementofbloodvolumeduringalivertransplantoperation.Moreover,splanchnicmodulationminimizesanyhighportalbloodflowthatmayoccurfollowingliverresectionandthesubsequentlivertransplant.Thiseffectissignificant,becausehighportalflowimpairsliverregeneration,andthusadverselyaffectsthepostoperativerecoveryofatransplantpatient.Anincreaseinportalbloodflowcanbeminimizedbyeithersurgicalmethods（e.g.,splenicarteryligation,splenectomyorportocavalshunting）oradministrationofsplanchnicvasoconstrictordrugssuchasVasopressinorterlipressin.Finally,modulationofsplanchniccirculationcanhelpmaintainperioperativerenalfunction.Splanchnicvasoconstrictorssuchasterlipressinmayhelpprotectagainstacutekidneyinjuryinpatientsundergoinglivertransplantationbyreducingportalpressureandtheseverityofahyperdynamicstate.Theseeffectsareespeciallyimportantinpatientswhoreceiveatoosmallforsizegraft.TerlipressinselectivelystimulatesV1receptors,andthuscausesarteriolarvasoconstrictioninthesplanchnicregion,withaconsequentshiftofbloodfromsplanchnictosystemiccirculation.Asaresult,terlipressinenhancesrenalperfusionbyincreasingbotheffectivebloodvolumeandmeanarterialpressure.

简介：AbstractObjective:This study aims to describe presenting characteristics of patients diagnosed with non-invasive chronic rhinosinusitis (CRS) following liver or kidney transplant and determine factors associated with disease-related complications, selection of endoscopic sinus surgery (ESS), and disease resolution in this population.Study design:Retrospective chart review.Setting:An academic tertiary care center (Mayo Clinic, Rochester, Minnesota).Subjects and methods:Liver and kidney transplant recipients evaluated by Mayo Clinic otolaryngologists for CRS between 1998 and 2018 were identified. Univariate and multivariate logistic regression analyses were used to determine patient factors and treatment modalities associated with developing complications, selection of ESS, and disease resolution.Results:Fifty-seven patients met inclusion criteria. No patients developed intraorbital or intracranial complications of their CRS. Multivariate modeling demonstrated that the presence of polyps (P = 0.036) was associated with undergoing ESS within one year of presentation. A higher Lund-Mackay (LM) computed tomography score (P = 0.023) and older age (P = 0.018) were significantly associated with decreased disease resolution. No other factors were significantly associated with the use of endoscopic sinus surgery within one year of otolaryngology presentation or resolution of CRS in this cohort.Conclusion:The risk of developing CRS-related intraorbital or intracranial complications in this immunecompromised patient cohort may be lower than originally thought. For liver- and kidney-recipients stable on immunosuppressive medication for many years, prognostic factors for CRS may mirror those for immunocompetent patients.

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简介：Nonalcoholicfattyliverdisease(NAFLD),definedasabnormalaccumulation(>5%)ofhepatictriglyceridewithoutexcessalcoholintake,isthemostcommonformofchronicliverdiseaseinadultsandchildrenintheUnitedStates.NAFLDencompassesaspectrumofhistologicfindingsincludinguncomplicatedsteatosis,steatosiswithinflammationandsteatohepatitis[nonalcoholicsteatohepatitis(NASH)];thelattercanadvancetocirrhosisandhepatocellularcarcinoma.NASHiscurrentlyacceptedasthehepaticmanifestationofthesetofcardiovascularriskfactorscollectivelyknownasmetabolicsyndrome.In1999asystemforhistologicgradingandstagingforNASHwasproposed;thiswasrevisedbytheNASHClinicalResearchNetworkin2005fortheentirespectrumoflesionsinNAFLD,includingthelesionsandpatternsofpediatricNAFLD,andforapplicationinclinicalresearchtrials.Diagnosisremainsdistinctfromgradeandstage.ArecentEuropeanproposalseparatessteatosisfromactivitytoderiveanumericdiagnosisofNASH.Eventhoughtherehavebeenpromisingadvancementsinnon-invasivetesting,thesetestsarenotyetdetailedenoughtoreplacethefullrangeoffindingsprovidedbyliverbiopsyevaluation.Limitationsofbiopsyareacknowledged,butliverbiopsyremainsthe'goldstandard'fordiagnosisanddeterminationofamountsofnecroinflammatoryactivity,andlocationoffibrosis,aswellasremodelingoftheparenchymainNASH.ThisreviewfocusesonthespecifichistologiclesionsofNAFLDandNASH,gradingandstaging,differentialdiagnosestobeconsidered,andthecontinuingroleoftheliverbiopsyinthisimportantliverdisease.

简介：肝纤维变性和它的结束阶段后果，肝硬化，代表最后的普通小径几乎所有长期的肝疾病。对肝的星形的房间激活的研究，细胞外的矩阵合成和降级和cytokines和chemokines的贡献的不平衡进一步阐明了机制内在的纤维变性。而且，在适应的主人和天生的免疫系统的变化的澄清加速了我们在肝发炎和纤维变性之间的协会的理解。肝的纤维变性的机制的继续的说明提供了纤维变性前进和回归的一个全面模型。这评论总结在纤维变性的领域里被做了的改进的当前的概念。

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简介：InordertoobserveseveralantibodiestoliverantigensinChinesepatientswithdifferentfiverdiseasesandtodiscussthecharacteristicsoftheautoantibodiesinautoimmuneliverdiseases,from1412patients,detectedbyindirectimmumofluoreseence(IIF)initially,230patientswithabnormalALTwerechosenanddividedinto5groups:①autoimmunediseasesgroup,42cases:18withautoimmtmehepatitis(AIH),21withprimarybiliarycirrhosis(PBC),3withprimarysclerosingcholangitis(PSC).②HAVgroup,23cases;③HBVgroup,70cases;④HCVgroup,35casesand⑤NonA-Egroup,60cases.First,ANA,AMA,SMA,liver-kidneymicrosomalantibody(LKM)andsoonweretestedby1/F.Then,LKM-1,fivercytosofic-1(LC-1),solubleliverantigen/fiverpancreas(SLA/LP)andsubtypeofAMA(M2)aswellasANAprofilesuchasSS-A,SS-BanddsDNAweretestedbyWesternblotandimmtmoblotstripsassay,respectively.Theresultswerethatamong1412cases,thosediagnosedasAIH,PBCandPSCaccotmtedfor12.7‰,14.9‰and2.1‰,respectively,ofthesamplesbeingtested.2/230withLKM-1and2/230withSLA/LPwereseeninindividualsinfectedwithAIHandHCV,respectively.AllpatientswithPBCshowedAMAandM2antibodies.NospecificANApatternwasseeninAIHby1/Fbutanti-actinwasonlyfoundinpatientswithAIH.InNonA-Egroup,fourcaseswerepositiveofAMAandM2;threehadhightiterofSMAandother4hadSS-A,SS-BordsDNAantibodies,etc.Itwasconcludedthatthedetectionofanti-fiverantigens,ANAprofileandAMAsubtypeswerehelpfulforthediagnosisofautoimmunefiverdiseasesandoverlapsyndromes.InpatientswithNonA-Ehepatitis,thediagnosisofPBCorAIHshouldbetakenintoconsideration.

简介：Inarecentstudy,researcherstookadultfemaleFischerratsandperformedaspinalcordtransectionontheminanattempttostudythegrowthoftransplantedearly-stageneurons.Whensuchearly-stageneuronsweretransplantedintoratssufferingfromparalysis,remarkableaxonalgrowthwasobserved.Theresultwasmanynewrelaycircuitsthatformed,whichsignificantlyimprovedfunction,

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简介：AIM:Toevaluatethecorrelationofshearwaveelastography(SWE)resultswithliverfibrosishistologyandquantitativefunctionreserve.METHODS:Weeklysubcutaneousinjectionof60%carbontetrachloride(1.5mL/kg)wasgivento12caninesfor24wktoinduceexperimentalliverfibrosis,witholiveoilgivento2controlcanines.At24wk,liverconditionwasevaluatedusingclinicalbiochemistryassays,SWEimaging,lidocainemetabolitemonoethylglycine-xylidide(MEGX)test,andhistologicfibrosisgrading.Clinicalbiochemistryassayswereperformedattheinstitutionalcentrallaboratoryforroutineliverfunctionevaluation.Liverstiffnesswasmeasuredintriplicatefromthreedifferentintercostalspacesandexpressedasmeanliverstiffnessmodulus(LSM).PlasmaconcentrationsoflidocaineanditsmetaboliteMEGXweredeterminedusinghigh-performanceliquidchromatographyrepeatedinduplicate.Liverbiopsysampleswerefixedin10%formaldehyde,andliverfibrosiswasgradedusingthemodifiedhistologicalactivityindexKnodellscore(F0-F4).Correlationsamonghistologicgrading,LSM,andMEGXmeasureswereanalyzedwiththePearsonlinearcorrelationcoefficient.RESULTS:At24wkliverfibrosishistologicgradingwasasfollows:F0,n=2(control);F1,n=0;F2,n=3;F3,n=7;andF4,n=2.SWELSMwaspositivelycorrelatedwithhistologicgrading(r=0.835,P<0.001).Specifically,theF4grouphadasignificantlyhigherelasticmodulusthantheF3,F2,andF0groups(P=0.002,P=0.003,andP=0.006,respectively),andtheF3groupalsohadasignificantlyhighermodulusthanthecontrolF0group(P=0.039).LSMwasnegativelyassociatedwithplasmaMEGXconcentrationsat30min(r=-0.642;P=0.013)and60min(r=-0.651;P=0.012),timeto?ofthemaximumconcentration(r=-0.538;P=0.047),andtheareaunderthecurve(r=-0.636;P=0.014).Multiplecomparisonsshowedidenticaldifferencesinthesethreemeasures:significantlylowerwithF4(P=0.037)andF3(P=0.032)ascomparedtoF0a

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简介：TheJanuskinase-signaltransducersandactivatorsoftranscription(JAK-STAT)signalingpathway,activatedbymorethan50cytokinesorgrowthfactors,playscriticalrolesinawidevarietyofcellularfunctionsinthehematopoietic,immune,neuronalandhepaticsystems.Intheliver,thissignalingpathway,activatedbymorethan20cytokines,growthfactors,hormones,andhepatitisviralproteins,playscriticalrolesinantiviraldefense,acutephaseresponse,hepaticinjury,repair,inflammation,transformation,andhepatitis.ThisarticlereviewsthebiologicalsignificanceofSTAT1,2,3,4,5,6inhepaticfunctionsanddiseases.Cellular&MolecularImmunology.2005;2(2):92-100.

简介：AccordingtoGLOBOCAN2012,livercanceristhesixthmostcommoncancerintheworld.Therewere782,000newcasesdiagnosedin2012,with50%inChinaalone.Livercanceristhesecondmostcommoncauseofcancerdeathworldwideanditsprognosisisverypoor.TheWorldHealthOrganization(WHO)declared745,517deathscausedbylivercancerin2012,withmorethanhalffromChina~1.

简介：Weprovideaconcisereviewofthemainepidemiologicalliteratureonfattyliver(FL)publishedbetweenJanuary2011andOctober2013.Thefindingsfromtheliteraturewillbeconsideredinlightofthealreadyavailableknowledge.WediscussthelimitationsinherentinthecategorizationofFLintonon-alcoholicandalcoholicFL,thepotentialrelevanceofFLasanindependentpredictorofcardiometabolicdisease,andrecentresearchaddressingtheroleofFLasanindependentpredictorofmortality.ThisreviewisorganizedasaseriesofanswerstorelevantquestionsabouttheepidemiologyofFL.

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简介：肝疾病包含许多肝条件，包括肝失败，肝肝硬化和尖锐、长期的肝炎的一个系列，例如酒鬼，丰满，药，病毒、长期的肝炎。肝损害是在肝疾病的一个主要原因的因素；通常，这些因素包括直接的肝损坏和调停免疫者的肝损害。Neutrophils(也作为neutrophilicgranulocytes或polymorphonuclear白血球(PMN)知道)是在人的最丰富的传播的白血房间类型，并且PMN是一个主要天生的有免疫力的房间子集。到微脉管系统的neutrophils的不恰当的激活和homing贡献肝疾病的许多类型的病理学的表明。这评论总结基于临床的电流和动物模型研究的嗜中性调停肝损害的新奇概念。