2.Nursing of hand-foot syndrome by oral intake of Nexavar in one patient with liver cancer
Chinese Journal of Practical Nursing 2012;28(23):51-52
Objective To summarize nursing measures of one liver cancer patient with hand-foot syndrome by onral intake of Nexavar. Methods Care focused on close observation of disease condition changes,strengthening skin care,psychological support,life care,health education and dietary care. Results The patient was discharged crred after two-week treatment.Through intensive care,the patient was discharged from hospital after 2 weeks. Conclusions To teach patients self-observation and prevention measures of hand-foot syndrome can ensure early detection,early treatment and early recovery of them.
4.The clinicopathological analysis of 88 patients with abnormal liver function test of unknown etiology
Shuzhen PANG ; Xiaojuan OU ; Xiaoyan SHI ; Tailing WANG ; Weijia DUAN ; Jidong JIA
Chinese Journal of Internal Medicine 2011;50(1):36-39
Objective To evaluate the clinical and histological features of patients with abnormal liver tests of unknown etiology, and then to investigate the diagnosis and differential diagnosis. Methods Patients with abnormal liver function test hospitalized and had liver biopsies during 2008-2009 constituted this retrospective study cohort. After excluding those patients diagnosed with hepatotropic viral hepatitis,space occupying lesions of the liver, alcoholic liver disease and obstruction of bile duct caused by stone or malignancy and AMA/AMA-M2 positive of primary biliary cirrhosis ( PBC ), the clinical and histological characteristics were evaluated. Results Out of the 180 patients who underwent liver biopsy, 88 patients were included in the present analysis. The final diagnosis involved 15 categories of diseases, with druginduced liver injury ( DILI ) [34. 09% ( 30/88 )], autoimmune liver diseases [22.73% ( 20/88 )], and nonalcoholic fatty liver disease (NAFLD) [12. 50% ( 11/88 )] being the most common causes, following by genetic and other rare diseases. Conclusion DILI, autoimmune liver disease and NAFLD were the most common causes of abnormal liver tests in these non-viral liver diseases. Some rare diseases such as hereditary metalbolic liver disease also represent a considerable proportion in patients with abnormal liver function test.
5. The importance of hyperdynamic circulation in the progression of liver cirrhosis and its therapeutic strategies
Yu WANG ; Xiaojuan OU ; Jidong JIA
Chinese Journal of Hepatology 2017;25(7):544-547
Portal hypertension is one of the main performance of liver cirrhosis, in addition to anatomical factors, hyperdynamic circulatory status caused by abnormal splanchnic vascular tension is also very important in this procession. We summarised the mechanism and treatment strategies of hyperdynamic circulation in cirrhosis, so as to provide some recommendation for clinical practice.
6.Diagnosis and treatment of portal hypertension caused by rare diseases
Yu WANG ; Min WANG ; Xiaojuan OU
Journal of Clinical Hepatology 2019;35(1):29-32
Portal hypertension caused by rare diseases is mostly presinusoidal (prehepatic) or posthepatic. It is non-cirrhotic portal hypertension in most cases, so hepatic venous pressure gradient cannot accurately reflect the portal venous pressure of such patients, which causes difficulties in clinical diagnosis and treatment. There are many diseases in this category. This article introduces the advances in the pathogenesis and treatment of portal hypertension caused by six rare diseases and summarizes the current status of treatment, in order to help improve the awareness of these diseases among clinicians.
7.Value of hepatic venous pressure gradient in predicting clinical end events in liver cirrhosis
Fuliang HE ; Xiaojuan OU ; Min WANG ; Guanhua ZHANG ; Yu WANG
Journal of Clinical Hepatology 2020;36(9):1931-1935
Liver cirrhosis is the end stage of liver disease, and decompensated liver cirrhosis has the significant feature of portal hypertension. At present, hepatic venous pressure gradient (HVPG) remains the “gold standard” for evaluating portal hypertension and thus has great significance in clinical practice. This article elaborates on the value of HVPG in predicting end events in compensated and decompensated liver cirrhosis and the application of HVPG in evaluating the therapeutic effect of drugs in the treatment of portal hypertension, so as to provide a basis for early prediction, early prevention, and early intervention of portal hypertension in clinical practice.
8.Definition, etiology, and epidemiology of liver cirrhosis
Shan SHAN ; Lianhui ZHAO ; Hong MA ; Xiaojuan OU ; Hong YOU ; Jidong JIA
Journal of Clinical Hepatology 2021;37(1):14-16
Liver cirrhosis is the leading cause of liver-related death globally, and the most common causes of liver cirrhosis are chronic hepatitis B and C, alcoholic liver disease, and nonalcoholic fatty liver disease. Recent studies have shown that despite an increase in the number of deaths due to liver cirrhosis around the world, there is a reduction in age-standardized death. In China, there are increases in number of patients with liver cirrhosis, prevalence rate of liver cirrhosis, number of deaths due to liver cirrhosis, and mortality rate of liver cirrhosis, while there are reductions in age-standardized prevalence rate and mortality rate; chronic hepatitis B remains the main cause of liver cirrhosis, with a gradual increase in the proportion of liver cirrhosis cases caused by alcoholic and nonalcoholic fatty liver diseases.
9.Clinical diagnosis, staging, and therapeutic principles of liver cirrhosis
Yu WANG ; Min WANG ; Guanhua ZHANG ; Fuliang HE ; Xiaojuan OU ; Jidong JIA
Journal of Clinical Hepatology 2021;37(1):17-21
With in-depth studies on the pathogenesis, pathophysiology, treatment, and prognosis of liver cirrhosis in recent years, there have been great changes in staging and treatment concepts among scholars in China and globally. Besides the traditional staging system of compensated and decompensated liver cirrhosis, liver cirrhosis can be divided into five stages based on ascites, variceal bleeding, and severe infection, which highlights the features of this disease in different disease stages and this provides potential targets and basis for treatment. At present, the comprehensive management of liver cirrhosis, including etiological treatment, treatment targeting key pathogenesis and major complications, nutritional support, exercise guidance, and lifestyle adjustment (smoking cessation, alcohol withdrawal, and improvement of oral hygiene), is the key to delaying disease progression and improving prognosis, and liver transplantation remains the most effective approach for end-stage liver cirrhosis.
10.Direct intrahepatic portosystemic shunt in treatment of Budd-Chiari syndrome
Fuliang HE ; Lei WANG ; Hongwei ZHAO ; Zhendong YUE ; Yu WANG ; Ke ZHANG ; Ruizhao QI ; Yuening ZHANG ; Xiaojuan OU ; Hong YOU ; Jidong JIA ; Fuquan LIU
Chinese Journal of Hepatobiliary Surgery 2021;27(1):30-35
Objective:To study the efficacy of direct intrahepatic portosystemic shunt (DIPS) in treatment of Budd-Chiari syndrome (BCS).Methods:From January 1, 2015 to June 31, 2017, consecutive patients with BCS who were treated with DIPS at the Department of Interventional Therapy of Beijing Shijitan Hospital, the Liver Disease Research Center of Beijing Friendship Hospital and the General Surgery Department of Beijing Ditan Hospital were retrospectively analyzed. The symptoms, physical signs (including abdominal distension, ascites, pleural effusion, splenomegaly, hepatic encephalopathy) and perioperative laboratory results of these patients were collected and analyzed. Biochemical indicators including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil), and portal pressure gradient were compared before and 2 weeks after treatment. The patients were followed up for at least 3 years to assess their clinical symptoms, patency of shunt, oncological status and survival.Results:Of 67 patients with BCS who were included in the study, there were 45 males and 22 females, aged (38.12±23.22) years. The BCS classification of these patients were hepatic vein type ( n=65), including 62 patients with complete hepatic vein obstruction, 3 patients with hepatic vein occlusion due to thrombosis, and 2 patients with mixed hepatic vein and inferior vena cava occlusion. All 67 patients underwent DIPS with 93 stents being implanted. In addition, 43 patients underwent gastric coronary vein embolization, and 2 patients with mixed type of BCS underwent inferior vena cava stenting. The portal pressure gradient decreased from (22.17±9.16) mmHg (1 mmHg=0.133 kPa) to (9.87±4.75) mmHg, the difference was statistically significant ( P<0.05). Abdominal distension was relieved, at one month and ascites completely subsided in 3 months after operation. The liver congestion and swelling were obviously relieved. Comparison of patients 2 weeks after operation and before operation, ALT decreased from (65.28±27.75) U/L to (28.43±13.46)U/L, AST from (68.75±29.23) U/L to (26.92±13.33)U/L, TBil from (175.31±80.48)μmol/L to (45.08±26.54)μmol/L, DBil from (127.55±44.65)μmol/L to (35.12±10.77)μmol/L, and albumin increased from (31.56±7.22) g/L to (44.18±11.36)g/L, the difference was statistically significant (all P<0.05). All patients were followed up for at least 3 years. Shunt stenosis was detected in 5 patients (7.46%) with shunt expansion being performed, variceal bleeding in 2 patients (2.99%), ascites recurrence in 4 patients (5.97%) and hepatic encephalopathy in 2 patients (2.99%). No patients were diagnosed with hepatic cancer, and no patients died. Conclusion:DIPS was efficacious, safe and reliable to that BCS patients. It rapidly reduced portal venous pressure, relieved liver congestion, and restored liver morphology and liver function in these patients.