Progress Report( 研究进度报告 ) Apr 2017

Presented by Dr.Raja Waqar Ali (PG MD) Mentor ; Prof Dr Mr. Huang,(MD,PhD) Department of Gastroenterology Lanzhou University Second Hospital 兰州大学第二医院

消化科基本方向• General Orientation – Gastroenterology

Department and Endoscopy Center of Lanzhou university second hospital.

• Common clinical procedures carried out in the wards .

• MDT or MDD 讨论

最常见的疾病出现在病房。• Patients with most common Gastrointestinal

diseases presented to ward

Esophagus and Stomach （食道和胃）•Achalasia 贲门失弛缓症•Gastrointestinal hemorrhage 胃肠道出血•Esophageal Cancer 食道癌。•Stomach (Gastric) Cancer 胃癌。•Gastroesophageal Reflux Disease (GERD)•Gastritis 胃炎•Peptic Ulcer Disease （ PUD ）•Swallowing Disorders

Pancreas and Biliary Tract 胰腺和胆道• •Acute Pancreatitis• •Chronic Pancreatitis• •Bile Duct Cancer (Cholangiocarcinoma)• •Gallstone Disease• •Sphincter of Oddi Dysfunction (SOD)• 急性胰腺炎慢性胰腺炎胆管癌（胆管癌）胆石疾病

Oddi 功能障碍括约肌（ SOD ）

LiverCholestasis Cirrhosis Fatty Liver Disease Gallstones Hepatitis A Hepatitis B Hepatitis C Hemochromatosis Polycystic Liver Disease Liver Cancer

肝硬化

Cirrhosis

• A brief study report on Cirrhosis

EPIDEMIOLOGY 流行病学• Cirrhosis is an increasing cause of morbidity and mortality in

more developed countries.

• It is the 14th most common cause of death in developed countries.

• Fourth in central Europe.

• Cirrhosis is the main indication for 5500 liver transplants each year in Europe.

(Blachier M et al. The burden of liver disease in Europe: a review of available epidemiological data. J Hepatol 2013)

Introduction 介绍。• Cirrhosis has been seen to be not a single

disease entity, but one that can be sub classified into distinct clinical prognostic stages, with 1-year mortality ranging from 1% to 57% depending on the stage.

D’Amico G et al. Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol 2006

Pathophysiology 病理生理学• Histopathologists have proposed that the

histological term cirrhosis should be substituted by Advanced liver disease, to underline the dynamic processes and variable prognosis of the disorder.

Hytiroglou P et al. Beyond “cirrhosis”:a proposal from the International Liver Pathology Study Group.Am J Clin Pathol 2012

肝损害阶段。

Prognostic clinical sub-classification预后临床分类• four distinct stages has been proposed with

substantially differing likelihoods of mortality: stage 1(compensated with no oesophageal varices) has anestimated mortality of 1% per year stages 2(compensated with varices), stage 3 (decompensated with ascites),

预后临床分类• Stage 4 • (decompensated with gastrointestinal bleeding) have annual

mortality rates of 3·4%, 20%, and 57%, respectively. (D’Amico G et al.Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies. J Hepatol 2006)

• Infections and renal failure have been considered as stage 5, with 67% 1-year mortality.

• Acute decompensating events that lead to organ failure have mortality of 30%

(Moreau R et al, and the CANONIC Study Investigators of the EASL–CLIF Consortium. Acute-on-chronic liver failure is a distinct syndrome that develops in patients with acute decompensation of cirrhosis. Gastroenterology 2013)

Clinical features 临床表现。

进一步学习计划。Continued…Lab investigations,Radiographic investigations, Treatment modalities New treatment approaches for cirrhosis.继续学习 肝硬化的实验室调查，放射学检查，治疗方式和肝硬化新治疗方法 . 。。。。。

• Further advise and evaluation by respected mentor. 指导尊敬的导师。感谢

Thanking you,