Liver transplantation(LT)has significantly improved survival for patients with end-stage liver disease,but post-transplant metabolic syndrome(MetS)has emerged as a major challenge,affecting graft function and long-ter...Liver transplantation(LT)has significantly improved survival for patients with end-stage liver disease,but post-transplant metabolic syndrome(MetS)has emerged as a major challenge,affecting graft function and long-term outcomes.Characterized by obesity,dyslipidemia,hypertension,and insulin resistance,MetS increases the risk of cardiovascular disease,recurrent liver disease,and reduced graft survival.We systematically examine current literature on the diagnosis,risk stratification,and management of MetS in LT recipients,with a focus on lifestyle interventions,pharmacologic strategies,and potential modifications in immunosuppressive regimens.Additionally,we discuss the role of emerging therapies,including GLP-1 receptor agonists,PCSK-9 inhibitors,and bariatric interventions,in mitigating metabolic risk in this population.With cardiovascular complications being the leading cause of post-LT mortality,proactive management of MetS is crucial.A multidisciplinary approach integrating hepatology,endocrinology,and cardiology is essential to optimize patient outcomes.Future research should focus on personalized metabolic interventions and long-term strategies to enhance posttransplant survival and quality of life.展开更多
In recent years,variable-order fractional partial differential equations have attracted growing interest due to their enhanced ability tomodel complex physical phenomena withmemory and spatial heterogeneity.However,ex...In recent years,variable-order fractional partial differential equations have attracted growing interest due to their enhanced ability tomodel complex physical phenomena withmemory and spatial heterogeneity.However,existing numerical methods often struggle with the computational challenges posed by such equations,especially in nonlinear,multi-term formulations.This study introduces two hybrid numerical methods—the Linear-Sine and Cosine(L1-CAS)and fast-CAS schemes—for solving linear and nonlinear multi-term Caputo variable-order(CVO)fractional partial differential equations.These methods combine CAS wavelet-based spatial discretization with L1 and fast algorithms in the time domain.A key feature of the approach is its ability to efficiently handle fully coupled spacetime variable-order derivatives and nonlinearities through a second-order interpolation technique.In addition,we derive CAS wavelet operational matrices for variable-order integration and for boundary value problems,forming the foundation of the spatial discretization.Numerical experiments confirm the accuracy,stability,and computational efficiency of the proposed methods.展开更多
Primary biliary cholangitis(PBC)is a chronic autoimmune cholestatic liver disease characterized by progressive bile duct destruction,leading to fibrosis,cirrhosis,and eventual liver failure.Over the past two decades,s...Primary biliary cholangitis(PBC)is a chronic autoimmune cholestatic liver disease characterized by progressive bile duct destruction,leading to fibrosis,cirrhosis,and eventual liver failure.Over the past two decades,significant advancements have paved the way for novel therapeutic strategies.Ursodeoxycholic acid(UDCA)has been the cornerstone of PBC management,improving survival and delaying disease progression in most patients.However,up to 40%of patients demonstrate an inadequate response to UDCA,necessitating additional treatment options.Obeticholic acid(OCA),a farnesoid X receptor agonist,has emerged as a second-line therapy,showing efficacy in reducing alkaline phosphatase levels and improving liver biochemistry.Beyond UDCA and OCA,a new wave of therapeutic agents are reshaping the PBC landscape.These include fibrates,peroxisome proliferator-activated receptor agonists and novel immunomodulatory drugs aimed at reducing autoimmune-mediated liver injury.Bile acid transport inhibitors,anti-fibrotic agents,and gut microbiome-targeted therapies are also under investigation,offering hope for personalized treatment approaches.This review highlights the evolution of PBC therapy,emphasizing the unmet needs of patients with refractory disease and the potential of emerging therapies to improve outcomes.As the therapeutic landscape continues to expand,optimizing treatment strategies through precision medicine holds the promise of transforming the management of PBC.展开更多
文摘Liver transplantation(LT)has significantly improved survival for patients with end-stage liver disease,but post-transplant metabolic syndrome(MetS)has emerged as a major challenge,affecting graft function and long-term outcomes.Characterized by obesity,dyslipidemia,hypertension,and insulin resistance,MetS increases the risk of cardiovascular disease,recurrent liver disease,and reduced graft survival.We systematically examine current literature on the diagnosis,risk stratification,and management of MetS in LT recipients,with a focus on lifestyle interventions,pharmacologic strategies,and potential modifications in immunosuppressive regimens.Additionally,we discuss the role of emerging therapies,including GLP-1 receptor agonists,PCSK-9 inhibitors,and bariatric interventions,in mitigating metabolic risk in this population.With cardiovascular complications being the leading cause of post-LT mortality,proactive management of MetS is crucial.A multidisciplinary approach integrating hepatology,endocrinology,and cardiology is essential to optimize patient outcomes.Future research should focus on personalized metabolic interventions and long-term strategies to enhance posttransplant survival and quality of life.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korean government(MSIT)(NRF-2021R1A2C1011817)the BK21 Program(Next Generation Education Program for Mathematical Sciences,4299990414089)funded by the Ministry of Education(MOE,Republic of Korea).
文摘In recent years,variable-order fractional partial differential equations have attracted growing interest due to their enhanced ability tomodel complex physical phenomena withmemory and spatial heterogeneity.However,existing numerical methods often struggle with the computational challenges posed by such equations,especially in nonlinear,multi-term formulations.This study introduces two hybrid numerical methods—the Linear-Sine and Cosine(L1-CAS)and fast-CAS schemes—for solving linear and nonlinear multi-term Caputo variable-order(CVO)fractional partial differential equations.These methods combine CAS wavelet-based spatial discretization with L1 and fast algorithms in the time domain.A key feature of the approach is its ability to efficiently handle fully coupled spacetime variable-order derivatives and nonlinearities through a second-order interpolation technique.In addition,we derive CAS wavelet operational matrices for variable-order integration and for boundary value problems,forming the foundation of the spatial discretization.Numerical experiments confirm the accuracy,stability,and computational efficiency of the proposed methods.
文摘Primary biliary cholangitis(PBC)is a chronic autoimmune cholestatic liver disease characterized by progressive bile duct destruction,leading to fibrosis,cirrhosis,and eventual liver failure.Over the past two decades,significant advancements have paved the way for novel therapeutic strategies.Ursodeoxycholic acid(UDCA)has been the cornerstone of PBC management,improving survival and delaying disease progression in most patients.However,up to 40%of patients demonstrate an inadequate response to UDCA,necessitating additional treatment options.Obeticholic acid(OCA),a farnesoid X receptor agonist,has emerged as a second-line therapy,showing efficacy in reducing alkaline phosphatase levels and improving liver biochemistry.Beyond UDCA and OCA,a new wave of therapeutic agents are reshaping the PBC landscape.These include fibrates,peroxisome proliferator-activated receptor agonists and novel immunomodulatory drugs aimed at reducing autoimmune-mediated liver injury.Bile acid transport inhibitors,anti-fibrotic agents,and gut microbiome-targeted therapies are also under investigation,offering hope for personalized treatment approaches.This review highlights the evolution of PBC therapy,emphasizing the unmet needs of patients with refractory disease and the potential of emerging therapies to improve outcomes.As the therapeutic landscape continues to expand,optimizing treatment strategies through precision medicine holds the promise of transforming the management of PBC.
