BACKGROUND:Decreased cardiac contractility has been observed in cirrhosis,suggesting a latent cardiomyopathy in these patients.This study was designed to evaluate left ventricular structure and function in patients wi...BACKGROUND:Decreased cardiac contractility has been observed in cirrhosis,suggesting a latent cardiomyopathy in these patients.This study was designed to evaluate left ventricular structure and function in patients with end-stage liver disease by the model for end-stage liver disease(MELD)scoring system.METHODS:We recruited 82 patients(72 male,10 female;mean age 50.3±8.9 years)with end-stage liver disease who underwent orthotopic liver transplantation between January 2002 and May 2008.Seventy-eight patients had cirrhosis and 4 had primary liver cancer.Patients were categorized into three groups on the basis of MELD score:≤9(27 patients,33%);10-19(40,49%);and≥20(15,18%).The relationship between MELD score and cardiac structure and function was determined.Preoperative assessments of blood biochemistry,blood coagulation,serum virology,echocardiography and electrocardiography were performed.RESULTS:MELD score was positively correlated with enlarged left atrial diameter,increased interventricular septum thickness(IVST),increased aortic flow,corrected QT interval(QTc)extension and cardiac output(P=0.033,0.002,0.000,0.000 and 0.009,respectively).International normalized ratio also had a correlation with the above parameters and enlarged left ventricular end-diastolic diameter(P=0.043,0.010,0.000,0.001,0.016 and 0.008,respectively).Serum creatinine was positively correlated with IVST(r=0.257,P=0.020),but negatively correlated with early maximal ventricular filling velocity/late diastolic or atrial velocity ratio(r=-0.300,P=0.006).A difference of QTc>440 ms among the three groups was statistically significant(χ2=9.791,P=0.007).CONCLUSIONS:Abnormalities in cardiac structure and function are common in patients with end-stage liver disease.MELD score is a practically useful approach for the assessment of cardiac function in such patients.展开更多
Gastric cancer is one of the most common malignant tumors,for patients with advanced gastric cancer,the traditional treatment is mainly chemotherapy or combined targeted therapy;however,these have not achieved ideal e...Gastric cancer is one of the most common malignant tumors,for patients with advanced gastric cancer,the traditional treatment is mainly chemotherapy or combined targeted therapy;however,these have not achieved ideal efficacy.However,with the continuous deepening of research on molecular targeted drugs and immunosuppressants,the treatment of advanced gastric cancer patients has made new progress,and some new technologies have also been continuously emerged and applied,which brings hope for the treatment of advanced gastric cancer.Recently,several multicenter randomized controlled phase III studies on immunotherapy for advanced gastric cancer yielded encouraging results,demonstrating its superior efficacy in the treatment of advanced gastric cancer.However,prospective data to support the acceptance of surgery and the R0 removal rate following conversion therapy with immune checkpoint inhibitors are lacking.In this study,a 58-year-old woman with advanced gastric cancer and positive PD-L1 expression,negative HER-2 expression,and microsatellite stable status received immunochemotherapy combined with traditional Chinese medicine to achieve R0 resection and satisfactory efficacy.展开更多
The diagnosis of metabolic-associated fatty liver disease is based on the detection of liver steatosis together with the presence of metabolic dysfunction.According to this new definition,the diagnosis of metabolic-as...The diagnosis of metabolic-associated fatty liver disease is based on the detection of liver steatosis together with the presence of metabolic dysfunction.According to this new definition,the diagnosis of metabolic-associated fatty liver disease is independent of the amount of alcohol consumed.Actually,alcohol and its metabolites have various effects on metabolicassociated abnormalities during the process of alcohol metabolism.Studies have shown improved metabolic function in light to moderate alcohol drinkers.There are several studies focusing on the role of light to moderate alcohol intake on metabolic dysfunction.However,the results from studies are diverse,and the conclusions are often controversial.This review systematically discusses the effects of alcohol consumption,focusing on light to moderate alcohol consumption,obesity,lipid and glucose metabolism,and blood pressure.展开更多
基金supported by a grant from the Science and Technology Bureau of Liaoning Province,China(2007225011-1)
文摘BACKGROUND:Decreased cardiac contractility has been observed in cirrhosis,suggesting a latent cardiomyopathy in these patients.This study was designed to evaluate left ventricular structure and function in patients with end-stage liver disease by the model for end-stage liver disease(MELD)scoring system.METHODS:We recruited 82 patients(72 male,10 female;mean age 50.3±8.9 years)with end-stage liver disease who underwent orthotopic liver transplantation between January 2002 and May 2008.Seventy-eight patients had cirrhosis and 4 had primary liver cancer.Patients were categorized into three groups on the basis of MELD score:≤9(27 patients,33%);10-19(40,49%);and≥20(15,18%).The relationship between MELD score and cardiac structure and function was determined.Preoperative assessments of blood biochemistry,blood coagulation,serum virology,echocardiography and electrocardiography were performed.RESULTS:MELD score was positively correlated with enlarged left atrial diameter,increased interventricular septum thickness(IVST),increased aortic flow,corrected QT interval(QTc)extension and cardiac output(P=0.033,0.002,0.000,0.000 and 0.009,respectively).International normalized ratio also had a correlation with the above parameters and enlarged left ventricular end-diastolic diameter(P=0.043,0.010,0.000,0.001,0.016 and 0.008,respectively).Serum creatinine was positively correlated with IVST(r=0.257,P=0.020),but negatively correlated with early maximal ventricular filling velocity/late diastolic or atrial velocity ratio(r=-0.300,P=0.006).A difference of QTc>440 ms among the three groups was statistically significant(χ2=9.791,P=0.007).CONCLUSIONS:Abnormalities in cardiac structure and function are common in patients with end-stage liver disease.MELD score is a practically useful approach for the assessment of cardiac function in such patients.
文摘Gastric cancer is one of the most common malignant tumors,for patients with advanced gastric cancer,the traditional treatment is mainly chemotherapy or combined targeted therapy;however,these have not achieved ideal efficacy.However,with the continuous deepening of research on molecular targeted drugs and immunosuppressants,the treatment of advanced gastric cancer patients has made new progress,and some new technologies have also been continuously emerged and applied,which brings hope for the treatment of advanced gastric cancer.Recently,several multicenter randomized controlled phase III studies on immunotherapy for advanced gastric cancer yielded encouraging results,demonstrating its superior efficacy in the treatment of advanced gastric cancer.However,prospective data to support the acceptance of surgery and the R0 removal rate following conversion therapy with immune checkpoint inhibitors are lacking.In this study,a 58-year-old woman with advanced gastric cancer and positive PD-L1 expression,negative HER-2 expression,and microsatellite stable status received immunochemotherapy combined with traditional Chinese medicine to achieve R0 resection and satisfactory efficacy.
文摘The diagnosis of metabolic-associated fatty liver disease is based on the detection of liver steatosis together with the presence of metabolic dysfunction.According to this new definition,the diagnosis of metabolic-associated fatty liver disease is independent of the amount of alcohol consumed.Actually,alcohol and its metabolites have various effects on metabolicassociated abnormalities during the process of alcohol metabolism.Studies have shown improved metabolic function in light to moderate alcohol drinkers.There are several studies focusing on the role of light to moderate alcohol intake on metabolic dysfunction.However,the results from studies are diverse,and the conclusions are often controversial.This review systematically discusses the effects of alcohol consumption,focusing on light to moderate alcohol consumption,obesity,lipid and glucose metabolism,and blood pressure.
