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01 September 2013, Volume 33 Issue 9 Previous Issue    Next Issue

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Prevention and treatment of complications of liver cirrhosis. FAN Jian-Gao，CAO Hai-xia. 2013, 33(9): 673-675.  Abstract ( )   PDF (880KB) ( )   Abstract：Cirrhosis is a major health problem with an inevitably poor prognogis.Manegement of patients with cirrhosis should change from treating complications as they occur，to preventing the advent of all complications.

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Management of refractory ascites in liver cirrhosis. LI Lan，LI You-ming. 2013, 33(9): 676-678.  Abstract ( )   PDF (880KB) ( )   Abstract：Refractory ascites is a common complication of liver cirrhosis associated with a poor prognosis.The current medical managements of refractory ascites include sodium restriction，a combination of albumin and diuretic，large-volume paracentesis，transjugular intrahepatic portosystemic shunt，and ascites concentration-reinfusion.Potential new treatment options for refractory ascites include the use of terlipressin，vasopressin type 2 receptor antagonists，midodrine，and nonselective b-blocker，all of which could possibly improve the management of ascites.This paper makes an introduction of current management and novel therapeutic strategies for refractory ascites.

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Research progress in the management of hyponatremia in cirrhosis. WANG Yu-ming. 2013, 33(9): 679-683.  Abstract ( )   PDF (898KB) ( )   Abstract：Hyponatremia in liver cirrhosis is defined by a serum sodium concentration of less than 130 mmol/L，but some scholars think that the definition is too strict and serum sodium concentration should be less than 135 mmol/L.Hyponatremia in liver cirrhosis is characterized by excessive renal retention of water relative to sodium due to reduced solute-free water clearance.The primary cause is increased release of arginine vasopressin.As clinical hyponatremia is usually difficult to treat，the occurrence of vanptans，particullarlly tolvaptan，a highly selective arginine vasopressin V2 receptor antagonist on hyponatremia cirrhosis is of importance in clinical practice.A number of studies have suggested short-term，few of them even with long-term，application tolvaptan is safe and effective，and it is currently the sole vanptan to be used in clinical hyponatremia in patients with cirrhosis.

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The empirical therapy of pulmonary infection complicated with hepatic cirrhosis. NAN Yue-min，ZHANG Qing-shan，WANG Rong-qi. 2013, 33(9): 684-686.  Abstract ( )   PDF (878KB) ( )   Abstract：Pulmonary infection is common in the patients suffered from liver cirrhosis due to declined immunoability.Reasonable application of antibiotics is the key measurement for the patients’recovery.Cephalosporins and quinolones were preferred antibiotics to treat bacterial pneumonia，and compound antibiotics with β-lactamase inhibitors or carbapenems were used to extended spectrum β-lactamases bacteria infection.Vancomycin was the first-line treatment for pulmonary infection caused by drug resistance of staphylococcus aureus，penicillin-resistant streptococcus and enterococcus.Pulmonary candidiasis and aspergillosis were usually treated with caspofungin or voriconazole.Quinolone antibiotics were often selected for mycoplasma and chlamydia pneumonia treatment.

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Prevention of risk factors and treatment of hepatorenal syndrome. WANG Jing-yan，DOU Xiao-guang. 2013, 33(9): 687-689.  Abstract ( )   PDF (879KB) ( )   Abstract：Hepatorenal syndrome (HRS) is a well-recognized complication of end-stage liver disease which carriers a poor prognosis and high mortality rate without transplantation.The pathophysiological mechanisms of HRS are characterized by significant hemodynamic changes.These changes consist of systemic arterial vasodilatation and effective arterial underfilling.The purpose of the present paper is to provide a review of the pathophysiology，risk factors，preventions，and therapies on HRS.

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Risk Assessment and Prevention of Gastroesophageal Varices and Variceal Hemorrhage in Cirrhosis. ZHONG Bi-hui，WANG Jin-ping，LIN Jing-hua，CHAO Kang. 2013, 33(9): 690-693.  Abstract ( )   PDF (894KB) ( )   Abstract：Esophageal gastric varices is one of the most common complications of liver cirrhosis.The disease develop progressively as soon as the formation of Gastroesophageal varices，with a bleeding rate of about one third.The risk of recurrent variceal hemorrhage and mortality are as high as 60% and 15%~30% in patients with no prevention treatment，respectively.Evaluation of Varices bleeding risk is mainly rely on endoscopic finding and liver function.Preventive measures mainly include nonselective beta blockers and endoscopic treatment.A short duration of antibiotic prophylaxis may be benefit patients after the acute bleeding.

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Risk factors，survelliance and treatment for hepatocellular carcinoma in cirrhosis. HAN Ying，ZHU Jiang-yi. 2013, 33(9): 694-697.  Abstract ( )   PDF (889KB) ( )   Abstract：Hepatocellular carcinoma (HCC) is one of the malignant tumors with high incidence and mortality worldwide.Scheduled surveillance of high-risk patients and early diagnosis and treatment are effective in maximizing life expectancy outcomes.High-risk group is defined as：cirrhotic patients with a family history of HCC，high viral load，long course of disease，combined with a variety of virus infection or with alcohol，obesity and diabetes.Monitoring AFP and abdominal ultrasound every 3-6 months are suggested for high-risk group to make an early diagnosis of HCC.Treatment methods include operation，local ablation，chemoembolization，targeted drug therapy.Rational application of comprehensive treatment can effectively increase the overall survival rate of HCC patients.

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The clinical treatment practice of cirrhosis with chronic liver failure. NIE Qing-he. 2013, 33(9): 698-701.  Abstract ( )   PDF (890KB) ( )   Abstract：The clinical comprehensive treatment is the basic method of cirrhosis with chronic liver failure.Emphasis on importance of infection control，nutritional support，transfusion of fresh plasma，whole blood or albumin and the key to successful clinical treatment is to keep balance of maintain water and electrolyte，maintain machine homeostasis and control intestinal endotoxemia.At the same time，active prevention and treatment of its complications.The liver transplantation is recognized as the most effective treatment for end-stage liver disease era in clinical.

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Nutritional support in end-stage liver disease patients. XU Ke-shu，DU Fan. 2013, 33(9): 702-704.  Abstract ( )   PDF (881KB) ( )   Abstract：Almost all of the patients with end-stage liver disease exist different degree of malnutrition and metabolic disorders.Malnutrition is considered to be one of the most important and independent prognostic factors in patients with end-stage liver disease and its severity influences the short-term surviva1 of patients directly.Proper nutrition support therapy can improve the prognosis of patients with end-stage liver disease，improve the patients’ quality of life and prolong the survival period.Based on the specific disease condition and the patient’s tolerance，nutritional supports with proper nutritional substances and administrative route should be provided individually.

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Interpretation of the international consensus of the 2012 Revision Atlanta acute pancreatitis classification. HE Wen-hua，Lv Nong-hua. 2013, 33(9): 708-711.  Abstract ( )   PDF (888KB) ( )   Abstract：The Atlanta Classification of acute pancreatitis developed by the 1992 Atlanta symposium，to guide the diagnosis and treatment of acute pancreatitis.In 2012，the Acute Pancreatitis Classification Working Group has published a new revised the Atlanta Classification Criteria，which provides clear definitions to classify acute pancreatitis using easily identified clinical and radiologic criteria.We summarized and interpreted the main content of the consensus opinion，and compared it with the 1992 Atlanta Classification Criteria.