首页 > 最新文献

Livers最新文献

英文 中文
Hidden Dangers: Herbal and Dietary Supplement Induced Hepatotoxicity 隐患:草药和膳食补充剂引起的肝毒性
Pub Date : 2023-10-31 DOI: 10.3390/livers3040041
Shannan Tujios
Herbal and dietary supplements represent a multi-billion-dollar industry reportedly used by over half of American adults. However, these products are not regulated by the Federal Drug Agency and contain a wide range of contaminants, leading to over 50,000 adverse events each year. This review aims to highlight the widespread use and current regulatory status of herbal and dietary supplements, identify the presentation and diagnostic dilemmas faced with liver injury, and discuss the most common agents implicated in herbal and dietary supplement hepatotoxicity.
据报道,超过一半的美国成年人使用草药和膳食补充剂,这是一个价值数十亿美元的产业。然而,这些产品不受联邦药品管理局的监管,含有多种污染物,每年导致超过5万起不良事件。本文旨在强调草药和膳食补充剂的广泛使用和目前的监管状况,确定肝损伤的表现和诊断困境,并讨论与草药和膳食补充剂肝毒性有关的最常见药物。
{"title":"Hidden Dangers: Herbal and Dietary Supplement Induced Hepatotoxicity","authors":"Shannan Tujios","doi":"10.3390/livers3040041","DOIUrl":"https://doi.org/10.3390/livers3040041","url":null,"abstract":"Herbal and dietary supplements represent a multi-billion-dollar industry reportedly used by over half of American adults. However, these products are not regulated by the Federal Drug Agency and contain a wide range of contaminants, leading to over 50,000 adverse events each year. This review aims to highlight the widespread use and current regulatory status of herbal and dietary supplements, identify the presentation and diagnostic dilemmas faced with liver injury, and discuss the most common agents implicated in herbal and dietary supplement hepatotoxicity.","PeriodicalId":74083,"journal":{"name":"Livers","volume":"24 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135765825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Therapeutics for Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) 代谢功能障碍相关脂肪肝的治疗
Pub Date : 2023-10-28 DOI: 10.3390/livers3040040
Kamlesh K. Bhopale, Mukund P. Srinivasan
Metabolic dysfunction associated fatty liver disease (MAFLD) has been recently recognized as a new global chronic liver disease entity with non-alcoholic fatty liver disease (NAFLD) associated with overweight/obesity or type 2 diabetes mellitus (T2DM) and evidence of metabolic dysregulation. Due to the rising rates of obesity and diabetes, MAFLD is considered a rapidly emerging chronic liver disease globally. Nearly 25–30% of the global population poses health issues due to MAFLD with a substantial economic burden to societies. Disease progression depends on the persistence of risk factors and etiological agents, from simple steatosis, hepatitis, fibrosis, to cirrhosis, and if untreated, leads to hepatocellular carcinoma. In this review article we summarize various risk and etiological factors, diagnostic techniques, and therapeutic evaluation of pharmacological agents developed for MAFLD. Effective pharmaceutical agents for the treatment of MAFLD (and NAFLD) are lacking, and research is ongoing to search for effective medications in this direction. Currently, pioglitazone is advised for MAFLD patients, whereas Vitamin E is advised for non-diabetic MAFLD patients with ≥F2 non-cirrhosis. Current approaches to disease management emphasize diet control, lifestyle changes, and weight loss. In this review, we summarized the pharmacological agents currently being developed and their current status to treat patients with MAFLD.
代谢功能障碍相关脂肪性肝病(MAFLD)最近被认为是一种新的全球慢性肝病实体,非酒精性脂肪性肝病(NAFLD)与超重/肥胖或2型糖尿病(T2DM)相关,并有代谢失调的证据。由于肥胖和糖尿病发病率的上升,mald被认为是全球范围内迅速出现的慢性肝病。全球近25-30%的人口因马蹄疫造成健康问题,给社会带来沉重的经济负担。疾病进展取决于危险因素和病因的持续存在,从单纯脂肪变性、肝炎、纤维化到肝硬化,如果不治疗,可导致肝细胞癌。在这篇综述文章中,我们总结了各种危险因素和病因,诊断技术,以及对MAFLD药物的治疗评价。目前缺乏治疗MAFLD(和NAFLD)的有效药物,研究人员正在寻找这方面的有效药物。目前,推荐吡格列酮用于MAFLD患者,而维生素E用于≥F2非肝硬化的非糖尿病型MAFLD患者。目前的疾病管理方法强调控制饮食、改变生活方式和减轻体重。在这篇综述中,我们总结了目前正在开发的药物和他们的现状,以治疗MAFLD患者。
{"title":"Therapeutics for Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)","authors":"Kamlesh K. Bhopale, Mukund P. Srinivasan","doi":"10.3390/livers3040040","DOIUrl":"https://doi.org/10.3390/livers3040040","url":null,"abstract":"Metabolic dysfunction associated fatty liver disease (MAFLD) has been recently recognized as a new global chronic liver disease entity with non-alcoholic fatty liver disease (NAFLD) associated with overweight/obesity or type 2 diabetes mellitus (T2DM) and evidence of metabolic dysregulation. Due to the rising rates of obesity and diabetes, MAFLD is considered a rapidly emerging chronic liver disease globally. Nearly 25–30% of the global population poses health issues due to MAFLD with a substantial economic burden to societies. Disease progression depends on the persistence of risk factors and etiological agents, from simple steatosis, hepatitis, fibrosis, to cirrhosis, and if untreated, leads to hepatocellular carcinoma. In this review article we summarize various risk and etiological factors, diagnostic techniques, and therapeutic evaluation of pharmacological agents developed for MAFLD. Effective pharmaceutical agents for the treatment of MAFLD (and NAFLD) are lacking, and research is ongoing to search for effective medications in this direction. Currently, pioglitazone is advised for MAFLD patients, whereas Vitamin E is advised for non-diabetic MAFLD patients with ≥F2 non-cirrhosis. Current approaches to disease management emphasize diet control, lifestyle changes, and weight loss. In this review, we summarized the pharmacological agents currently being developed and their current status to treat patients with MAFLD.","PeriodicalId":74083,"journal":{"name":"Livers","volume":"10 17","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136232693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Evolution of Circulating Biomarkers for Use in Acetaminophen/Paracetamol-Induced Liver Injury in Humans: A Scoping Review 用于对乙酰氨基酚/扑热息痛引起的人类肝损伤的循环生物标志物的演变:范围综述
Pub Date : 2023-10-27 DOI: 10.3390/livers3040039
Mitchell R. McGill, Steven C. Curry
Acetaminophen (APAP) is a widely used drug, but overdose can cause severe acute liver injury. The first reports of APAP hepatotoxicity in humans were published in 1966, shortly after the development of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) as the first biomarkers of liver injury as opposed to liver function. Thus, the field of liver injury biomarkers has evolved alongside the growth in APAP hepatotoxicity incidence. Numerous biomarkers have been proposed for use in the management of APAP overdose patients in the intervening years. Here, we comprehensively review the development of these markers from the 1960s to the present day and briefly discuss possible future directions.
对乙酰氨基酚(APAP)是一种广泛使用的药物,但过量可引起严重的急性肝损伤。在丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)成为肝损伤而非肝功能的第一个生物标志物后不久,关于APAP对人类肝毒性的第一批报告于1966年发表。因此,肝损伤生物标志物领域随着APAP肝毒性发生率的增长而发展。在此期间,许多生物标志物被提议用于APAP过量患者的管理。在这里,我们全面回顾了这些标记物从20世纪60年代到现在的发展,并简要讨论了可能的未来方向。
{"title":"The Evolution of Circulating Biomarkers for Use in Acetaminophen/Paracetamol-Induced Liver Injury in Humans: A Scoping Review","authors":"Mitchell R. McGill, Steven C. Curry","doi":"10.3390/livers3040039","DOIUrl":"https://doi.org/10.3390/livers3040039","url":null,"abstract":"Acetaminophen (APAP) is a widely used drug, but overdose can cause severe acute liver injury. The first reports of APAP hepatotoxicity in humans were published in 1966, shortly after the development of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) as the first biomarkers of liver injury as opposed to liver function. Thus, the field of liver injury biomarkers has evolved alongside the growth in APAP hepatotoxicity incidence. Numerous biomarkers have been proposed for use in the management of APAP overdose patients in the intervening years. Here, we comprehensively review the development of these markers from the 1960s to the present day and briefly discuss possible future directions.","PeriodicalId":74083,"journal":{"name":"Livers","volume":"9 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136234795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pemafibrate Improves Alanine Aminotransferase Levels Independently of Its Lipid-Lowering Effect 培马非特提高丙氨酸转氨酶水平独立于其降脂作用
Pub Date : 2023-10-23 DOI: 10.3390/livers3040038
Azuma Watanabe, Ryoko Horigome, Yumiko Nakatsuka, Shuji Terai
Aim: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. Pemafibrate, a selective peroxisome-proliferator-activated receptor α modulator (SPPARMα), has been reported to ameliorate liver function among patients with dyslipidemia. However, there are not many reports of the clinical effects of pemafibrate. This study aims to summarize the experience of using pemafibrate and analyze the effects on liver function in patients with dyslipidemia. Methods: One hundred twelve cases of hyperlipidemia receiving pemafibrate 0.2 mg/day were retrospectively enrolled in this study. Age, gender, BMI, complications, concomitant medications, serum parameters (TG, HDL-C, LDL-C, AST, ALT, γGTP, ALP, platelets, M2BPGi, Cre, eGFR, HbA1c, blood glucose level at any time) were investigated and evaluated. Results: Pemafibrate administration significantly improved serum TG and HDL-C, but not in LDL-C. Serum AST, ALT, γGTP, and ALP were also significantly improved. The fib-4 index, a liver fibrosis score, did not significantly change, but M2-BPGi, an index of fibrosis, significantly decreased. No correlation was observed between each lipid parameter and ALT, and ALT decreased independently of the lipid parameters. Conclusions: As we expected, pemafibrate demonstrated a lipid-improving effect without adversely affecting hepatic and renal functions. An unexpected finding was the decrease in ALT that was independent of lipid parameters.
目的:非酒精性脂肪性肝病(NAFLD)是慢性肝病最常见的病因。pemafbrate是一种选择性过氧化物酶体增殖物激活受体α调节剂(SPPARMα),据报道可改善血脂异常患者的肝功能。然而,关于培马颤动的临床效果的报道并不多。本研究旨在总结使用培马颤动的经验,分析其对血脂异常患者肝功能的影响。方法:回顾性分析112例高脂血症患者接受培马哌特0.2 mg/d治疗。调查并评估年龄、性别、BMI、并发症、合并症、血清参数(TG、HDL-C、LDL-C、AST、ALT、γ - gtp、ALP、血小板、M2BPGi、Cre、eGFR、HbA1c、任意时间血糖水平)。结果:培马替特可显著改善血清TG和HDL-C,但对LDL-C无显著影响。血清AST、ALT、γ - gtp、ALP均显著升高。肝纤维化评分fib-4指数无明显变化,但纤维化指数M2-BPGi明显下降。各项血脂参数与ALT无相关性,ALT的下降与血脂参数无关。结论:正如我们预期的那样,培马哌特显示出改善血脂的作用,而不会对肝肾功能产生不利影响。一个意想不到的发现是ALT的下降与脂质参数无关。
{"title":"Pemafibrate Improves Alanine Aminotransferase Levels Independently of Its Lipid-Lowering Effect","authors":"Azuma Watanabe, Ryoko Horigome, Yumiko Nakatsuka, Shuji Terai","doi":"10.3390/livers3040038","DOIUrl":"https://doi.org/10.3390/livers3040038","url":null,"abstract":"Aim: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. Pemafibrate, a selective peroxisome-proliferator-activated receptor α modulator (SPPARMα), has been reported to ameliorate liver function among patients with dyslipidemia. However, there are not many reports of the clinical effects of pemafibrate. This study aims to summarize the experience of using pemafibrate and analyze the effects on liver function in patients with dyslipidemia. Methods: One hundred twelve cases of hyperlipidemia receiving pemafibrate 0.2 mg/day were retrospectively enrolled in this study. Age, gender, BMI, complications, concomitant medications, serum parameters (TG, HDL-C, LDL-C, AST, ALT, γGTP, ALP, platelets, M2BPGi, Cre, eGFR, HbA1c, blood glucose level at any time) were investigated and evaluated. Results: Pemafibrate administration significantly improved serum TG and HDL-C, but not in LDL-C. Serum AST, ALT, γGTP, and ALP were also significantly improved. The fib-4 index, a liver fibrosis score, did not significantly change, but M2-BPGi, an index of fibrosis, significantly decreased. No correlation was observed between each lipid parameter and ALT, and ALT decreased independently of the lipid parameters. Conclusions: As we expected, pemafibrate demonstrated a lipid-improving effect without adversely affecting hepatic and renal functions. An unexpected finding was the decrease in ALT that was independent of lipid parameters.","PeriodicalId":74083,"journal":{"name":"Livers","volume":"SE-12 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135405195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The 863C>A and 1031T>C Single Nucleotide Polymorphisms (SNPs) in the Tumor Necrosis Factor Alpha (TNF-α) Promoter Gene May Not Be Putative Predictors of HBV Endemicity 肿瘤坏死因子α (TNF-α)启动子基因的863C>A和1031T>C单核苷酸多态性(SNPs)可能不是推测的HBV地方性的预测因子
Pub Date : 2023-09-22 DOI: 10.3390/livers3040037
Hussein Mukasa Kafeero, Dorothy Ndagire, Ponsiano Ocama, Charles Drago Kato, David Patrick Kateete, Abdul Walusansa, Ali Kudamba, Kigozi Edgar, Fred Ashaba Katabazi, Maria Magdalene Namaganda, Jamilu E. Ssenku, Eddie Wampande, Henry Kajumbula, Hakim Sendagire
Background: Genetic polymorphisms within the gene loci of the promoter region of tumor necrosis factor (TNF) alpha have been associated with the pathogenesis of hepatitis B virus (HBV) infection. In Uganda, there is a wide variation in the HBV endemicity, ranging from low endemicity, through moderate endemicity, to hyper-endemicity. However, the underlying reasons for this disparity in HBV burden are not fully elucidated. Thus, we aimed to test the hypothesis that the TNF-α-863C/A and -1031T/C polymorphic sites may have an effect on the difference between the burden of HBV in our country. We screened 384 participants, from which a sample of 134 was drawn, to determine the HBV, TNF-α-863C/A, and TNF-α-863T/C genotypes. The nucleotide BLAST was used to match the unknown targeted sequence obtained from the Sanger sequence against the known deposited sequence. This process unveiled the base substitution mutation and the HBV genotypes. The odds ratio (OR) and Chi-square test of proportions were used for the analysis. All the analyses were performed using SPSS version 26.0 and MedCalc software version 20.010 at 95% CI. A p < 0.05 was considered statistically significant. Results: The prevalence of both the TNF-α-863C/A and the TNF-α-1031T/C genotypes and their alleles did not differ significantly by endemicity (p > 0.05). However, the prevalence of the nucleotide substitution mutations for TNF-α-863C>A and TNF-α-1031T>C was significantly low for all the study groups (p < 0.05). Conclusion: The TNF-α gene promoter at the TNF-α-863C/A and 1031T/C positions is conserved in our population and may not affect the endemicity of HBV infection. However, future research should focus on the use of nationwide samples in order to reach concreate determinations regarding the role of the TNF-α polymorphisms in the risk/resolution of HBV infections in an African or Black population.
背景:肿瘤坏死因子(TNF) α启动子区域基因位点的遗传多态性与乙型肝炎病毒(HBV)感染的发病机制有关。在乌干达,乙型肝炎病毒的地方性差异很大,从低地方性,到中等地方性,再到高地方性。然而,乙肝病毒负担差异的根本原因尚未完全阐明。因此,我们旨在验证TNF-α-863C/A和-1031T/C多态性位点可能影响我国HBV负担差异的假设。我们筛选了384名参与者,从中抽取了134名样本,以确定HBV, TNF-α-863C/ a和TNF-α-863T/C基因型。利用核苷酸BLAST将从Sanger序列中获得的未知目标序列与已知沉积序列进行比对。这一过程揭示了碱基置换突变和HBV基因型。采用比值比(OR)和卡方比例检验进行分析。所有分析均采用SPSS 26.0版和MedCalc 20.010版软件进行,95% CI。A & p;0.05认为有统计学意义。结果:TNF-α-863C/A和TNF-α-1031T/C基因型及其等位基因在不同地区的患病率差异无统计学意义(p >0.05)。然而,TNF-α-863C>A和TNF-α-1031T>C的核苷酸替代突变发生率在所有研究组中均明显较低(p <0.05)。结论:TNF-α基因启动子TNF-α- 863c /A和1031T/C位点在我国人群中具有保守性,可能不影响HBV感染的地方性。然而,未来的研究应该集中在全国范围内的样本的使用上,以获得关于TNF-α多态性在非洲或黑人人群中HBV感染风险/解决方案中的作用的具体确定。
{"title":"The 863C&gt;A and 1031T&gt;C Single Nucleotide Polymorphisms (SNPs) in the Tumor Necrosis Factor Alpha (TNF-α) Promoter Gene May Not Be Putative Predictors of HBV Endemicity","authors":"Hussein Mukasa Kafeero, Dorothy Ndagire, Ponsiano Ocama, Charles Drago Kato, David Patrick Kateete, Abdul Walusansa, Ali Kudamba, Kigozi Edgar, Fred Ashaba Katabazi, Maria Magdalene Namaganda, Jamilu E. Ssenku, Eddie Wampande, Henry Kajumbula, Hakim Sendagire","doi":"10.3390/livers3040037","DOIUrl":"https://doi.org/10.3390/livers3040037","url":null,"abstract":"Background: Genetic polymorphisms within the gene loci of the promoter region of tumor necrosis factor (TNF) alpha have been associated with the pathogenesis of hepatitis B virus (HBV) infection. In Uganda, there is a wide variation in the HBV endemicity, ranging from low endemicity, through moderate endemicity, to hyper-endemicity. However, the underlying reasons for this disparity in HBV burden are not fully elucidated. Thus, we aimed to test the hypothesis that the TNF-α-863C/A and -1031T/C polymorphic sites may have an effect on the difference between the burden of HBV in our country. We screened 384 participants, from which a sample of 134 was drawn, to determine the HBV, TNF-α-863C/A, and TNF-α-863T/C genotypes. The nucleotide BLAST was used to match the unknown targeted sequence obtained from the Sanger sequence against the known deposited sequence. This process unveiled the base substitution mutation and the HBV genotypes. The odds ratio (OR) and Chi-square test of proportions were used for the analysis. All the analyses were performed using SPSS version 26.0 and MedCalc software version 20.010 at 95% CI. A p < 0.05 was considered statistically significant. Results: The prevalence of both the TNF-α-863C/A and the TNF-α-1031T/C genotypes and their alleles did not differ significantly by endemicity (p > 0.05). However, the prevalence of the nucleotide substitution mutations for TNF-α-863C>A and TNF-α-1031T>C was significantly low for all the study groups (p < 0.05). Conclusion: The TNF-α gene promoter at the TNF-α-863C/A and 1031T/C positions is conserved in our population and may not affect the endemicity of HBV infection. However, future research should focus on the use of nationwide samples in order to reach concreate determinations regarding the role of the TNF-α polymorphisms in the risk/resolution of HBV infections in an African or Black population.","PeriodicalId":74083,"journal":{"name":"Livers","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136061140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nutrition Therapy in Critically Ill Patients with Liver Disease: A Narrative Review 危重肝病患者的营养治疗:叙述性综述
Pub Date : 2023-09-21 DOI: 10.3390/livers3030036
Miguel Ángel Hidalgo-Blanco, Juan Carlos Lopez-Delgado, José Antonio Sarria-Guerrero
Nutrition therapy in critically ill patients with liver disease represents a challenge for Intensive Care Units (ICUs). Nutritional status is correlated with the degree of hepatic dysfunction and the presence of malnutrition worsens outcomes in these patients. The nutritional risk that critically ill patients represent, together with the pathophysiological alterations of liver disease, especially in terms of nutrition intake and protein depletion, leads to malnutrition and sarcopenia. Nutrition therapy improves the survival of these patients; however, this is challenging since they more frequently experience difficulties with nutrition delivery. In consequence, both evaluation of nutritional status and an individualized approach seem mandatory for achieving nutrition objectives. The present narrative review discusses the importance of nutrition therapy, the recommendations of contemporary clinical practice guidelines, and a practical approach to provide the best possible nutrition therapy in patients with liver disease admitted to ICUs.
重症肝病患者的营养治疗是重症监护病房(icu)面临的一个挑战。营养状况与肝功能障碍程度相关,营养不良会使这些患者的预后恶化。危重病人的营养风险,加上肝病的病理生理改变,特别是在营养摄入和蛋白质消耗方面,导致营养不良和肌肉减少症。营养治疗提高了这些患者的生存率;然而,这是具有挑战性的,因为他们更经常遇到营养输送方面的困难。因此,营养状况的评估和个性化的方法似乎是实现营养目标的必要条件。本文讨论了营养治疗的重要性,当代临床实践指南的建议,以及为icu住院的肝病患者提供最佳营养治疗的实用方法。
{"title":"Nutrition Therapy in Critically Ill Patients with Liver Disease: A Narrative Review","authors":"Miguel Ángel Hidalgo-Blanco, Juan Carlos Lopez-Delgado, José Antonio Sarria-Guerrero","doi":"10.3390/livers3030036","DOIUrl":"https://doi.org/10.3390/livers3030036","url":null,"abstract":"Nutrition therapy in critically ill patients with liver disease represents a challenge for Intensive Care Units (ICUs). Nutritional status is correlated with the degree of hepatic dysfunction and the presence of malnutrition worsens outcomes in these patients. The nutritional risk that critically ill patients represent, together with the pathophysiological alterations of liver disease, especially in terms of nutrition intake and protein depletion, leads to malnutrition and sarcopenia. Nutrition therapy improves the survival of these patients; however, this is challenging since they more frequently experience difficulties with nutrition delivery. In consequence, both evaluation of nutritional status and an individualized approach seem mandatory for achieving nutrition objectives. The present narrative review discusses the importance of nutrition therapy, the recommendations of contemporary clinical practice guidelines, and a practical approach to provide the best possible nutrition therapy in patients with liver disease admitted to ICUs.","PeriodicalId":74083,"journal":{"name":"Livers","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136236448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hepatitis E Virus: Epidemiology, Clinical Aspects, and Its Significance as a Major Pregnancy Risk 戊型肝炎病毒:流行病学、临床方面及其作为主要妊娠风险的意义
Pub Date : 2023-09-15 DOI: 10.3390/livers3030035
Sidra Urooj, Sadia Anjum, Fareeha Iqbal, Maisa Siddiq Abduh, Hashaam Akhtar, Sumbal Javed, Salik Javed Kakar, Aamer Ikram, Nabeel Ahmed Maqbool, Tahir Ahmad
HEV is a single-stranded, positive RNA virus. The hepatitis E virus (HEV) is the causing agent of hepatitis, with a high prevalence rate in low-income countries due to poor sanitary conditions. It can exhibit acute, continuous, or extrahepatic consequences in immunocompromised individuals such as those undergoing organ transplantation and having HIV infection. HEV infection is either self limiting (silent), meaning the patient will possibly recover on his own, or symptomatic, causing acute liver injury or fulminant hepatitis and may eventually cause death. It can also cause chronic hepatitis that can progress to cirrhosis or recovery. Pregnancy-related HEV infection has an incidence rate of 30%. HEV escape from innate immunity, hormonal imbalances, defective monocyte–macrophage function, downregulation of the T-cell-mediated immune system, high cytokine production, nutritional factors, and socioeconomic conditions may play fundamental roles in the prevalence of HEV infection. It is necessary to take particular measures to reduce the incidence burden of HEV infection in high endemic locations as the incidence data, not the prevalence data, is more accurate at estimating disease dynamics. The purpose of this study is to throw light on several aspects of the hepatitis E virus and to discuss the incidence of HEV infection concerning other diseases. HEV molecular features, clinical features, epidemiology, extrahepatic manifestations, and multiple available diagnostics and treatment strategies for HEV are debated in the current review.
HEV是一种单链阳性RNA病毒。戊型肝炎病毒(HEV)是引起肝炎的病原体,由于卫生条件差,在低收入国家的流行率很高。它可以在免疫功能低下的个体中表现出急性、持续或肝外后果,例如那些接受器官移植和感染艾滋病毒的个体。HEV感染要么是自限性的(无症状),这意味着患者可能会自行康复,要么是有症状的,引起急性肝损伤或暴发性肝炎,并可能最终导致死亡。它也可以引起慢性肝炎,可以发展为肝硬化或恢复。妊娠相关HEV感染的发生率为30%。HEV逃避先天免疫、激素失衡、单核巨噬细胞功能缺陷、t细胞介导的免疫系统下调、高细胞因子产生、营养因素和社会经济条件可能在HEV感染的流行中发挥重要作用。有必要采取特别措施,减少高流行地区HEV感染的发病率负担,因为发病率数据比患病率数据更准确地估计疾病动态。本研究的目的是阐明戊型肝炎病毒的几个方面,并讨论戊型肝炎病毒感染与其他疾病的发病率。当前的综述讨论了HEV的分子特征、临床特征、流行病学、肝外表现以及多种可用的HEV诊断和治疗策略。
{"title":"Hepatitis E Virus: Epidemiology, Clinical Aspects, and Its Significance as a Major Pregnancy Risk","authors":"Sidra Urooj, Sadia Anjum, Fareeha Iqbal, Maisa Siddiq Abduh, Hashaam Akhtar, Sumbal Javed, Salik Javed Kakar, Aamer Ikram, Nabeel Ahmed Maqbool, Tahir Ahmad","doi":"10.3390/livers3030035","DOIUrl":"https://doi.org/10.3390/livers3030035","url":null,"abstract":"HEV is a single-stranded, positive RNA virus. The hepatitis E virus (HEV) is the causing agent of hepatitis, with a high prevalence rate in low-income countries due to poor sanitary conditions. It can exhibit acute, continuous, or extrahepatic consequences in immunocompromised individuals such as those undergoing organ transplantation and having HIV infection. HEV infection is either self limiting (silent), meaning the patient will possibly recover on his own, or symptomatic, causing acute liver injury or fulminant hepatitis and may eventually cause death. It can also cause chronic hepatitis that can progress to cirrhosis or recovery. Pregnancy-related HEV infection has an incidence rate of 30%. HEV escape from innate immunity, hormonal imbalances, defective monocyte–macrophage function, downregulation of the T-cell-mediated immune system, high cytokine production, nutritional factors, and socioeconomic conditions may play fundamental roles in the prevalence of HEV infection. It is necessary to take particular measures to reduce the incidence burden of HEV infection in high endemic locations as the incidence data, not the prevalence data, is more accurate at estimating disease dynamics. The purpose of this study is to throw light on several aspects of the hepatitis E virus and to discuss the incidence of HEV infection concerning other diseases. HEV molecular features, clinical features, epidemiology, extrahepatic manifestations, and multiple available diagnostics and treatment strategies for HEV are debated in the current review.","PeriodicalId":74083,"journal":{"name":"Livers","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135397332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of IL-12B Genetic Variants on Antiviral Treatment Response among Hepatitis B Patients in Pakistan IL-12B基因变异对巴基斯坦乙型肝炎患者抗病毒治疗反应的影响
Pub Date : 2023-09-12 DOI: 10.3390/livers3030034
Yasmin Badshah, Maria Shabbir, Sameen Zafar, Uzma Mussarat, Aamer Ikram, Sumbal Javed, Hashaam Akhtar
HBV is a continuous major global health concern. Genetic factors of hosts are known to play a role in HBV infection outcomes. This study aimed to reveal the association of IL-12b 3′ UTR variant rs3212227 in HBV patients. Genotyping was performed using ARMS-PCR to detect IL-12b rs3212227 polymorphism. The patients were categorized into groups based on their response to the antiviral therapy. Group I: non-sustained virological response (NSR); Group II: sustained virological responders (SVR); and Group III: HBV-positive fresh cases. ALT levels were measured to evaluate liver function, and viral load was determined to evaluate viral infectivity among the study groups. The variant genotype CC was found to be significantly associated with the non-sustained virological response to the antiviral therapy (with a p-value of 0.0117; OR = 2.914; RR = 1.556). It was also determined that the genotype CC was the most prevalent genotype among both genders in the NSR group. Viral load was found to be 6-fold higher in Group III compared to Group I and Group II. The results suggest that genotype CC is the most prevalent genotype in the NSR groups, and it is associated with a poor response to antiviral therapy in Pakistani patients with HBV infection.
乙型肝炎病毒一直是一个主要的全球卫生问题。已知宿主的遗传因素在HBV感染结果中起作用。本研究旨在揭示IL-12b 3 ' UTR变异rs3212227在HBV患者中的相关性。采用ARMS-PCR检测IL-12b rs3212227多态性。根据患者对抗病毒治疗的反应将患者分为不同的组。第一组:非持续性病毒学反应(NSR);第二组:持续病毒学应答者(SVR);第三组:hbv阳性新病例。测定ALT水平以评估肝功能,测定病毒载量以评估各研究组的病毒感染性。发现变异基因型CC与抗病毒治疗的非持续性病毒学反应显著相关(p值为0.0117;Or = 2.914;Rr = 1.556)。研究还发现,CC基因型在NSR组中是最普遍的基因型。发现III组的病毒载量比I组和II组高6倍。结果表明,CC基因型是NSR组中最普遍的基因型,并且它与巴基斯坦HBV感染患者对抗病毒治疗的不良反应有关。
{"title":"Impact of IL-12B Genetic Variants on Antiviral Treatment Response among Hepatitis B Patients in Pakistan","authors":"Yasmin Badshah, Maria Shabbir, Sameen Zafar, Uzma Mussarat, Aamer Ikram, Sumbal Javed, Hashaam Akhtar","doi":"10.3390/livers3030034","DOIUrl":"https://doi.org/10.3390/livers3030034","url":null,"abstract":"HBV is a continuous major global health concern. Genetic factors of hosts are known to play a role in HBV infection outcomes. This study aimed to reveal the association of IL-12b 3′ UTR variant rs3212227 in HBV patients. Genotyping was performed using ARMS-PCR to detect IL-12b rs3212227 polymorphism. The patients were categorized into groups based on their response to the antiviral therapy. Group I: non-sustained virological response (NSR); Group II: sustained virological responders (SVR); and Group III: HBV-positive fresh cases. ALT levels were measured to evaluate liver function, and viral load was determined to evaluate viral infectivity among the study groups. The variant genotype CC was found to be significantly associated with the non-sustained virological response to the antiviral therapy (with a p-value of 0.0117; OR = 2.914; RR = 1.556). It was also determined that the genotype CC was the most prevalent genotype among both genders in the NSR group. Viral load was found to be 6-fold higher in Group III compared to Group I and Group II. The results suggest that genotype CC is the most prevalent genotype in the NSR groups, and it is associated with a poor response to antiviral therapy in Pakistani patients with HBV infection.","PeriodicalId":74083,"journal":{"name":"Livers","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135878443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship between Non-Alcoholic Fatty Liver Disease and Visceral Fat Measured by Imaging-Based Body Composition Analysis: A Systematic Review 基于影像学的身体成分分析测定非酒精性脂肪肝与内脏脂肪的关系:系统综述
Pub Date : 2023-09-05 DOI: 10.3390/livers3030033
Ker Ming Seaw, Christiani Jeyakumar Henry, Xinyan Bi
Imaging-based body composition analysis can quantify visceral fat, which is an important feature of lean non-alcoholic fatty liver disease (NAFLD) patients. This review assesses current evidence of the relationship between NAFLD, particularly hepatic steatosis, and visceral fat that is measured using imaging-based body composition analysis. PubMed Central and ScienceDirect were searched for studies that provided quantification of the relationship between NAFLD, hepatic steatosis and visceral fat. Twenty studies comprising 15,763 subjects were included, consisting of the relationship with NAFLD (n = 15) and the relationship with hepatic steatosis (n = 7). All studies reported a positive relationship between NAFLD and visceral fat. For hepatic steatosis regardless of severity, only one study reported no correlation with visceral fat. Further results showed that visceral fat is more related to NAFLD and hepatic steatosis in females than males. More studies including NAFLD of different stages must be performed in the future to validate the degree of association between visceral fat and NAFLD at all stages as well as this relationship difference between genders.
基于影像学的身体成分分析可以量化内脏脂肪,这是瘦型非酒精性脂肪肝(NAFLD)患者的一个重要特征。这篇综述评估了NAFLD,特别是肝脂肪变性和内脏脂肪之间关系的最新证据,这些证据是通过基于成像的身体成分分析测量的。PubMed Central和ScienceDirect搜索了提供NAFLD、肝脂肪变性和内脏脂肪之间关系量化的研究。纳入了20项研究,包括15763名受试者,包括与NAFLD的关系(n=15)和与肝脂肪变性的关系(n=7)。所有研究报告NAFLD与内脏脂肪呈正相关。对于肝脏脂肪变性,无论严重程度如何,只有一项研究报告与内脏脂肪无关。进一步的研究结果表明,女性内脏脂肪与NAFLD和肝脂肪变性的关系比男性更大。未来必须进行更多的研究,包括不同阶段的NAFLD,以验证内脏脂肪和NAFLD在所有阶段之间的关联程度,以及性别之间的这种关系差异。
{"title":"Relationship between Non-Alcoholic Fatty Liver Disease and Visceral Fat Measured by Imaging-Based Body Composition Analysis: A Systematic Review","authors":"Ker Ming Seaw, Christiani Jeyakumar Henry, Xinyan Bi","doi":"10.3390/livers3030033","DOIUrl":"https://doi.org/10.3390/livers3030033","url":null,"abstract":"Imaging-based body composition analysis can quantify visceral fat, which is an important feature of lean non-alcoholic fatty liver disease (NAFLD) patients. This review assesses current evidence of the relationship between NAFLD, particularly hepatic steatosis, and visceral fat that is measured using imaging-based body composition analysis. PubMed Central and ScienceDirect were searched for studies that provided quantification of the relationship between NAFLD, hepatic steatosis and visceral fat. Twenty studies comprising 15,763 subjects were included, consisting of the relationship with NAFLD (n = 15) and the relationship with hepatic steatosis (n = 7). All studies reported a positive relationship between NAFLD and visceral fat. For hepatic steatosis regardless of severity, only one study reported no correlation with visceral fat. Further results showed that visceral fat is more related to NAFLD and hepatic steatosis in females than males. More studies including NAFLD of different stages must be performed in the future to validate the degree of association between visceral fat and NAFLD at all stages as well as this relationship difference between genders.","PeriodicalId":74083,"journal":{"name":"Livers","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44737669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perspective on Quantitative Structure–Toxicity Relationship (QSTR) Models to Predict Hepatic Biotransformation of Xenobiotics 定量结构-毒性关系(QSTR)模型预测异种药物肝脏生物转化的前景
Pub Date : 2023-08-30 DOI: 10.3390/livers3030032
Mansi Rai, Namuna Paudel, Mesevilhou Sakhrie, D. Gemmati, I. Khan, V. Tisato, Anurag Kanase, A. Schulz, Ajay Vikram Singh
Biotransformation refers to the metabolic conversion of endogenous and xenobiotic chemicals into more hydrophilic substances. Xenobiotic biotransformation is accomplished by a restricted number of enzymes with broad substrate specificities. The biotransformation of xenobiotics is catalyzed by various enzyme systems that can be divided into four categories based on the reaction they catalyze. The primary concentration is in cytochrome P450, while the CYP enzymes responsible for xenobiotic biotransformation are located within the hepatic endoplasmic reticulum (microsomes). Cytochrome P450 (CYP450) enzymes are also present in extrahepatic tissues. Enzymes catalyzing biotransformation reactions often determine the intensity and duration of the action of drugs and play a key role in chemical toxicity and chemical tumorigenesis. The structure of a given biotransforming enzyme may differ among individuals, which can cause differences in the rates of xenobiotic biotransformation. The study of the molecular mechanisms underlying chemical liver injury is fundamental for preventing or devising new modalities of treatment for liver injury using chemicals. Active metabolites arise from the biotransformation of a parent drug compound using one or more xenobiotic-processing enzymes to generate metabolites with different pharmacological or toxicological properties. Understanding how exogenous chemicals (xenobiotics) are metabolized, distributed, and eliminated is critical to determining the impact of these compounds on human health. Computational tools such as Biotransformer have been developed to predict all the possible metabolites of xenobiotic and enzymatic profiles that are linked to the production of metabolites. The construction of xenobiotic metabolism maps can predict enzymes catalyzing metabolites capable of binding to DNA.
生物转化是指内源性和外源性化学物质代谢转化为更亲水的物质。异种生物转化是通过数量有限的具有广泛底物特异性的酶来实现的。外源性物质的生物转化是由各种酶系统催化的,根据它们催化的反应可分为四类。主要浓度在细胞色素P450中,而负责外源生物转化的CYP酶位于肝内质网(微粒体)内。细胞色素P450(CYP450)酶也存在于肝外组织中。催化生物转化反应的酶通常决定药物作用的强度和持续时间,并在化学毒性和化学肿瘤发生中发挥关键作用。特定生物转化酶的结构可能因个体而异,这可能导致外源生物转化率的差异。研究化学性肝损伤的分子机制对于预防或设计使用化学物质治疗肝损伤的新模式至关重要。活性代谢产物来源于使用一种或多种外源性加工酶对母体药物化合物进行生物转化,以产生具有不同药理学或毒理学特性的代谢产物。了解外源性化学物质(外源性物质)是如何代谢、分布和消除的,对于确定这些化合物对人类健康的影响至关重要。已经开发了生物转化器等计算工具来预测与代谢物产生相关的异生素和酶谱的所有可能代谢物。外源代谢图谱的构建可以预测催化能够与DNA结合的代谢产物的酶。
{"title":"Perspective on Quantitative Structure–Toxicity Relationship (QSTR) Models to Predict Hepatic Biotransformation of Xenobiotics","authors":"Mansi Rai, Namuna Paudel, Mesevilhou Sakhrie, D. Gemmati, I. Khan, V. Tisato, Anurag Kanase, A. Schulz, Ajay Vikram Singh","doi":"10.3390/livers3030032","DOIUrl":"https://doi.org/10.3390/livers3030032","url":null,"abstract":"Biotransformation refers to the metabolic conversion of endogenous and xenobiotic chemicals into more hydrophilic substances. Xenobiotic biotransformation is accomplished by a restricted number of enzymes with broad substrate specificities. The biotransformation of xenobiotics is catalyzed by various enzyme systems that can be divided into four categories based on the reaction they catalyze. The primary concentration is in cytochrome P450, while the CYP enzymes responsible for xenobiotic biotransformation are located within the hepatic endoplasmic reticulum (microsomes). Cytochrome P450 (CYP450) enzymes are also present in extrahepatic tissues. Enzymes catalyzing biotransformation reactions often determine the intensity and duration of the action of drugs and play a key role in chemical toxicity and chemical tumorigenesis. The structure of a given biotransforming enzyme may differ among individuals, which can cause differences in the rates of xenobiotic biotransformation. The study of the molecular mechanisms underlying chemical liver injury is fundamental for preventing or devising new modalities of treatment for liver injury using chemicals. Active metabolites arise from the biotransformation of a parent drug compound using one or more xenobiotic-processing enzymes to generate metabolites with different pharmacological or toxicological properties. Understanding how exogenous chemicals (xenobiotics) are metabolized, distributed, and eliminated is critical to determining the impact of these compounds on human health. Computational tools such as Biotransformer have been developed to predict all the possible metabolites of xenobiotic and enzymatic profiles that are linked to the production of metabolites. The construction of xenobiotic metabolism maps can predict enzymes catalyzing metabolites capable of binding to DNA.","PeriodicalId":74083,"journal":{"name":"Livers","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43397317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
期刊
Livers
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1