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 advances in the application of machine learning in the diagnosis and treatment of liver disease. Method The recent literatures on the progress of machine learning in the diagnosis, treatment and prognosis of liver diseases were reviewed. Results Machine learning could be used to diagnose and categorize substantial liver lesions, tumourous lesions and rare liver diseases at an early stage, which could facilitate clinicians to take timely and appropriate treatment measures. Machine learning was helpful in informing clinicians in choosing the best treatment decision, which was conducive to reducing medical risks. It could also help to determine the prognosis of patients in a comprehensive manner, and provide assistance in formulating early rehabilitation treatment plans, adjusting follow-up strategies and improving future prognosis. Conclusions Multiple types of machine learning algorithms have achieved positive results in the clinical application of liver diseases by constructing different prediction models, and have great potential and excellent prospects in multiple aspects such as diagnosis, treatment and prognosis of liver diseases.
【Abstract】ObjectiveBy using multidetector row spiral CT (MDCT) to investigate the CT imaging findings of gallbladder abnormalities caused by hepatic parenchymal diseases and those of inflammatory cholecystitis. MethodsCT and clinical data of 80 patients with gallbladder abnormalities were retrospectively reviewed. Fifty patients were in hepatic disease group, including 20 chronic hepatitis, 25 liver cirrhosis, and 5 cirrhosis with hepatocellular carcinoma. Thirty patients were in inflammatory group, including 19 chronic cholecystitis, 6 acute cholecystitis, 3 cholecystitis with acute pancreatitis, 1 gangrenous cholecystitis, and 1 xanthogranulomatous cholecystitis. All patients underwent MDCT plain scan and contrastenhanced dualphase scanning of upper abdomen. ResultsIn hepatic disease group, 48 cases had evenly thickened gallbladder wall (96%) with mean thickness of (3.67±0.49) mm; 38 cases had clear gallbladder outlines (76%); 38 cases had gallbladder wall enhancement of various degree (76%); 14 cases had gallbladder bed edema and localized nondependant pericholecystic fluid collection (28%). In inflammatory cholecystitis group, 28 cases had obscuring gallbladder outlines (93%) ; 26 cases had gallbladder wall evenly thickened (87%), 4 cases showed unevenly thicked wall (13%), the mean thickness being (4.54±1.14) mm; 30 cases had inhomogenous enhancement of the gallbladder wall (100%); 9 cases had highattenuation bile (30%); 4 cases had dependant pericholecystic fluid collection (13%); 5 cases had transient enhancement of adjacent hepatic bed in arterial phase (17%); microabscess and gas in the gallbladder wall was observed in 1 case respectively. ConclusionMDCT can offer imaging findings useful for differentiating abnormal gallbladder changes caused by hepatic parenchymal diseases from those due to inflammatory cholecystitis.
Objective To summarize the application and prospect of susceptibility weighted imaging （SWI） in diagnosis of hepatic disease. Methods The application of SWI in diagnosis of hepatic disease was analyzed retrospectively via reviewed the literatures home and abroad, and to look forward to the future of the clinical values of SWI. Results A number of hepatic diseases such as cirrhosis, hematochromatosis， and malignant tumors could induce iron overload in hepatic cell and Kuffper cell. Because of SWI is sensitive to vein， vascular abnormality, haemorrhage （including all kinds of metabolities after bleeding）， iron overload， calcification, and so on, so the use of SWI in hepatic disease is explored continually. Conclusions SWI may be a new method for diagnosis of hepatic disease, which can supply more valuable information for clinician.
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.
ObjectiveTo summarize the current status of research in the correlation between the liver diseases and oral microbiota, to provide the scientific basis for the prevention and treatment of oral diseases in the patients with liver diseases, and to provide the guidance for further research on the biomarkers for the noninvasive diagnosis of liver diseases.MethodThe related literatures about the studies of correlation between liver diseases and oral microbiota were reviewed by searching the databases such as the PubMed, Web of Science, CNKI, and Wanfang, etc.ResultsAs the second richest microbiota, the oral flora closely interacted with the hepatitis, alcoholic liver disease, non-alcoholic fatty liver disease, cirrhosis, liver cancer, etc. Meanwhile, the prognosis of patients underwent liver transplantation was also closely correlated to oral flora.ConclusionsSpecific oral flora in patients with different liver diseases may be a potential non-invasive diagnostic biomarker. At the same time, it is necessary to pay attention to oral health and maintain oral microbiota balance for preventing and treating of liver diseases.
内镜技术的问世是医学史上的一次革命，是21世纪医学的重要进展之一。目前,内镜技术在肝胆胰外科领域得到了广泛的应用，有力地促进了肝胆胰外科的发展，肝胆胰内镜技术已成为微创外科重要的组成部分。。。。。。
Objective To understand and analyze technique development of magnetic resonance elastography (MRE) and its application in chronic liver disease. Method The relevant literatures about the application of MRE in the field of chronic liver disease were reviewed. Results The liver fibrosis was a common pathway of chronic liver disease, which would progress to cirrhosis of the liver if untreated. The diagnosis and assessment of fibrosis was important in the treatment of patients with chronic liver disease. The liver biopsy was considered to be the reference standard for clinical assessment of liver fibrosis. However, this technique was invasive and still had inevitable drawbacks in the clinical practice. With the update of the imaging technology and equipment, the MRE had been developed as a safe and noninvasive examination method for the evaluation of liver fibrosis in the chronic liver disease, early diagnosis of nonalcoholic fatty liver disease, evaluation of focal liver lesions, and other clinical applications. Conclusion MRE is currently regarded as an attractive noninvasive technique in management of chronic liver disease.
ObjectiveTo summarize the changes of gut microbiota after cholecystectomy, the mechanisms of changes, and the relation with colorectal cancer, nonalcoholic fatty liver disease and post-cholecystectomy syndrome after cholecystectomy, in order to provide new ideas for the perioperative management of patients undergoing cholecystectomy. MethodThe studies related to gut microbiota after cholecystectomy at home and abroad were searched and analyzed for review. ResultsThe cholecystectomy disrupted the liver–bile acid–gut flora axis of the patients, and the composition and diversity of the gut microbiota of the patients were altered, and the alteration might lead to the occurrence of colorectal cancer, nonalcoholic fatty liver disease, and post-cholecystectomy syndrome, but the exact mechanism remained unclear. ConclusionsThe balance of intestinal microecology is disrupted after cholecystectomy, and the relation between cholecystectomy and gut microbiota may provide new ideas for the perioperative management of cholecystectomy patients and the prevention and treatment of diseases or symptoms after cholecystectomy, but the effect of cholecystectomy on gut microbiota and the relation with diseases or symptoms still need to be further studied.