Humans ; Liver Cirrhosis ; diagnosis ; etiology

Humans ; Liver Cirrhosis, Biliary ; diagnosis ; etiology ; therapy

Humans ; Liver Cirrhosis ; diagnosis ; etiology ; therapy

Ascites ; diagnosis ; etiology ; Diagnosis, Differential ; Humans ; Liver Cirrhosis ; complications ; diagnosis

Most patients with liver cirrhosis have hyperdynamic circulatory alterations with increased cardiac output, and decreased systemic vascular resistance and arterial pressure. But, in spite of the increased resting cardiac output, ventricular contractile response to stressful stimuli is attenuated in cirrhotic patients which is termed as cirrhotic cardiomyopathy. The prevalence of cirrhotic cardiomyopathy remains unknown at present. Clinical features include structural, histological, electrophysiological, systolic and diastolic dysfunction. Multiple factors are considered as responsible, including impaired beta-adrenergic receptor signal transduction, abnormal membrane biophysical characteristics, and increased activity of cardiodepressant systems mediated by cGMP. Generally, cirrhotic cardiomyopathy with overt severe heart failure is rare. However, major stresses on the cardiovascular system such as liver transplantation, infections and insertion of transjugular intrahepatic portosystemic shunts (TIPS) can unmask the presence of cirrhotic cardiomyopathy and thereby convert latent to overt heart failure. Cirrhotic cardiomyopathy may also contribute to the pathogenesis of hepatorenal syndrome and circulatory failure in liver cirrhosis. Because of the marked paucity of treatment studies, current recommendations for management are empirical, nonspecific measures. Further studies for pathogenesis and new therapeutic strategies in this area are required.
Cardiomyopathies/*diagnosis/*etiology/therapy ; Humans ; Liver Cirrhosis/*complications ; Prognosis

OBJECTIVETo explore the similarity between traditional Chinese medicine (TCM) syndromes and clinical symptoms and biological parameters in patients with post-hepatitis cirrhosis (PHC).

METHODSAfter the variants had been normalized, 4 methods for similarity analysis, i.e. method of cosine distance, correlation coefficient, D and spectral similarity, were used to analyze the similarity of clinical characteristic information (symptoms), biological parameters and TCM syndromes obtained from 279 patients with PHC.

RESULTSThe corresponding similarity matrixes were used to reflect the similarity between TCM syndromes and symptoms and biological parameters respectively, results obtained by the 4 methods were basically identical. As compared with the traditional correlation coefficient analysis, the other three methods showed a higher level of matching, sensitivity, rationality in quantitative accepting-rejecting and reliability, and were more accordant with clinical practice.

CONCLUSIONThe resemblance between TCM syndromes and clinical information on disease obtained from similarity analysis is basically in accordance with the clinical practice, so, the technique could be taken as a method for finding the characteristics of TCM syndrome with simplified clinical parameters.

Acute Kidney Injury ; diagnosis ; etiology ; Biomarkers ; Early Diagnosis ; Humans ; Liver Cirrhosis ; complications ; diagnosis

Ascites ; diagnosis ; etiology ; therapy ; Europe ; Humans ; Liver Cirrhosis ; complications ; diagnosis ; therapy ; Practice Guidelines as Topic

Acute-on-chronic liver failure (ACLF) is an increasingly recognized distinct disease entity encompassing an acute deterioration of liver function in patients with chronic liver disease. Although there are no widely accepted diagnostic criteria for ACLF, the Asia.Pacific Association for the Study of the Liver (APASL) and the American Association for the Study of Liver Disease and the European Association for the Study of the Liver (AASLD/EASL) consensus definitions are commonly used. It is obvious that the APASL and the AASLD/EASL definitions are based on fundamentally different features. Two different definitions in two different parts of the world hamper the comparability of studies. Recently, the EASL-Chronic Liver Failure Consortium proposed new diagnostic criteria for ACLF based on analyses of patients with organ failure. There are areas of uncertainty in defining ACLF, such as heterogeneity of ACLF, ambiguity in qualifying underlying liver disease, argument for infection or sepsis as a precipitating event, etc. Although the exact pathogenesis of ACLF remains to be elucidated, alteration of host response to injury, infection, and unregulated inflammation play important roles. The predisposition, infection/inflammation, response, organ failure (PIRO) concept used for sepsis might be useful in describing the pathophysiology and clinical categories for ACLF. Treatment strategies are limited to organ support but better understanding of the pathophysiology is likely to lead to discovery of novel biomarkers and therapeutic strategies in the future.
Chronic Disease ; Echocardiography ; Humans ; Liver Cirrhosis/complications ; Liver Failure/diagnosis/etiology/*pathology/prevention & control ; Liver Failure, Acute/diagnosis/etiology/*pathology/prevention & control ; Liver Transplantation ; Sepsis/complications

Esophageal and Gastric Varices ; diagnosis ; etiology ; pathology ; Hemorrhage ; Humans ; Liver Cirrhosis ; complications ; pathology