RESUMO
BACKGROUND: It is controversial whether adjuvant steroid treatment should be given to biliary atresia (BA) patients following a Kasai portoenterostomy (KPE). This study aimed to quantitatively and systematically evaluate the effect of adjuvant steroid therapy post-KPE in relation to major clinical outcomes of BA patients. METHODS: We systematically reviewed the literature in PubMed, Embase, the Cochrane Library, China Knowledge Resource Integrated Database, Wanfang Database, Scholarly and Academic Information Navigator and manually searched for relevant papers published before August, 2015. We extracted data on the effects of steroid treatment following KPE on clinical outcome, including jaundice free rate and native liver survival rate at 6 months, 1 or 2 years after KPE. The weighted overall relative risk (RR) and 95% confidence intervals (CIs) were calculated by using a random-effects model. RESULTS: Eight cohort studies and two randomized controlled trials (RCTs) were identified (n=998). Of them, 6 cohort studies and 2 trials investigated the effect of steroid treatment as compared to non-users or placebo (n=566), and 2 cohort studies compared the effects of high-dose to low-dose steroid treatment (n=432). Steroid usage increased the clearance rates of jaundice at 6 months (pooled RR: 1.32; 95% CI: 0.995-1.76; I 2=72.6%) and 1 year (pooled RR: 1.35; 95% CI: 1.12-1.61; I 2=0.0%), but not 2 years (pooled RR: 0.82; 95% CI: 0.55-1.22; I 2=0.0%) after KPE. There was no solid evidence supporting that steroid treatment would improve native liver survival rate at 6 months (pooled RR: 1.02; 95% CI: 0.90-1.15; I 2=0.0%), 1 year (pooled RR: 1.10; 95% CI: 0.91-1.34; I 2=35.2%) or 2 years (pooled RR: 1.00; 95% CI: 0.73-1.35; I 2=57.4%) after KPE. CONCLUSIONS: Adjuvant steroid treatment following KPE may improve short-term (≤1 year) clearance rate of jaundice, but no significant effects on long-term (≥2 years) clearance rate of jaundice and native liver survival rate. Studies on doses and duration of steroids, and long-term follow-up studies are warranted.
Assuntos
Atresia Biliar/cirurgia , Portoenterostomia Hepática/métodos , Complicações Pós-Operatórias/tratamento farmacológico , Esteroides/uso terapêutico , Atresia Biliar/diagnóstico , Quimioterapia Adjuvante , China , Estudos de Coortes , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Seguimentos , Humanos , Recém-Nascido , Icterícia/prevenção & controle , Masculino , Portoenterostomia Hepática/efeitos adversos , Complicações Pós-Operatórias/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Taxa de Sobrevida , Resultado do TratamentoRESUMO
OBJECTIVE: To determine serum bile acid (BA) and fatty acid (FA) profiles in Chinese children with non-alcoholic fatty liver disease (NAFLD). METHODS: A total 76 children aged 4-17 years were categorized into three groups according to the presence and absence of as well as the severity of NAFLD, that is, non-NAFLD (control), mild and moderate to severe NAFLD groups, respectively, based on their liver ultrasonography findings. Serum BA and FA profiles were quantified separately by mass spectrometry and gas chromatography. General linear models were performed to assess the differences among the groups. RESULTS: After adjusted for potential confounders, children with NAFLD had higher levels of chenodeoxycholic acid (CDCA), unconjugated primary BAs (CDCA + cholic acid) but lower levels of deoxycholic acid (DCA), taurodeoxycholic acid (TDCA), glycodeoxycholic acid (GDCA), total DCA (DCA + TDCA + GDCA), glycolithocholic acid (GLCA) and total lithocholic acid (GLCA + taurolithocholic acid) than children without NAFLD. As for FAs, children with mild and moderate to severe NAFLD had higher levels of n-7 monounsaturated FA. CONCLUSIONS: Circulating BA and FA profiles may change in children with NAFLD. Further studies are needed to determine their associations and to understand the underlying mechanism of action.
Assuntos
Ácidos e Sais Biliares/sangue , Ácidos Graxos/sangue , Hepatopatia Gordurosa não Alcoólica/sangue , Adolescente , Antropometria/métodos , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Fígado/diagnóstico por imagem , Masculino , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Índice de Gravidade de Doença , UltrassonografiaRESUMO
OBJECTIVE: To evaluate the advantage and disadvantage of laser-assisted liposuction compared with conventional liposuction. METHODS: Ten swines were devided into three groups, the laser liposuction group, conventional liposuction group and control group. We compared the two surgical groups with the following aspects: ecchymosi, edema, lipocrit study, hemoglobin studies and blood biochemical changes, etc. RESULTS: There is a benefit of laser-assisted liposuction in the following aspects such as ecchymosi, edema, lipocrit and postoperative complications. The two aspects, that is, ecchymosi and lipocrit study was statistically significant. Hemoglobin change was not statistically significant between the two groups. Laser-assisted liposuction did not lead to dysfunction of organs such as liver and kidney. CONCLUSIONS: Laser-assisted liposuction can significantly decrease the blood lose, ecchymosis and edema compared with conventional liposuction, and it did not give rise to dysfunction of organs.