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| 1 | 2012至2016年中国放宽独生子女政策与剖宫产率及出生结局的趋势分析:基于近700万医院出生个案的观察性研究显示文摘目的研究放宽独生子女政策和降低剖宫产率政策会如何影响中国剖宫产率和围产儿及孕产妇死亡率。研究设计观察性研究。研究地点全国危重孕产妇医院监测系统。研究对象2012--2016年,全国危重孕产妇医院监测系统的438家医院中,妊娠28周及以上或出生体重≥1000g的6838582例围产儿。主要结局指标使用修改的Robson分类定义产科风险。主要结局指标包括:产次、产妇年龄和Robson分类的分布变化;每个风险类别中,剖宫产率随时间变化的原始和调整趋势(使用稳健方差估计的泊松回归);同期围产儿及孕产妇死亡率随时间变化的趋势。结果剖宫产率在20122016年稳步下降(原始相对风险0.91,95%可信区间为0.89~0.93),在2016年总的剖宫产率达到41.1%。放宽独生子女政策伴随着经产妇生育比例的上升(从2012年的34.1%到2016年的46.7%),有既往剖宫产史的妇女的分娩量几乎翻了一番(从9.8%到17.7%)。在控制了这些影响因素后,剖宫产率随时间下降的趋势更大(调整后的相对风险0.82,95%可信区间为0.81~0.84)。初产妇的剖宫产率明显下降(0.75,95%可信区间为0.73~0.77),但无既往剖宫产史的经产妇的剖宫产率也有所下降(0.65,95%可信区间为0.62~0.77)。下降幅度最明显的是2012年剖宫产率最高的医院,这与政府针对剖宫产率最高的医院实行的政策是一致的。同期围产儿死亡率从每千出生10.1降至7.2(0.87,95%可信区间为0.83~0.91),而孕产妇死亡率没有变化。结论中国是唯一一个成功扭转剖宫产率上升趋势的国家。放宽独生子女政策相关的产科风险变化将增加剖宫产需求,考虑这一因素,中国的成功显得尤为显著。中国的经验表明,当政策能全面、系统地控制导致剖宫产过度使用的因素,再结合临床实践中各种激励措施,就能够改变剖宫产持续上升的趋势。 | 梁娟 牟祎 李小洪 唐雯 王艳萍 刘铮 黄小娜 Robert W Scherpbier 郭素芳 李明蓉 代礼 邓奎 邓长飞 李琪 康乐妮 朱军 Carine Ronsmans | 2018 | 英国医学杂志中文版2018，21，7： | 47 |
| 2 | Nonalcoholic fatty liver disease: An overview of current insights in pathogenesis, diagnosis and treatment显示文摘Estimates of people suffering from overweight (one billion) and obesity (300 million) are increasing. The accumulation of triglycerides in the liver, in the absence of excess alcohol intake, has been described in the early sixties. It was not until 1980, however, that Ludwig et al named this condition nonalcoholic steatohepatitis (NASH). Subsequently, nonalcoholic fatty liver disease (NAFLD) has been used as a general name for conditions ranging from simple steatosis through steatohepatitis to end-stage liver disease (cirrhosis). Many studies have demonstrated the significant correlation with obesity and insulin resistance. Other studies have revealed a signifi- cant correlation between hepatic steatosis, cardiovascu- lar disease and increased intima-media thickness. WHO estimated that at least two million patients will develop cirrhosis due to hepatic steatosis in the years to come. Longitudinal cohort studies have demonstrated that those patients with cirrhosis have a similar risk to devel- op hepatocellular carcinoma as those with other causes of cirrhosis. Taken all together, NAFLD has become the third most important indication for liver transplantation. There- fore, training programmes in internal medicine, gastroen- terology and hepatology should stress the importance of diagnosing this entity and treat properly those at risk for developing complications of portal hypertension and con- comittant cardiovascular disease. This review will focus on the clinical characteristics, pathophysiology, imaging tech- niques and the readily available therapeutic options. | Tim CMA Schreuder Bart J Verwer Carin MJ van Nieuwkerk Chris JJ Mulder | 2008 | World Journal of Gastroenterology2008，14，16： | 35 |
| 3 | Circadian Clock Genes Universally Control Key Agricultural Traits显示文摘生理节奏的钟是使植物能同步的内长的定时器有每日、季节的环境条件的生物过程以便在白天和年的最有益的时间期间分配资源。生理节奏的钟调整很多项中央植物活动,包括生长,开发,和复制,首先通过控制 transcriptional 活动和蛋白质功能的一个实质的比例。这评论检验生理节奏的钟基因的等位基因在庄稼植物的驯服和改进起了的作用。这里的焦点在到在 Arabidopsis thaliana 的钟功能的三组生理节奏的钟基因必需品上:伪反应管理者, GIGANTEA,和晚上建筑群基因早 FLOWERING 3,早 FLOWERING 4,并且勒克司 ARRHYTHMO。从每个组的相应基因位于量的特点 loci 下面在关键农业特点,特别 flowering 时间而且收益上有有益的影响,生物资源,和二年的生长习惯。包括对不能生活、关於生命的压力的回答,进另外的基本植物过程的生理节奏的钟规定的新兴的卓见被讨论为进一步的庄稼改进加亮有希望的大街。 | Claire Bendix | 2015 | Molecular Plant2015，8，8： | 26 |
| 4 | Disruption of the Sugar Transporters AtSWEET11 and AtSWEET12 Affects Vascular Development and Freezing Tolerance in Arabidopsis显示文摘Dear Editor, In plants,the transport of sugars from the site of biosynthesis to the site of utilization or storage relies on sugar transporters located in different subcellular compartments and different vascular cell types.The SWEET sugar transporter family is one such class and is represented by 17 members in Arabidopsis.AtSWEET1 was the first plant SWEET transporter to be characterized;it acts as a glucose uniporter in multiple systems (Chen et al.,2010). | Rozenn Le Hir Lara Spinner Patrick A. W. Klemens Dipankar Chakraborti Federica de Marco Francoise Vilaine Nelly Wolff Remi Lemoine Benoit Porcheron Carine Gery Evelyne Teoule Salem Chabout Gregory Mouille H. Ekkehard Neuhaus Sylvie Dinant Catherine Bellini | 2015 | Molecular Plant2015，8，11： | 16 |
| 5 | Activation of Defense Response Pathways by OGs and Fig22 Elicitors in Arabidopsis Seedlings显示文摘 | Carine Denoux Roberta Galletti Nicole Mammarella Suresh Gopalan Danièle Werck Giulia De Lorenzo Simone Ferrari Frederick M. Ausubel Julia Dewdney | 2008 | Molecular Plant2008，1，3： | 13 |
| 6 | 饲粮中色氨酸对畜禽的免疫调节作用显示文摘色氨酸是一种具有调节机体免疫功能的必需氨基酸。色氨酸的代谢产物吲哚-2,3-双加氧酶(IDO)、犬尿氨酸、喹啉酸和褪黑激素等,可通过抑制T淋巴细胞增殖、增加血液免疫球蛋白含量和促进组织的抗原递呈等,来提高机体免疫力、抗炎症反应和影响肿瘤细胞免疫逃逸。本文就色氨酸及其代谢产物对畜禽免疫功能的调控作用和机制进行简要叙述。 | 白苗苗 刘红南 吴信 刘刚 TOSSOU Myrlene Carine 徐康 习欠云 印遇龙 | 2016 | 动物营养学报2016，28，2： | 12 |
| 7 | 日粮中添加酵母硒对断奶仔猪生长性能及抗氧化性能的影响显示文摘饲养断奶仔猪时添加一定量的硒,可以降低仔猪死亡率、增加进食量和体重、降低料肉比,这种方法已得到了较为普遍的应用,但是对于硒的最佳添加量争论不一。文中试验研究酵母硒的添加量对仔猪生长性能的影响,筛选出三元杂交仔猪酵母硒的最适添加量。选取21日龄、初生重相近、杜洛克×长白×约克夏三元杂交断奶仔猪192头,随机分为4个处理,每个处理8栏,每栏6头,对照组仔猪饲喂基础日粮,处理组仔猪在基础日粮中分别添加0.15、0.30、0.60 mg/kg的酵母硒,试验期为4周(28 d)。结果表明,添加酵母硒各组仔猪的平均日增重比对照组高,饲料利用率有所提高,且试验组仔猪腹泻率低、健康状况良好,其中0.30 mg/kg的添加量的料肉比最低,且抗氧化性最好、最稳定。3%的酵母硒,添加量可作为首选添加比例。 | 罗霄 方俊 刘刚 Myrlene Carine B.Tossou 李铁军 邓近平 | 2015 | 饲料工业2015，36，6： | 11 |
| 8 | An executive review of sludge pretreatment by sonication显示文摘Ultrasonication(US), which creates hydro-mechanical shear forces in cavitation, is an advanced technology in sludge pretreatment. However, there are many factors affecting the efficacy of cavitation and ultrasonication disintegration of sludge as a consequence.The objective of this work is to present an extensive review of evaluation approaches of sludge US pretreatment efficiency. Besides, optimization methodologies of related parameters,the differences of optimum values and the similarities of affecting trends on cavitation and sludge pretreatment efficiency were specifically pointed out, including ambient conditions,ultrasonic properties, and sludge characteristics. The research is a prerequisite for optimization of sludge US pretreatment efficiency in lab-scale and practical application. There is not-yet a comprehensive method to evaluate the efficiency of sludge US pretreatment, but some main parameters commonly used for this purpose are degree of sludge disintegration, proteins,particle size reduction, etc. Regarding US parameters, power input PUS, intensity IUS, and frequency FSseem to have significant effects. However, the magnitude of the effect of PUSand probe size in terms of IUShas not been clearly detailed. Investigating very low FSseems interesting but has not yet been taken into consideration. In addition, static pressure effect has been marginally studied only and investigation on the effect of pH prior to US process has been restricted. Their effects therefore should be varied separately and simultaneously with other related parameters, i.e. process conditions, ultrasonic properties, and sludge characteristics, to optimize sludge US pretreatment process. | Ngoc Tuan Le Carine Julcour-Lebigue Henri Delmas | 2015 | Journal of Environmental Sciences2015，27，11： | 6 |
| 9 | Practice Guidelines for Management of the Difficult Airway: An Updated Report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway显示文摘 | Jeffrey L. Apfelbaum Carin A. Hagberg Robert A. Caplan Casey D. Blitt Richard T. Connis David G. Nickinovich Carin A. Hagberg Robert A. Caplan Jonathan L. Benumof Frederic A. Berry Casey D. Blitt Robert H. Bode Frederick W. Cheney Richard T. Connis Orin F | 2013 | Anesthesiology2013，，2： | 4 |
| 10 | A striking local esophageal cytokine expression profile in eosinophilic esophagitis显示文摘 | Carine Blanchard Emily M. Stucke Beatriz Rodriguez-Jimenez Karen Burwinkel Margaret H. Collins Annette Ahrens Eileen S. Alexander Bridget K. Buckmeier Butz Sean C. Jameson Ajay Kaul James P. Franciosi Jonathan P. Kushner Philip E. Putnam J. Pablo Abonia M | 2010 | The Journal of Allergy and Clinical Immunology2010，，1： | 3 |
| 11 | A convergence analysis for a class of practical variance-reduction stochastic gradient MCMC显示文摘Stochastic gradient Markov chain Monte Carlo(SG-MCMC) has been developed as a flexible family of scalable Bayesian sampling algorithms. However, there has been little theoretical analysis of the impact of minibatch size to the algorithm's convergence rate. In this paper, we prove that at the beginning of an SG-MCMC algorithm, i.e., under limited computational budget/time, a larger minibatch size leads to a faster decrease of the mean squared error bound. The reason for this is due to the prominent noise in small minibatches when calculating stochastic gradients, motivating the necessity of variance reduction in SG-MCMC for practical use. By borrowing ideas from stochastic optimization, we propose a simple and practical variance-reduction technique for SG-MCMC, that is efficient in both computation and storage.More importantly, we develop the theory to prove that our algorithm induces a faster convergence rate than standard SG-MCMC. A number of large-scale experiments, ranging from Bayesian learning of logistic regression to deep neural networks, validate the theory and demonstrate the superiority of the proposed variance-reduction SG-MCMC framework. | Changyou CHEN Wenlin WANG Yizhe ZHANG Qinliang SU Lawrence CARIN | 2019 | Science China(Information Sciences)2019，62，1： | 3 |
| 12 | Quality of life after liver transplantation:State of the art显示文摘Quality of life(QoL) after deceased donor liver transplantation is increasingly recognized as a major outcome parameter. We reviewed recent publications in this rapidly evolving field in order to summarize recent achievements in the field and to define opportunities and perspectives for research and improvement of patient care. QoL does improve after liver transplantation according to a typical pattern. During the first year, there is a significant improvement in QoL. After one year, the improvement does stabilise and tends to decline slightly. In addition to the physical condition, different psychological parameters(such as depression, anxiety, sexual function) and sociodemographic elements(professional state, sex, marital state) seem to impact QoL. Opportunities for further research are the use of dedicated questionnaires and identification of influencing factors for QoL. | Louis Onghena Wouter Develtere Carine Poppe Anja Geerts Roberto Troisi Aude Vanlander Frederik Berrevoet Xavier Rogiers Hans Van Vlierberghe Xavier Verhelst | 2016 | World Journal of Hepatology2016，8，18： | 3 |
| 13 | Auto immune hepatitis显示文摘To provide an update of the latest trends in epidemiology, clinical course, diagnostics, complications and treatment of auto immune hepatitis(AIH). A search ofthe MEDLINE database was performed using the search terms: 'auto immune hepatitis', 'clinical presentation', 'symptoms', 'signs', 'diagnosis', 'auto antibodies', 'laboratory values', 'serology', 'histopathology', ' h i s t o l o g y ', ' g e n e t i c s ', 'HLA g e n e s ', 'non-HLA genes', 'environment', 'epidemiology', 'prevalence', 'incidence', 'demographics', 'complications', 'HCC', 'PBC', 'PSC', 'corticosteroid', 'therapy', 'treatment', 'alternative treatment'. English-language full-text articles and abstracts were considered. Articles included reviews, meta-analysis, prospective retrospective studies. No publication date restrictions were applied. AIH is an immune meditated progressive inflammatory liver disease that predominantly affects middle-aged females but may affect people of all ages. The clinical spectrum of AIH is wide, ranging from absent or mild symptoms to fulminant hepatic failure. The aetiology of AIH is still unknown, but is believed to occur as the consequence of an aberrant immune response towards an un-known trigger in a genetically susceptible host. In the absence of a gold standard, diagnosis is based on the combination of clinical, biochemical and histopathological criteria. Immunosuppressive treatment has been the cornerstone of treatment since the earliest description of the disease in 1950 by Waldenstr?m. Such treatment is often successful at inducing remission and generally leads to normal life expectancy. Nevertheless, there remain significant areas of unmet aetiological a clinical needs including fundamental insight in disease pathogenesis, optimal therapy, duration of treatment and treatment alternatives in those patients unresponsive to standard treatment regimens. | nicole mf van gerven ynto s de boer chris jj mulder carin mj van nieuwkerk gerd bouma | 2016 | World Journal of Gastroenterology2016，22，19： | 3 |
| 14 | Juvenile ferric iron prevents microbiota dysbiosis and colitis in adult rodents显示文摘AIM: To assess whether juvenile chronic ferric iron ingestion limit colitis and dysbiosis at adulthood in rats and mice. METHODS: Two sets of experiments were designed. In the first set, recently weaned mice were either orally administered ferrous (Fe2+) iron salt or ferric (Fe3+) microencapsulated iron for 6 wk. The last week of experiments trinitrobenzene sulfonic acid (TNBS) colitis was induced. In the second set, juvenile rats received the microencapsulated ferric iron for 6 wk and were also submitted to TNBS colitis during the last week of experiments. In both sets of experiments, animals were sacrificed 7 d after TNBS instillation. Severity of the inflammation was assessed by scoring macroscopic lesions and quantifying colonic myeloperoxidase (MPO) activity. Alteration of the microflora profile was estimated usingquantitative polymerase chain reaction (qPCR) by measuring the evolution of total caecal microflora, Bacteroidetes, Firmicutes and enterobacteria. RESULTS: Neither ferrous nor ferric iron daily exposures at the juvenile period result in any effect in control animals at adulthood although ferrous iron repeated administration in infancy limited weight gain. Ferrous iron was unable to limit the experimental colitis (1.71 ± 0.27 MPO U/mg proteinvs 2.47 ± 0.22 MPO U/mg protein in colitic mice). In contrast, ferric iron significantly prevented the increase of MPO activity (1.64 ± 0.14 MPO U/mg protein) in TNBS-induced colitis. Moreover, this positive effect was observed at both the doses of ferric iron used (75 and 150 mg/kg per day po - 6 wk). In the study we also compared, in both rats and mice, the consequences of chronic repeated low level exposure to ferric iron (75 mg/kg per day po - 6 wk) on TNBS-induced colitis and its related dysbiosis. We confirmed that ferric iron limited the TNBS-induced increase of MPO activity in both the rodent species. Furthermore, we assessed the ferric iron incidence on TNBS-induced intestinal microbiota dysbiosis. At first, we needed to optimize the isolation and quantify DNA copy numbers using standard curves to perform by qPCR this interspecies comparison. Using this approach, we determined that total microflora was similar in control rats and mice and was mainly composed of Firmicutes and Bacteroidetes at a ratio of 10/1. Ferric juvenile administration did not modify the microflora profile in control animals. Total microflora numbers remained unchanged whichever experimental conditions studied. Following TNBS-induced colitis, the Firmicutes/Bacteroidetes ratio was altered resulting in a decrease of the Firmicutes numbers and an increase of the Bacteroidetes numbers typical of a gut inflammatory reaction. In parallel, the subdominant population, the enterobacteria was also increased. However, ferric iron supplementation for the juvenile period prevented the increase of Bacteroidetes and of enterobacteria numbers consecutive to the colitis in both the studied species at adulthood.CONCLUSION: Rats and mice juvenile chronic ferric iron ingestion prevents colitis and dysbiosis at adulthood as assessed by the first interspecies comparison. | Chourouk Ettreiki Pascale Gadonna-Widehem Irène Mangin Mose Coёffier Carine Delayre-Orthez Pauline M Anton | 2012 | World Journal of Gastroenterology2012，18，21： | 3 |
| 15 | Relationship Between HLA Tissue Type, CMV Infection, and Acute Graft-vs-Host Disease After Allogeneic Hematopoietic Stem Cell Transplantation: Single-Center Experience显示文摘 | C. Kekik S.K. Besisik Y. Seyhun F.S. Oguz D. Sargin M.N. Carin | 2009 | Transplantation Proceedings2009，，9： | 2 |
| 16 | A population-based study of 135 lymphomas after solid organ transplantation: The role of Epstein-Barr virus, hepatitis C and diffuse large B-cell lymphoma subtype in clinical presentation and survival显示文摘 | Amelie Kinch Eva Baecklund Carin Backlin Tor Ekman Daniel Molin Gunnar Tufveson Pia Fernberg Christer Sundstr? m Karlis Pauksens Gunilla Enblad | 2014 | Acta Oncologica2014，，5： | 2 |
| 17 | 便携式医疗设备中的信号调整显示文摘现今的医疗便携设备方便病人自行诊疗、自由走动,甚至可在外出时使用设备。便携式电子医疗设备要实现“方便携带”的特色功能,就必须具备微型化和低功耗的特性。此外,这些设备还要有极高的精度以确保病人的安全。医疗设备采用多种不同的传感器来龄视病人的健康状况,然后传感器将生理信号转换成电子信号供电子设备分析使用。由于医疗设备中传输的信号都比较微弱,而且还会受到诸多噪声源的干扰,因此信号路径设计对便携式医疗设备就显得格外重要了。本文将针对心电图机和血糖测量仪这两种设备应用,讨论如何将传感器与匹配的PowerWise放大器相连接,以便延长电池寿命和提高诊疗安全性。 | Carine Albert | 2008 | 世界电子元器件2008，，6： | 2 |
| 18 | Prevalence of Malnutrition and Frailty in Elderly Cancer Patients and Resulting Impact on Primary Treatment Recommendations in Colorectal and Breast Cancer显示文摘Objectives To estimate the prevalence of malnutrition in elderly cancer patients and its association with frailty and primary cancer treatment recommendations in patients with the two most prevalent cancers(colorectal cancer,CRC and breast cancer,BC)in the Centre-Val de Loire region of France.Methods The entire cohort of 704 patients aged 75 years or older presenting with cancer who underwent comprehensive geriatric assessment(CGA)between 2014 and 2017 was included.Nutritional status,frailty(defined by the Balducci classification system based on CGA parameters and comorbidity),and pathological criteria were analyzed in terms of the cancer treatment recommendations suggested by geriatricians both in the whole cohort and in those with CRC and BC.Results In the whole group of 704 patients(84.3+/-4.8 years),the prevalence of malnutrition was 62.9%,and was higher in CRC than in BC patients(71.1%vs 55.4%,P<0.01).In a multivariate analysis,malnutrition and frailty(as determined by the Balducci classification system)were independently related in CRC patients(OR:7.28,95%CI,1.58~34.03;P=0.012)and were unrelated to metastasis[odds ratio(OR):1.34,95%CI,0.56~3.18;P=0.5].By contrast,malnutrition in BC patients was related exclusively to the extent of metastasis(OR:3.52,95%CI,1.50~8.24;P=0.002).It was also demonstrated that geriatricians had a greater tendency to suggest only palliative care to CRC patients presenting with malnutrition(15.4%vs 2.7%,P=0.006)than to BC patients(9.8%vs 5.4%,NS).Conclusion Malnutrition in elderly cancer patients is prevalent,especially in those with colorectal cancer,where malnutrition is frailty-related and may strongly impact on cancer treatment strategies. | Vittoria Balzano Véronique Dardaine Giraud Carine Sauger Carole Lefebvre Patrick Heitzmann Thierry Lecomtef Étienne Dorvalg | 2020 | Journal of Nutritional Oncology2020，5，4： | 2 |
| 19 | Outcome and prognostic factors in 110 consecutive patients with primary uterine leiomyosarcoma:A Rare Cancer Network study显示文摘Objective: Primary uterine leiomyosarcomas(ULMS) are rare,and the optimal treatment is controversial.We aimed to assess the outcome and prognostic factors in a multicenter population of women treated for primary ULMS.Methods: We retrospectively collected data of 110 women treated in 19 institutions of the Rare Cancer Network(RCN).Inclusion criteria consisted of a pathology report confirming the diagnosis of ULMS,aged 18–80 years,complete International Federation of Gynecology and Obstetrics(FIGO) stage information,complete information on treatment,and a minimum follow-up of 6 months.Local control(LC) and locoregional control(LRC),overall survival(OS) and disease-free survival(DFS) rates were computed using the Kaplan-Meier method.Univariate analysis was implemented using the log rank test,and multivariate analysis using the Cox model.Results: All patients underwent surgery.Seventy-five patients(68%) received adjuvant radiotherapy(RT),including brachytherapy in 18(16%).Seventeen patients(15%) received adjuvant chemotherapy.Median follow-up was 58(range,6–240) months.Five-year OS and DFS rates were 50% and 34%,and LC and LRC rates were 88%and 72%,respectively.On multivariate analysis,independent favorable prognostic factors were younger age,FIGO stage I,small tumor size,previous uterine disease,and no vascular invasion for OS and DFS.FIGO stage was the only favorable factor influencing LRC.Adjuvant local or systemic treatments did not improve the outcomes.Eight patients treated with RT presented a grade 3 acute toxicity,and only one patient with grade 3 late toxicity.Conclusions: In this large population of primary ULMS patients,we found good results in terms of LC and LRC.Nevertheless,OS remains poor,mainly due to the occurrence of distant metastases.An early diagnosis seemed to improve the prognosis of the patients.Adjuvant local or systemic treatments,or more aggressive surgicalprocedures such as the Wertheim procedure,did not seem to impact the outcome. | Alessandra Franzetti Pellanda Berardino De Bari Elisabeth Deniaud-Alexandre MarcoKrengli Paul Van Houtte Antonella Riehetti Salvador Villa Hadassah Goldberg EwaSzutowiez-Zielifiska Michel Bolla Heidi Rutten Marc Van Eijkeren Philip Poortmans Guido Henke Yavuz Anaeak Steve Chan Christine Landmann Carine Kirkove LueianoScandolaro Jacques Bernier Rene-Olivier Mirimanof Mahmut Ozsahin | 2017 | Chinese Journal of Cancer Research2017，29，6： | 2 |
| 20 | Drug-induced liver injury and COVID-19:A review for clinical practice显示文摘Coronavirus disease 2019(COVID-19)consists of a systemic disease that can present many complications.The infection presents broad clinical symptoms and a high rate of transmissibility.In addition to severe acute respiratory syndrome,the patients manifest complications beyond the respiratory system.The frequency of liver damage in COVID-19 patients ranges from 14.8% to 53% of patients.One should pay attention to drug-induced liver injury(DILI)in patients with COVID-19,especially considering the off-label use of drugs in prophylactic and therapeutic regimens applied on large scales.This review aims to present relevant information on the medication used so far in COVID-19 patients and its possible hepatotoxicity.We reviewed liver damage in patients with COVID-19 on PubMed and Virtual Health Library to investigate DILI cases.Four studies were selected,involving the medicines remdesivir,tocilizumab and a pharmacovigilance analysis study.The hepatotoxicity profile of drugs presented in the literature considers use in accordance to usual posology standards for treatment.However,drugs currently used in the management of COVID-19 follow different dosages and posology than those tested by the pharmaceutical industry.The deficiency of uniformity and standardization in the assessment of hepatotoxicity cases hinders the publication of information and the possibility of comparing information among healthcare professionals.It is suggested that severe liver injury in COVID-19 patients should be reported in pharmacovigilance institutions,and physicians should pay attention to any considerable abnormal liver test elevation as it can demonstrate unknown drug hepatotoxicity.Liver disorders in COVID-19 patients and the use of several concomitant off-label medications—with a potential risk of further damaging the liver-should at least be a warning sign for rapid identification and early intervention,thus preventing liver damage from contributing to severe impairment in patients. | Gabriela Xavier Ortiz Gabriele Lenhart Matheus William Becker Karin Hepp Schwambach Cristiane Valle Tovo Carine Raquel Blatt | 2021 | World Journal of Hepatology2021，13，9： | 2 |
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