The application of appropriate cell origin for utilizing inregenerative medicine is the major issue. Various kinds of stem cells have been used for the tissue engineering and regenerative medicine. Such as, several st...The application of appropriate cell origin for utilizing inregenerative medicine is the major issue. Various kinds of stem cells have been used for the tissue engineering and regenerative medicine. Such as, several stromal cells have been employed as treat option for regenerative medicine. For example, human bone marrow-derived stromal cells and adipose-derived stromal cells(ADSCs) are used in cell-based therapy. Data relating to the stem cell therapy and processes associated with ADSC has developed remarkably in the past 10 years. As medical options, both the stromal vascular and ADSC suggests good opportunity as marvelous cell-based therapeutics. The some biological features are the main factors that impact the regenerative activity of ADSCs, including the modulation of the cellular immune system properties and secretion of bioactive proteins such as cytokines, chemokines and growth factors, as well as their intrinsic anti-ulcer and anti-inflammatory potential. A variety of diseases have been treated by ADSCs, and it is not surprising that there has been great interest in the possibility that ADSCs might be used as therapeutic strategy to improve a wider range of diseases. This is especially important when it is remembered that routine therapeutic methods are not completely effective in treat of diseases. Here, it was discuss about applications of ADSC to colitis, liver failure, diabetes mellitus, multiple sclerosis, orthopaedic disorders, hair loss, fertility problems, and salivary gland damage.展开更多
Nonalcoholic fatty liver disease (NAFLD) represents a rapidly growing cause of chronic liver disease in the United States and is associated with significant morbidity and mortality,including progression to liver cirrh...Nonalcoholic fatty liver disease (NAFLD) represents a rapidly growing cause of chronic liver disease in the United States and is associated with significant morbidity and mortality,including progression to liver cirrhosis and hepatocellular carcinoma.NAFLD comprises a spectrum of liver conditions,ranging from simple steatosis to steatosis with inflammation (steatohepatitis) and progressive fibrosis.Weight loss represents a first line therapeutic modality for the management of NAFLD.Herein,we review the evidence base for medical,surgical,and endoscopic approaches to weight loss and their potential impact on the natural history of NAFLD.展开更多
目的探明桑叶水提物(mulberry leaves water extracts,MWE)对肥胖症大鼠脂代谢及肠道菌群的影响。方法采用饲喂SD大鼠高脂饲料,建立肥胖模型。在不改变饲喂方式的条件下,用不同剂量MWE进行干预;测定干预后大鼠的Lee’s指数、血脂水平;...目的探明桑叶水提物(mulberry leaves water extracts,MWE)对肥胖症大鼠脂代谢及肠道菌群的影响。方法采用饲喂SD大鼠高脂饲料,建立肥胖模型。在不改变饲喂方式的条件下,用不同剂量MWE进行干预;测定干预后大鼠的Lee’s指数、血脂水平;通过组织切片观察肝组织的变化;提取结肠粪便中的DNA,进行16S rRNA基因PCR,分析菌群组成。结果MWE能降低Lee’s指数;改善血脂水平;缓解肝脏脂肪性病变。肥胖大鼠粪便中的变形菌属、蓝细菌增加,拟杆菌减少;MWE干预后有所恢复。结论MWE能在肥胖症大鼠不改变摄食的条件下,减少脂肪的堆积,改善血脂状况,恢复紊乱的肠道菌群。展开更多
目的 评估半肝血流完全阻断法（THHVE）在肝细胞癌肝切除术中的应用价值及其对肿瘤复发、转移和患者生存期的影响。方法 2011年8月至2013年8月期间在我科住院拟行手术切除的肝癌患者中,选择符合标准的患者纳入本研究。将所有入选患者随...目的 评估半肝血流完全阻断法（THHVE）在肝细胞癌肝切除术中的应用价值及其对肿瘤复发、转移和患者生存期的影响。方法 2011年8月至2013年8月期间在我科住院拟行手术切除的肝癌患者中,选择符合标准的患者纳入本研究。将所有入选患者随机分为两组,THHVE组患者在肝切除术中采用THHVE法控制血流,Pringle组采用Pringle法控制血流。对两组患者的术中总出血量、断肝过程中出血量、输血率、手术时间、血流阻断时间、并发症发生率、死亡率、术后住院时间、术后肝功能指标、无瘤生存期和总生存期等进行比较。结果 剔除不符合纳入标准的患者,共有143例符合标准的患者纳入最终分析,THHVE组71例,Pringle组72例。与Pringle组相比较,THHVE组患者的术中总出血量[250.0（150.0-400.0）mL vs 350.0（200.0-637.5）mL,P〈0.001]及断肝过程中出血量[100.0（50.0-200.0）mL vs 215.0（100.0-380.0）mL,P〈0.001]均减少。THHVE组患者的血流阻断时间长于Pringle组[27.0（20.0-31.0）min vs 20.0（16.0-24.0）min,P〈0.001],术后第1、第3、第7天的丙氨酸氨基转移酶水平低于Pringle组（P〈0.05）,术后第7天的总胆红素水平低于Pringle组（P=0.013）、血清前白蛋白高于Pringle组（P=0.038）。THHVE组并发症发生率低于Pringle组（21.1%vs 37.5%,P=0.032）。THHVE组患者的总生存期长于Pringle组（P=0.036）,Cox比例风险回归模型多因素分析结果显示采用THHVE法是影响患者总生存期的独立因素之一,采用THHVE法的患者的死亡风险是采用Pringle法的47.6%。结论THHVE法是肝癌肝切除术中一种安全、有效的血流控制方法,可减少术中出血、减轻术后肝功能损害、降低并发症发生率,较Pringle法明显延长了患者的总生存期。展开更多
Dietary supplements represent an increasingly common source of drug-induced liver injury. Hydroxycut is a popular weight loss supplement which has previously been linked to hepatotoxicity, although the individual chem...Dietary supplements represent an increasingly common source of drug-induced liver injury. Hydroxycut is a popular weight loss supplement which has previously been linked to hepatotoxicity, although the individual chemical components underlying liver injury remain poorly understood. We report two cases of acute hepatitis in the setting of Hydroxycut exposure and describe possible mechanisms of liver injury. We also comprehensively review and summarize the existing literature on commonly used weight loss supplements, and their individual components which have demon-strated potential for liver toxicity. An increased effort to screen for and educate patients and physicians about supplement-associated hepatotoxicity is warranted.展开更多
AIM To evaluate liver resections without Pringle maneuver, i.e., clamping of the portal triad. METHODS Between 9/2002 and 7/2013, 175 consecutive liver resections(n = 101 major anatomical and n = 74 large atypical >...AIM To evaluate liver resections without Pringle maneuver, i.e., clamping of the portal triad. METHODS Between 9/2002 and 7/2013, 175 consecutive liver resections(n = 101 major anatomical and n = 74 large atypical > 5 cm) without Pringle maneuver were performed in 127 patients(143 surgeries). Accompanying, 37 wedge resections(specimens < 5 cm) and 43 radiofrequency ablations were performed. Preoperative volumetric calculation of the liver remnant preceeded all anatomical resections. The liver parenchyma was dissected by waterjet. The median central venous pressure was 4 mmH g(range: 5-14). Data was collected prospectively. RESULTS The median age of patients was 60 years(range: 16-85). Preoperative chemotherapy was used in 70 cases(49.0%). Liver cirrhosis was present in 6.3%, and liver steatosis of ≥ 10% in 28.0%. Blood loss was median 400 mL(range 50-5000 mL). Perioperative blood transfusions were given in 22/143 procedures(15%). The median weight of anatomically resected liver specimens was 525 g(range: 51-1850 g). One patient died postoperatively. Biliary leakages(n = 5) were treated conservatively. Temporary liver failure occurred in two patients.CONCLUSION Major liver resections without Pringle maneuver are feasible and safe. The avoidance of liver inflow clamping might reduce liver damage and failure, and shorten the hospital stay.展开更多
BACKGROUND With increasing rates of liver transplantation and a stagnant donor pool,the annual wait list removals have remained high.Living donor liver transplantation(LDLT)is an established modality in expanding the ...BACKGROUND With increasing rates of liver transplantation and a stagnant donor pool,the annual wait list removals have remained high.Living donor liver transplantation(LDLT)is an established modality in expanding the donor pool and is the primary method of liver donation in large parts of the world.Marginal living donors,including those with hepatic steatosis,have been used to expand the donor pool.However,due to negative effects of steatosis on graft and recipient outcomes,current practice excludes overweight or obese donors with more than 10%macro vesicular steatosis.This has limited a potentially important source to help expand the donor pool.Weight loss is known to improve or resolve steatosis and rapid weight loss with short-term interventions have been used to convert marginal donors to low-risk donors in a small series of studies.There is,however,a lack of a consensus driven standardized approach to such interventions.AIM To assess the available data on using weight loss interventions in potential living liver donors with steatotic livers and investigated the feasibility,efficacy,and safety of using such donors on the donor,graft and recipient outcomes.The principal objective was to assess if using such treated donor livers,could help expand the donor pool.METHODS We performed a comprehensive literature review and meta-analysis on studies examining the role of short-term weight loss interventions in potential living liver donors with hepatic steatosis with the aim of increasing liver donation rates and improving donor,graft,and recipient outcomes.RESULTS A total of 6 studies with 102 potential donors were included.Most subjects were males(71).All studies showed a significant reduction in body mass index postintervention with a mean difference of-2.08(-3.06,1.10,I2=78%).A significant reduction or resolution of hepatic steatosis was seen in 93 of the 102(91.2%).Comparison of pre-and post-intervention liver biopsies showed a significant reduction in steatosis with a mean difference of-21.22(-27.02,-15.43,I2=5展开更多
AIM: To determine the clinical effectiveness of intense psychological support to physical activity (PA) in nonalcoholic fatty liver disease (NAFLD), compared with cognitive-behavioral treatment (CBT).
文摘The application of appropriate cell origin for utilizing inregenerative medicine is the major issue. Various kinds of stem cells have been used for the tissue engineering and regenerative medicine. Such as, several stromal cells have been employed as treat option for regenerative medicine. For example, human bone marrow-derived stromal cells and adipose-derived stromal cells(ADSCs) are used in cell-based therapy. Data relating to the stem cell therapy and processes associated with ADSC has developed remarkably in the past 10 years. As medical options, both the stromal vascular and ADSC suggests good opportunity as marvelous cell-based therapeutics. The some biological features are the main factors that impact the regenerative activity of ADSCs, including the modulation of the cellular immune system properties and secretion of bioactive proteins such as cytokines, chemokines and growth factors, as well as their intrinsic anti-ulcer and anti-inflammatory potential. A variety of diseases have been treated by ADSCs, and it is not surprising that there has been great interest in the possibility that ADSCs might be used as therapeutic strategy to improve a wider range of diseases. This is especially important when it is remembered that routine therapeutic methods are not completely effective in treat of diseases. Here, it was discuss about applications of ADSC to colitis, liver failure, diabetes mellitus, multiple sclerosis, orthopaedic disorders, hair loss, fertility problems, and salivary gland damage.
文摘Nonalcoholic fatty liver disease (NAFLD) represents a rapidly growing cause of chronic liver disease in the United States and is associated with significant morbidity and mortality,including progression to liver cirrhosis and hepatocellular carcinoma.NAFLD comprises a spectrum of liver conditions,ranging from simple steatosis to steatosis with inflammation (steatohepatitis) and progressive fibrosis.Weight loss represents a first line therapeutic modality for the management of NAFLD.Herein,we review the evidence base for medical,surgical,and endoscopic approaches to weight loss and their potential impact on the natural history of NAFLD.
文摘目的探明桑叶水提物(mulberry leaves water extracts,MWE)对肥胖症大鼠脂代谢及肠道菌群的影响。方法采用饲喂SD大鼠高脂饲料,建立肥胖模型。在不改变饲喂方式的条件下,用不同剂量MWE进行干预;测定干预后大鼠的Lee’s指数、血脂水平;通过组织切片观察肝组织的变化;提取结肠粪便中的DNA,进行16S rRNA基因PCR,分析菌群组成。结果MWE能降低Lee’s指数;改善血脂水平;缓解肝脏脂肪性病变。肥胖大鼠粪便中的变形菌属、蓝细菌增加,拟杆菌减少;MWE干预后有所恢复。结论MWE能在肥胖症大鼠不改变摄食的条件下,减少脂肪的堆积,改善血脂状况,恢复紊乱的肠道菌群。
文摘目的 评估半肝血流完全阻断法（THHVE）在肝细胞癌肝切除术中的应用价值及其对肿瘤复发、转移和患者生存期的影响。方法 2011年8月至2013年8月期间在我科住院拟行手术切除的肝癌患者中,选择符合标准的患者纳入本研究。将所有入选患者随机分为两组,THHVE组患者在肝切除术中采用THHVE法控制血流,Pringle组采用Pringle法控制血流。对两组患者的术中总出血量、断肝过程中出血量、输血率、手术时间、血流阻断时间、并发症发生率、死亡率、术后住院时间、术后肝功能指标、无瘤生存期和总生存期等进行比较。结果 剔除不符合纳入标准的患者,共有143例符合标准的患者纳入最终分析,THHVE组71例,Pringle组72例。与Pringle组相比较,THHVE组患者的术中总出血量[250.0（150.0-400.0）mL vs 350.0（200.0-637.5）mL,P〈0.001]及断肝过程中出血量[100.0（50.0-200.0）mL vs 215.0（100.0-380.0）mL,P〈0.001]均减少。THHVE组患者的血流阻断时间长于Pringle组[27.0（20.0-31.0）min vs 20.0（16.0-24.0）min,P〈0.001],术后第1、第3、第7天的丙氨酸氨基转移酶水平低于Pringle组（P〈0.05）,术后第7天的总胆红素水平低于Pringle组（P=0.013）、血清前白蛋白高于Pringle组（P=0.038）。THHVE组并发症发生率低于Pringle组（21.1%vs 37.5%,P=0.032）。THHVE组患者的总生存期长于Pringle组（P=0.036）,Cox比例风险回归模型多因素分析结果显示采用THHVE法是影响患者总生存期的独立因素之一,采用THHVE法的患者的死亡风险是采用Pringle法的47.6%。结论THHVE法是肝癌肝切除术中一种安全、有效的血流控制方法,可减少术中出血、减轻术后肝功能损害、降低并发症发生率,较Pringle法明显延长了患者的总生存期。
文摘Dietary supplements represent an increasingly common source of drug-induced liver injury. Hydroxycut is a popular weight loss supplement which has previously been linked to hepatotoxicity, although the individual chemical components underlying liver injury remain poorly understood. We report two cases of acute hepatitis in the setting of Hydroxycut exposure and describe possible mechanisms of liver injury. We also comprehensively review and summarize the existing literature on commonly used weight loss supplements, and their individual components which have demon-strated potential for liver toxicity. An increased effort to screen for and educate patients and physicians about supplement-associated hepatotoxicity is warranted.
文摘AIM To evaluate liver resections without Pringle maneuver, i.e., clamping of the portal triad. METHODS Between 9/2002 and 7/2013, 175 consecutive liver resections(n = 101 major anatomical and n = 74 large atypical > 5 cm) without Pringle maneuver were performed in 127 patients(143 surgeries). Accompanying, 37 wedge resections(specimens < 5 cm) and 43 radiofrequency ablations were performed. Preoperative volumetric calculation of the liver remnant preceeded all anatomical resections. The liver parenchyma was dissected by waterjet. The median central venous pressure was 4 mmH g(range: 5-14). Data was collected prospectively. RESULTS The median age of patients was 60 years(range: 16-85). Preoperative chemotherapy was used in 70 cases(49.0%). Liver cirrhosis was present in 6.3%, and liver steatosis of ≥ 10% in 28.0%. Blood loss was median 400 mL(range 50-5000 mL). Perioperative blood transfusions were given in 22/143 procedures(15%). The median weight of anatomically resected liver specimens was 525 g(range: 51-1850 g). One patient died postoperatively. Biliary leakages(n = 5) were treated conservatively. Temporary liver failure occurred in two patients.CONCLUSION Major liver resections without Pringle maneuver are feasible and safe. The avoidance of liver inflow clamping might reduce liver damage and failure, and shorten the hospital stay.
文摘BACKGROUND With increasing rates of liver transplantation and a stagnant donor pool,the annual wait list removals have remained high.Living donor liver transplantation(LDLT)is an established modality in expanding the donor pool and is the primary method of liver donation in large parts of the world.Marginal living donors,including those with hepatic steatosis,have been used to expand the donor pool.However,due to negative effects of steatosis on graft and recipient outcomes,current practice excludes overweight or obese donors with more than 10%macro vesicular steatosis.This has limited a potentially important source to help expand the donor pool.Weight loss is known to improve or resolve steatosis and rapid weight loss with short-term interventions have been used to convert marginal donors to low-risk donors in a small series of studies.There is,however,a lack of a consensus driven standardized approach to such interventions.AIM To assess the available data on using weight loss interventions in potential living liver donors with steatotic livers and investigated the feasibility,efficacy,and safety of using such donors on the donor,graft and recipient outcomes.The principal objective was to assess if using such treated donor livers,could help expand the donor pool.METHODS We performed a comprehensive literature review and meta-analysis on studies examining the role of short-term weight loss interventions in potential living liver donors with hepatic steatosis with the aim of increasing liver donation rates and improving donor,graft,and recipient outcomes.RESULTS A total of 6 studies with 102 potential donors were included.Most subjects were males(71).All studies showed a significant reduction in body mass index postintervention with a mean difference of-2.08(-3.06,1.10,I2=78%).A significant reduction or resolution of hepatic steatosis was seen in 93 of the 102(91.2%).Comparison of pre-and post-intervention liver biopsies showed a significant reduction in steatosis with a mean difference of-21.22(-27.02,-15.43,I2=5
基金Supported by European Community’s Seventh Framework Program(FP7/2007-2013)under grant agreement,No.HEALTH-F2-2009-241762 for the project FLIP(in part)Centis E,Nuccitelli C and Moscatiello S supported by specific research contracts within the same program
文摘AIM: To determine the clinical effectiveness of intense psychological support to physical activity (PA) in nonalcoholic fatty liver disease (NAFLD), compared with cognitive-behavioral treatment (CBT).
