简介：AbstractBackground:Previously, dihydroceramide (d18:0/24:0) (dhCer (d18:0/24:0)) was reported to be a potential biomarker for acute-onchronic liver failure (ACLF) prognosis. In this study, we further explored the role of dhCer (d18:0/24:0) in the progression of ACLF to validate the biomarker using ACLF rat model.Methods:ACLF rats were sacrificed at 4 and 8 h post-D-galactosamine (D-gal)/lipopolysaccharide (LPS) administration to investigate the liver biochemical markers, prothrombin time and liver histopathology. Change in dhCer and other sphingolipids levels were investigated by high-performance liquid chromatography coupled to tandem mass spectrometry (HPLC-MS/MS). Rats were treated with N-(4-hydroxyphenyl) retinamide (4-HPR) to examine the mortality rate and its role in improving ACLF.Results:LPS/D-gal administration resulted in significant elevation in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Prothrombin time was prolonged and histopathological examination showed abnormality. HPLC-MS/MS results showed total dhCer levels in ACLF group (64.10 ± 8.90 pmol/100 μL, 64.22 ± 6.78 pmol/100 μL for 4 and 8 h, respectively) were decreased significantly compared with control group (121.61 ± 23.09 pmol/100 μL) (P < 0.05). In particular, dhCer (d18:0/24:0), dhCer (d18:0/20:0), and dhCer (d18:0/22:0) levels were decreased. Treatment with 4-HPR significantly increased the levels of dhCers, including dhCer (d18:0/24:0) compared with ACLF group, for the level of dhCer (d18:0/24:0) in 4-HPR group was 20.10 ± 8.60 pmol/100 μL and the level of dhCer (d18:0/24:0) in ACLF group was 9.74 ± 2.99 pmol/100 μL (P < 0.05). This was associated with reduced mortality rate and prolonged survival time. The ALT and AST in 4-HPR group were significantly decreased compared with ACLF group. The prothrombin time of 4-HPR group (41.49 s) was significantly lower than the prothrombin time of ACLF group (57.96 s) (P < 0.05). 4-HPR also decreased plasma ammonia levels slightly, as the plasma ammonia levels in 4-HPR group and ACLF group were 207.37 ± 60.43, 209.15 ± 60.43 μmol/L, respectively. Further, 4-HPR treatment improved histopathological parameters.Conclusions:DhCer, especially dhCer (d18:0/24:0), is involved in the progression of ACLF. Increasing the levels of dhCer can reduce the mortality rate of ACLF rats and alleviate liver injury.

简介：无

简介：AbstractBackground:The basis of individualized treatment should be individualized mortality risk predictive information. The present study aimed to develop an online individual mortality risk predictive tool for acute-on-chronic liver failure (ACLF) patients based on a random survival forest (RSF) algorithm.Methods:The current study retrospectively enrolled ACLF patients from the Department of Infectious Diseases of The First People’s Hospital of Foshan, Shunde Hospital of Southern Medical University, and Jiangmen Central Hospital. Two hundred seventy-six consecutive ACLF patients were included in the present study as a model cohort (n = 276). Then the current study constructed a validation cohort by drawing patients from the model dataset based on the resampling method (n = 276). The RSF algorithm was used to develop an individual prognostic model for ACLF patients. The Brier score was used to evaluate the diagnostic accuracy of prognostic models. The weighted mean rank estimation method was used to compare the differences between the areas under the time-dependent ROC curves (AUROCs) of prognostic models.Results:Multivariate Cox regression identified hepatic encephalopathy (HE), age, serum sodium level, acute kidney injury (AKI), red cell distribution width (RDW), and international normalization index (INR) as independent risk factors for ACLF patients. A simplified RSF model was developed based on these previous risk factors. The AUROCs for predicting 3-, 6-, and 12-month mortality were 0.916, 0.916, and 0.905 for the RSF model and 0.872, 0.866, and 0.848 for the Cox model in the model cohort, respectively. The Brier scores were 0.119, 0.119, and 0.128 for the RSF model and 0.138, 0.146, and 0.156 for the Cox model, respectively. The nonparametric comparison suggested that the RSF model was superior to the Cox model for predicting the prognosis of ACLF patients.Conclusions:The current study developed a novel online individual mortality risk predictive tool that could predict individual mortality risk predictive curves for individual patients. Additionally, the current online individual mortality risk predictive tool could further provide predicted mortality percentages and 95% confidence intervals at user-defined time points.

简介：cytokine发信号的Suppressor(SOCS)1在有免疫力的反应和力量起一个关键作用贡献与glucocorticoid对待的肝失败的预测。我们招募了接受glucocorticoid治疗和30健康控制在外部血mononuclear房间在SOCS1的transcriptional水平上决定glucocorticoid的潜在的效果的47个acute-on-chronic肝炎B肝失败(ACHBLF)病人。在glucocorticoid治疗的第三和八分之二十天，SOCS1表示否定地为结束阶段肝疾病与模型一起被相关(吞没)分数。Interleukin-6(IL-6)和肿瘤坏死factor-α；(TNF-α；)层次统计上更低，当SOCS1抄写水平在预告的处理和处理以后的ACHBLF病人两个都比非幸存者在幸存者是更高的时。在ACHBLF病人的SOCS1倡导者的methylation率比在由methylation特定的聚合酶链反应决定了的健康控制病人高。在methylated倡导者的SOCS1的mRNA水平是比从与unmethylatedSOCS1倡导者一起的病人显著地低的。干扰素(IFN)-γ-responsive和STAT1依赖的基因表示在幸存者是更高的并且戏剧性地在glucocorticoid治疗以后与SOCS1的升起的表示被减少。没有methylation，死亡率比为那些在methylated病人是显著地更高的。而且，我们在六发现了五熬过病人在治疗以后在八分之二十天显示了demethylatedSOCS1，当那个数字在非幸存者在10是3时。这些调查结果建议没有SOCS1methylation的ACHBLF病人可以有有利回答到corticosteroid治疗。

简介：objectivesTodemonstratethephenomenaandexplorethecausesofanemiainpatientswithchronicheartfailure(CHF).MethodsToobservethephenomenaofanemiainpatientswithCHF,atotalof276patientswithCHFwereincludedinthisretrospectivestudy.Theclinicalcharacteristicsofthepatientsare;meanage69.2±11.0years;male151,female125;NYHAⅢandⅣ115(41.7%).Results①Amongthe276patientswithCHF,81(29.4%)hadanemia(Meanhemoglobulinconcentration101.5±13.0g/L).②PatientswithAnemiaweremorelikelytobefemaleandtohavegreaterNYHA(ⅢorⅣ)(P<0.05),higherserumcreatinine,aswellaslowerserumalbuminandlow-densitylipoproteinlevels(P<0.01).③AweaknegativecorrelationwasalsonotedbetweenthelevelofNYHAandhemoglobulin.④Therewasnosignificantdifferenceinage,theprimarycardiacetiologyoftheCHF,thehistoryofdiabetes,leftventricularenddiastolicdiameter,andleftventricularejectionfractionbetweenCHFpatientwithandwithoutanemia.ConclusionsTheprevalenceofanemiaishighamongpatientswithCHF.TheanemiapatientswithCHFtendtobefemale,havegreatercardiacandrenalfunctionalimpairment,butwithlowerserumalbuminandLDLthatsuggestssomedegreeofmalnutrition.

简介：

简介：[摘要] 目的：探讨心理护理在急性心衰患者中的应用效果。方法：从2020年1月至2021年3月，来我院治疗的130例急性心衰患者。根据入院编号奇偶性分组：奇数编号的65例进入对照组，采用常规护理方案；偶数编号的65例进入试验组，在此基础上进行心理护理干预。比较临床依从性和负面情绪。结果：试验组依从性优良率更高（96.92%vs86.15%），干预后患者的SAS评分和SDS评分较对照组更低，经检验有统计学差异（P＜0.05）。结论：对急性心衰患者实施心理护理干预，能提高临床依从性、缓解负面情绪，具有推广价值。

简介：无

简介：无

简介：无

简介：丙肝在全球保健上强加重要负担。长期的感染与典型地在肝硬化，机关失败和癌症表明的肝的进步发炎被联系。由精致的避免策略的优点，丙肝病毒(HCV)作为一个坚持的人的病毒成功。它有一个非凡的能力破坏使它能建立长期的感染和联系的肝疾病的有免疫力的反应。Chemokines是低分子的重量调停的趋化性的肽进纸巾的煽动性的房间和进lymphatics和外部血的背的招募。因此，他们对受动器和规章的有免疫力的房间的时间、空间的分发中央。在chemokines和他们的血缘的受体帮助之间的相互作用塑造有免疫力的反应因此，在感染的结果上有主要影响。然而，chemokines包括HCV由病毒为调整代表一个目标。HCV被知道并且可以因此由通过改变的白血球在vivo破坏有免疫力的反应启用它的幸存趋化性导致损害病毒的清理和长期的低档发炎的建立在vitro调制chemokine表示。在这评论，在尖锐、长期的HCV感染的chemokines的角色被描述，一个特别重音作为有免疫力的颠覆的一个工具放了在chemokine调整上。我们提供一在里面部分的深度讨论在调停由chemokines玩了肝的纤维变性当在预示的药为这些chemoattractants探讨潜在的应用时。

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.

简介：无

简介：ObjectivesToexploretheeffectoflosartanoncardiacandrenalfunctioninpatientswithchronicheartfailure(CHF).MethodsSixty-fivepatientswithCHFweredividedintotwogroupsusingarandomized,controlandsingleblindmethod:losartangroup(n=30)andconventiongroup(n=35),withatreatmentcourseof8weeksforbothgroups.TheconcentrationsofcystatinC(cysC)inserum,microamountalbumin(MA)inurineweremeasuredbyimmunoturbidimetry.Theconcentrationofaquaporin-2(AQP-2)wasdeterminedbyenzyme-linked-immunosorbentassay(ELISA)andtheheartcontractilefunctionwasmeasuredbyechocardiographybeforeandaftertreatmentrespectively.ResultsComparingwithroutinetreatmentgroup,leftventricularend-diastolicdimension(LVEDd)decreasedsignificantly,whileleftventricularejectionfraction(LVEF)andleftventricularfractionalshortening(LVFS)increasedsignificantlyinlosartangroup.ThelevelsofcysCinserumandMA,AQP-2inurineweresignificantlylowerinlosartangroupthaninroutinetreatmentgroup.ConclusionLosartancanimprovecardiacandrenalfunctioninpatientswithCHF.

简介：[摘要] 目的：探讨个性化护理干预在慢性心衰护理中的效果。方法：从2020年1月至2021年3月，来我院治疗的102例慢性心衰患者。根据入院编号奇偶性分组：奇数编号的51例进入对照组，实施心内科护理常规；偶数编号的51例进入试验组，进行个性化护理干预。比较护理依从性和生活质量。结果：试验组依从性优良率更高（96.08%vs84.31%）；两组患者干预后的QOL均明显增高，且试验组评分结果较对照组更高，经检验有统计学差异（P＜0.05）。结论：对慢性心衰患者进行个性化护理干预，能提高护理依从性，有助于改善生活质量。

简介：无

简介：无

简介：在有长期的心失败(CHF)的病人的雄激素的浆液层次的预示的意义上的以前的研究让步了冲突结果。这研究的目的是与收缩CHF在人检验在睾丸激素和死亡的浆液集中之间的关系。175个老人的一个总数(age≥；60年)与CHF被招募。全部的睾丸激素(TT)和性荷尔蒙绑定血球素(SHBG)被测量，并且估计免费睾丸激素(水蜥)是计算的。中部的后续时间是3.46年。这些病人，17在8 下面有TT水平；nmoll−1(230 ；27有的ngdl−1),在0.225 下面的水蜥水平；nmoll−1(65 ；pgml−1)并且12有两个。用年龄特定在在我们截止指的实验室的健康的人的TT和水蜥的第十个百分位数，TT的流行和水蜥缺乏是21.7%；(38/175)并且27.4%；(48/175)分别地。TT和水蜥相反地与左室的喷射部分(LVEF)和N终端被联系支持大脑的natriuretic肽(NT-pro-BNP)(所有P<；0.01)。为根据TT和水蜥，水平看了显著地不同的累积幸存的在低、中等、高的tertiles的病人的Kaplan-Meier曲线评价(两P<；0.01由木头等级测试)。在为临床的变量的调整以后，然而，与幸存时间没有TT或水蜥层次的重要协会(OR=0.97，95%；CI：0.84-1.12，P=0.28和OR=0.92，95%；CI：0.82-1.06，P=0.14，分别地)。我们的学习证明TT和水蜥的层次通常与收缩CHF并且与疾病严厉有关在老病人被减少，但是他们不是为死亡的独立预言者。

简介：评估由于长期的心脏的失败为浮肿与中国植物粘住的acupoint的治疗学的效果。

简介：