ObjectiveTo analyze the incidence of bacterial lung infection after orthotopic liver transplantation and its risk factors.
MethodsNinety-six patients with end-stage liver disease who underwent liver transplantation from Jan. 2010 to Jun. 2012 in our hospital were retrospectively analyzed. The relationship of preoperative, intraoperative, and postoperative variables with early postoperative bacterial lung infection was explored by multivariate non-conditional logistic regression.
ResultsTwenty-nine cases of 96 cases after liver transplantation occurred early bacterial lung infection, and the infection rate was 30.21%(29/96), in which G-aerobic bacteria infection accounted for 65.52%(19/29), and G+ aerobic bacteria accounted for 34.48%(10/29). Preoperative model for end-stage liver disease score(OR=2.165, P=0.001), intraoperative blood transfusion(OR=1.952, P=0.003), average of plasma creatinine during 3 days after operation(OR=1.913, P=0.001), liquid negative balance time during 3 days after operation(OR=0.916, P=0.023), and postoperative hospital stay(OR=1.923, P=0.003) were all associated with early postoperative bacterial lung infection.
ConclusionsRetrograde reperfusion in orthotopic liver transplantation patients are susceptible to bacterial lung infections. Improving basic status before operation, controlling volume of intraoperative blood transfusion, the volume of transfusion, and postoperative hospital stay, and improving renal function can reduce incidence of early postoperative bacterial lung infection.
ObjectiveTo summarize the research progress of phytochemicals in the prevention and treatment of alcoholic liver disease and its possible clinical application value.MethodThe current literatures about the preventive and therapeutic effects of phytochemicals on alcoholic liver disease at home and abroad were reviewed.ResultsPhyto- chemicals could prevent and treat alcoholic liver disease by reducing inflammation, reducing oxidative stress, and improving lipid metabolism. They had the advantage of multi-targets.ConclusionPhytochemicals play an important role in the prevention and treatment of alcoholic liver disease, and it also lay a solid foundation for translational medicine.
Objective To investigate the risk factors for end-stage liver disease (ESLD) complicated with fungal esophagitis (FE). Methods The clinical data of ESLD patients who underwent gastroscopy during their hospitalization in the Second Affiliated Hospital of Chongqing Medical University between January 1, 2017 and December 31, 2023 were retrospectively analyzed. The ESLD patients with FE were selected as the study group, and the ESLD patients without FE during the same period were included as the control group by 1∶2 propensity score matching method. Multivariate logistic regression model was used to analyze the risk factors of ESLD complicated with FE. Results A total of 75 ESLD patients with FE and 150 ESLD patients without FE were enrolled. There was no significant difference in age, gender, decompensated cirrhosis, liver cancer, diabetes mellitus, or etiology of ESLD between the two groups (P>0.05). Multivariate logistic regression analysis showed that longer hospital stay [odds ratio (OR)=1.115, 95% confidence interval (CI) (1.069, 1.164)], with invasive procedures [OR=10.820, 95%CI (4.393, 26.647)], and higher total bilirubin [OR=1.015, 95%CI (1.005, 1.024)] were risk factors for ESLD complicated with FE (P<0.05). In the study group, 41 patients were treated with antifungal drugs, and 4 of them developed invasive fungal infection. Among the 34 patients who did not receive antifungal drugs, 10 developed invasive fungal infection. Conclusions ESLD patients with longer hospital stay, worse liver function, and invasive procedures are more likely to develop FE, and regular gastroscopy should be performed. Once FE is found, active antifungal treatment should be taken to reduce the occurrence of invasive fungal infection and improve the prognosis of patients.
Objective To summarize the current progress in diagnosis and treatment of polycystic liver disease, and provide ideas for further research direction and clinical practice of polycystic liver disease. Method The domestic and foreign literature about polycystic liver disease was reviewed, screened, and summarized. Results The diagnosis, evaluation, and classification of polycystic liver disease were mainly performed clinically by abdominal ultrasound and CT. Surgical treatment was the main treatment, including aspiration sclerotherapy, fenestration, segmental hepatectomy, and liver transplantation. Conclusions The classification and evaluation scheme of polycystic liver disease needs to be improved, and its medical treatment still needs further research. Estrogen receptor and gonadotropin-releasing hormone receptor are promising therapeutic targets.
ObjectiveTo summarize the relationship between Kupffer cells (KCs) and liver diseases.MethodsThe related literatures about the research progress of KCs in liver diseases in recent years were collected and analyzed.ResultsKCs were an important component of the monocyte-macrophage system. In a specific environment, activated KCs participated in a variety of inflammatory reactions, immune tolerance, and damage to hepatocytes by presenting antigens, secreting cytokines and chemokines, phagocytosis, and so on. KCs could not only be activated into M1 to promote inflammatory reaction and aggravate hepatocyte injury, but also could be activated to M2 to play an anti-inflammatory effect and improve liver injury. The role of KCs in liver diseases was very complex, but it also had potential research value.ConclusionKCs can affect the progression of liver diseases through many mechanisms and can provide new ideas for the prevention and treatment of liver diseases.
Objective To summarize the mechanism and research progress of Kruppel-like factor 2 (KLF2) in various liver diseases and related drug development, providing theoretical basis for further mechanism exploration and clinical application. Method The literatures on the mechanism of KLF2 in liver diseases at home and abroad were collected and summarized. Results KLF2 was widely distributed and had various functions in human body, mainly regulating the growth, differentiation and function of endothelial cells, inhibiting pro-inflammatory and pro-thrombotic gene expression, and participating in important physiological processes such as liver inflammation, oxidative stress and thrombosis, and affecting the occurrence and development of various liver diseases. The regulation of KLF2 expression by statins had been widely used in the treatment of liver diseases. Conclusion KLF2 regulates the expression of related molecules through a variety of pathways and affects the functions of various cells in the liver, which is the focus of research on improving liver injury.
【Abstract】Objective To introduce the birth and development of model of endstage liver disease (MELD) and evaluate its effect on liver transplantation(LT) as a new scoring system. Methods Literatures of MELD applied in LT were analyzed retrospectively. Results MELD scoring system was used for predicting the prognosis of patients with endstage liver disease and the death risk of candidates on waiting LT extensively and the order of organ sharing was determined by its predicable results. Conclusion MELD has been had a successful initial implementation for predicting the shortterm survival probability and mortality in patients with endstage liver disease, and meeting the goal of providing a system of allocation that emphasizes the urgency of the candidate while diminishing the reliance on waiting time, which has been proven to be a powerful tool for auditing the liver allocation system.
Unhealthy diet, habits and drug abuse cause a variety of liver diseases, including steatohepatitis, liver fibrosis, liver cirrhosis and liver cancer, which seriously affect human health. The fabrication of highly simulated cell models in vitro is important in the treatment of liver diseases and drug development. This article summarized the common strategies for the construction of liver pathology models in vitro. It introduced four typical cell models in vitro related to liver disease and provided a reference for the study of liver disease models.
ObjectiveTo expounded the relationship between phenylalanine, tyrosine and their metabolites and non-alcoholic fatty liver disease (NAFLD). MethodThe literatures related to NAFLD in recent years were reviewed and analyzed. ResultThe levels of phenylalanine, tyrosine and their metabolites had changed significantly in the occurrence and development of NAFLD, and could lead to the progress of NAFLD by affecting the related pathways of lipid metabolism. ConclusionPhenylalanine, tyrosine and their related metabolites are associated with NAFLD, but the specific pathogenesis is still unclear.
ObjectiveTo understand the current research progress on the role of hydrogen sulfide (H2S) in liver diseases. MethodThe relevant literature on the role of H2S in the liver diseases published in recent years was retrieved and reviewed. ResultsCurrent research focused primarily on exploring the mechanisms of H2S in various liver diseases. Studies had shown that H?S played an important role in the occurrence and development of liver diseases through mechanisms such as antioxidative stress, anti-inflammatory effects, regulation of autophagy, endoplasmic reticulum stress, angiogenesis, and cell death. ConclusionsBy supplementing exogenous H2S, adjusting the gut microbiota, or inhibiting key enzymes involved in H?S synthesis, the concentration of H2S in the body can be modulated, providing new strategies for treating liver diseases. However, the related mechanisms are still controversial. Future research should further investigate the specific role of H2S in different liver diseases and how to precisely control its level in the body to achieve targeted drug delivery.
