简介：HeartFailureisasyndromeratherthanaspecificdiagnosis.Itisthefinalresultofmanydiseasesaffectingtheheart.Heartfailureisusuallyviewedintermsofheartmuscledisease,butothercausesofthesyndromeincludevalxaxlarheartdiseaseandchronicarrhythmias.Inindustrializedsocieties,themostcommoncauseofheartfailureiscoronaryarterydisease.Asubstantialminorityofpatientshave'dilatedcardiomyopathy',inwhichthereisintrinsicheartmuscledamagewithnormalcoronaryarteries.Bydefinition,thecauseofcardiomyopathyisunknown,andthisdiagnosisshouldthereforeeventuallydisappearonceallthecausesofheartmuscledysfunctionareidentified.Therangeofcausesofspecificheartmusclediseaseisalreadywide(Figure1).

简介：胆汁酸(BA)由充当tensioactives在肠在胖消化有一个长确定的角色，由于他们的amphipatic特征。BA被肠上皮很高效地重新吸收并且经由大部分被阐明了的运输机制再循环回到肝。BA的运输和合成被特定的血浆膜受体和原子受体紧部分地调整。除了他们的主要效果，BA被宣称在胃肠的癌症，肠的发炎和肠的离子的运输起一个作用。BA不在任何这些生物活动，和结构的要求是相等的通常被识别了。特别地，一些BA可能在煽动性的肠疾病为癌症chemoprevention并且也许是有用的，尽管进一步的研究在这个领域里是必要的。这评论在BA肠的生物学的这些方面盖住最近的开发。

简介：AbstractBone disease is the most common complication in patients with multiple myeloma (MM), and it may lead to skeletal-related events (SREs) such as bone pain, pathological fractures, and spinal cord compression, which impair a patients' quality of life and survival. The pathogenesis of myeloma bone disease (MBD) involves disruption of bone reconstitution balance including excessive activation of osteoclasts, inhibition of osteoblasts, and participation of osteocytes and bone marrow stromal cells. Various factors, such as the receptor activator of nuclear factor-κB ligand (RANKL)/osteoprotegerin (OPG), dickkopf-1 (DKK-1), sclerostin, and activin-A, are involved in the development of MBD. Bisphosphonates and the anti-RANKL antibody denosumab are currently the main treatment options for MBD, delaying the onset of SREs. Denosumab is preferred in patients with MM and renal dysfunction. Although effective drugs have been approved, antimyeloma therapy is the most important method for controlling bone disease.

简介：摘要Functional dyspepsia (FD) and gastroparesis are two common functional gastrointestinal diseases, affecting millions of people in both China and around the world. However, treatment options are limited and difficult due to multiple factors involved in their pathophysiologies. Therefore it is critically important to assess and understand pathophysiologies of these diseases before a treatment is given. In this minireview we provide updates on recent development in the pathophysiologies and treatments of FD and gastroparesis. In addition to common abnormalities in gastric accommodation, antral hypomotility and visceral hypersensitivity, FD has recently been reported to display a number of impairment in duodenal functions, such as low-grade inflammation and increased permeability. For gastroparesis, macrophages have recently been reported to play an important role in its pathophysiology. A brief overview on the assessment of pathophysiologies of FD and gastroparesis is also provided; pros and cons of clinically available methodologies as well as emerging methods are discussed. Finally, available treatment options for FD and gastroparesis are presented in this minireview, including authors′ opinions on the advantages and disadvantages of each therapy. Potential novel therapies for FD and gastroparesis, especially those associated with Traditional Chinese Medicine, are also introduced and discussed.

简介：Recentfindingsinthepathophysiologyandmonitoringofhemostasisinpatientswithendstageliverdiseasehavemajorimpactoncoagulationmanagementduringlivertransplantation.Thereisincreasingevidence,thatthechangesinbothcoagulationfactorsandplateletcountregularlyobservedinpatientswithlivercirrhosiscannotbeinterpretedasareliableindicatorofdiffusebleedingrisk.Instead,adifferentiatedviewonhemostasishasledtotheconceptofarebalancedcoagulationsystemWhileitisimportanttorecognizethatprocoagulantfactorsarereducedinlivercirrhosis,itisalsoevidentthatsynthesisofanticoagulantfactorsandfibrinolyticproteinsproducedintheliverisalsodiminished.Similarly,thedecreasedplateletcountmaybecounterbalancedbyincreasedplateletaggregabilitycausedbyhighlyactivevonWillebrandmultimeres.Thecoagulationsystemisthereforstatedtoberebalanced.Whileundernormal＂unstressed＂conditionsdiffusebleedingisrarelyobserved,howeverbothdiffusebleedingorthrombusformationmayoccurwhencompensationmechanismsareexhausted.Whilemostpatientspresentingforlivertransplantationhaveseverecirrhosis,liverfunctionandthusproductionofpro-andanticoagulantfactorscanbepreservedespeciallyincholestaticliverdisease.Duringlivertransplantation,profoundchangesinthehemostasissystemcanoccur.Surgicalbleedingcanleadtodiffusebleedingascoagulationfactorsandplateletsarealreadyreduced.Ischemiaandtissuetraumacanleadtoalterationsofhemostasiscomparabletotraumainducedcoagulopathy.Afurthercommondisturbanceoftenstartingwiththereperfusionofthetransplantedorganishyperfibrinolysiswhichcaneventuallyprecipitatecompleteconsumptionoffibrinogenandanendogenousheparinizationbyglycocalyxshedding.Moreover,thromboticeventsinlivertransplantationsarenotuncommonandcontributetoincreasedmortality.Besidesconventionallaboratorymethods,bed-sidemonitoringofhemostasis（e.g.,thrombelastography,thrombe

简介：Thisreviewaimsatevaluatingtheexistingevidenceregardingpostreperfusionsyndrome,providingadescriptionofthepathophysiologicmechanismsinvolvedandpossiblemanagementandpreventivestrategies.APubMedsearchwasconductedusingtheMeSHdatabase,＂Reperfusion＂AND＂livertransplantation＂werethecombinedMeSHheadings;EMBASEandtheCochranelibrarywerealsosearchedusingthesameterms.52relevantstudiesandoneongoingtrialwerefound.Theconceptofpostreperfusionsyndromehasevolvedthroughyearstoamultisystemicdisorder.Theimplicationsofthemainorgan,recipientandprocedurerelatedfactorsinthegenesisofthiscomplexsyndromearediscussedinthetextasthenovelpharmacologicandtechnicalapproachestoreduceitsincidence.Howevertheavailableevidenceaboutriskfactors,physiopathologyandpreventivemeasuresisstillconfusing,thepresenceoftwomaindefinitionsandthenumerosityofpossibleconfoundingfactorsgreatlycomplicatestheinterpretationofthestudies.

简介：精索静脉曲张与减少的男繁殖潜力被联系了。与在biomolecular技术的进展，更好理解涉及精索静脉曲张挑起的阴囊的损坏的机制是可能的。尽管机制充分还没被描述了，它是可能的是multifactorial，当前的证据在联系精索静脉曲张的男subfertility的致病建议反应的氧种类(ROS)和结果的氧化压力(OS)的中央角色。过多的ROS与精子DNA破碎被联系，它可以调停与精索静脉曲张有关的差的精子功能和授精结果的临床的表明。ROS/OS和DNA破碎测试有潜力与常规精液分析相比提供另外的诊断、预示的信息并且可以在单个病人指导治疗学的管理策略。

简介：AbstractNonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, placing an increasing burden on human health. NAFLD is a complex multifactorial disease involving genetic, metabolic, and environmental factors. It is closely associated with metabolic syndrome, obesity, and type 2 diabetes, of which insulin resistance is the main pathophysiological mechanism. Over the past few decades, investigation of the pathogenesis, diagnosis, and treatments has revealed different aspects of NAFLD, challenging the accuracy of definition and therapeutic strategy for the clinical practice. Recently, experts reach a consensus that NAFLD does not reflect the current knowledge, and metabolic (dysfunction) associated fatty liver disease (MAFLD) is suggested as a more appropriate term. The new definition puts increased emphasis on the important role of metabolic dysfunction in it. Herein, the shared features and potential changes in epidemiology, pathophysiology, diagnosis, and pharmacotherapy of the newly defined MAFLD, as compared with the formerly defined NAFLD, are reviewed for updating our understanding.