Importance of fatigue and its measurement in chronic liver disease
心理问题往往是导致疾病的原因,英语作文
心理问题往往是导致疾病的原因,英语作文全文共3篇示例，供读者参考篇1Title: The Link Between Psychological Issues and Physical HealthIntroduction:It is widely recognized that our mental health can have a significant impact on our physical well-being. Numerous studies have shown that psychological problems can manifest themselves in various physical illnesses. In this essay, we will explore the relationship between mental health and physical health and how psychological issues can be a root cause of disease.Body:1. Psychosomatic Illnesses:Psychosomatic illnesses are conditions that are influenced by psychological factors. These include ailments such as irritable bowel syndrome, migraines, and chronic pain. Stress, anxiety,and depression can all exacerbate these conditions and lead to worsened physical symptoms.2. Autoimmune Disorders:Research has shown that psychological stress can weaken the immune system and increase susceptibility to autoimmune disorders such as rheumatoid arthritis and lupus. Chronic stress can cause inflammation in the body, leading to a host of health issues.3. Cardiovascular Health:There is a strong correlation between mental health and heart health. Depression and anxiety have been linked to an increased risk of heart disease, stroke, and other cardiovascular problems. Stress can also contribute to high blood pressure and heart rhythm abnormalities.4. Digestive Disorders:The gut-brain connection is a well-established phenomenon, with the gut being referred to as the "second brain." Mental health issues such as anxiety and depression can disrupt the balance of bacteria in the gut, leading to digestive disorders like irritable bowel syndrome and Crohn's disease.5. Chronic Pain:Chronic pain conditions like fibromyalgia and chronic fatigue syndrome often have a psychological component. Trauma, stress, and emotional distress can all contribute to the onset and severity of pain symptoms.Conclusion:In conclusion, the connection between psychological issues and physical health is undeniable. It is important to address mental health concerns to prevent the development or exacerbation of physical illnesses. By promoting mentalwell-being through therapy, stress management, and self-care practices, we can improve our overall health and quality of life.篇2Psychological issues are often the root cause of many diseases. The connection between the mind and the body has long been recognized, and numerous studies have shown the impact of psychological factors on physical health. In this essay, we will explore how psychological issues can lead to the development of various diseases and discuss the importance of addressing mental health in conjunction with physical health.One of the most well-known ways in which psychological issues can impact physical health is through stress. Chronic stresshas been linked to a host of health problems, including heart disease, diabetes, and autoimmune disorders. When we are under stress, our bodies release cortisol and adrenaline, which can increase blood pressure, suppress the immune system, and contribute to inflammation. Over time, this can lead to the development of serious health conditions.Another way in which psychological issues can manifest in physical health is through unhealthy coping mechanisms. Many people turn to substances like alcohol, drugs, or food to cope with stress, anxiety, or depression. These behaviors can not only mask underlying psychological issues but also have detrimental effects on physical health. For example, excessive alcohol consumption can lead to liver damage, obesity, and heart disease.Moreover, psychological issues can directly impact the functioning of the immune system. Studies have shown that chronic stress, depression, and anxiety can weaken the immune response, making individuals more susceptible to infections and illnesses. Additionally, unresolved emotional trauma can manifest as physical symptoms, such as chronic pain, digestive issues, or skin conditions.It is essential to recognize the connection between mental and physical health and address both aspects when treating diseases. Integrative medicine approaches, which combine traditional medical treatments with complementary therapies like cognitive-behavioral therapy, mindfulness, and relaxation techniques, can be effective in improving outcomes for patients with both psychological and physical health issues.In conclusion, psychological problems are often the underlying cause of many diseases. By addressing mental health issues and providing comprehensive care that considers the mind-body connection, we can improve overall health outcomes and help individuals live healthier, more fulfilling lives. It is crucial to prioritize mental health and seek support when needed to prevent and treat a wide range of physical health issues stemming from psychological factors.篇3Psychological problems are often the root cause of various diseases. In today's fast-paced and stressful world, mental health issues have become increasingly common and have been linked to a range of physical ailments. It is important to recognize the connection between our psychological well-being and ourphysical health in order to prevent and treat these conditions effectively.One of the key ways in which psychological issues can lead to physical diseases is through the impact of stress on the body. When we are under constant stress, our bodies release cortisol, a hormone that can have damaging effects on our immune system, cardiovascular system, and other bodily functions. Over time, chronic stress can increase the risk of developing conditions such as heart disease, diabetes, and autoimmune disorders. Additionally, stress can also exacerbate existing health conditions, making them more difficult to manage and treat.Furthermore, psychological problems such as depression and anxiety have been shown to have a direct impact on our physical health. People suffering from depression are more likely to experience chronic pain, fatigue, and other physical symptoms. Similarly, individuals with anxiety disorders may have an increased risk of developing gastrointestinal problems, respiratory issues, and other health issues. This suggests that addressing mental health concerns is essential for maintaining overall wellness and preventing the onset of diseases.Moreover, unhealthy coping mechanisms for psychological issues, such as overeating, excessive drinking, or substanceabuse, can also contribute to the development of physical illnesses. These behaviors can lead to weight gain, high blood pressure, liver damage, and other health problems. By understanding the connection between our mental and physical health, we can adopt healthier coping strategies and reduce the risk of developing diseases related to psychological issues.In conclusion, it is clear that psychological problems play a significant role in the development and progression of various diseases. By addressing mental health concerns, managing stress effectively, and adopting healthy coping mechanisms, we can protect our physical well-being and reduce the risk of developing serious health conditions. It is essential to prioritize mental health in order to ensure overall wellness and quality of life.。
健康喝的英文作文
健康喝的英文作文Healthy DrinkingWater is the most essential nutrient for our bodies and plays a vital role in maintaining overall health and well-being. It is recommended that adults should drink at least 8 glasses or 2 liters of water per day to stay hydrated and support various bodily functions. However many people often overlook the importance of staying hydrated and instead turn to sugary drinks or caffeinated beverages that can have negative impacts on their health.Proper hydration is crucial for our bodies to function optimally. Water makes up about 60% of our body weight and is involved in numerous physiological processes such as regulating body temperature transporting nutrients and oxygen to cells flushing out waste and toxins and lubricating joints. Dehydration can lead to a range of health issues including fatigue headaches muscle cramps and even more serious conditions like kidney stones and urinary tract infections.In addition to water the beverages we consume can also have a significant impact on our overall health. Sugary drinks like soda fruit juices and sports drinks are loaded with added sugars that provide excessive calories without any nutritional value. Consuming too many of these beverages has been linked to weight gain obesity type 2 diabetes and other chronic health problems. It is recommended to limit the intake of sugary drinks and instead opt for healthier alternatives.One of the best beverage choices is plain water. Water is calorie-free and does not contain any added sugars or artificial sweeteners. It is the ideal choice for staying hydrated and supporting various bodily functions. Drinking water throughout the day can also help curb appetite and promote weight management by making you feel fuller and less likely to overeat.In addition to plain water there are several other healthy beverage options to consider. Unsweetened tea whether it's black green or herbal is a great choice as it provides antioxidants and other beneficial plant compounds without the added sugars. Milk is another nutritious beverage that is high in protein calcium and other essential vitamins and minerals. For those who prefer a bit more flavor infused water with sliced fruits herbs or vegetables can be a refreshing and healthy alternative.It's also important to be mindful of our caffeine intake. While moderate amounts of caffeine from coffee or tea can provide a boost of energy and focus too much can lead to jitteriness anxiety and disrupted sleep patterns. It's recommended to limit caffeine consumption especially later in the day.Alcohol is another beverage that should be consumed in moderation. Excessive alcohol intake can have numerous negative health effects including liver damage increased risk of certain cancers and impaired brain function. The Dietary Guidelines for Americans recommend that adult men consume no more than 2 alcoholic drinks per day and adult women consume no more than 1 alcoholic drink per day.Staying hydrated and making healthy beverage choices is crucial for maintaining overall health and well-being. By replacing sugary and caffeinated drinks with water unsweetened tea milk and other nutrient-rich options we can support our bodies' natural functions reduce the risk of chronic diseases and feel our best. Developing healthy drinking habits takes time and commitment but the long-term benefits are well worth the effort.。
垃圾食品的英语作文
垃圾食品的英语作文In today's fast-paced society, the convenience and accessibility of junk food have made it a staple in many people's diets. However, the consumption of these foods has far-reaching effects on our health, which are worth exploring in depth.Firstly, junk food is often high in unhealthy fats, sugars, and salts. These ingredients contribute to a range of health issues, including obesity, diabetes, and heart disease. The high sugar content in many junk foods can lead to a spike in blood sugar levels, which over time can result in type 2 diabetes. Additionally, the excessive intake of sodium found in processed foods can increase blood pressure, potentially leading to hypertension.Secondly, the lack of essential nutrients in junk food can lead to nutritional deficiencies. Fresh fruits, vegetables, and whole grains are rich in vitamins, minerals, and fiber, which are vital for maintaining good health. By replacing these nutrient-dense foods with junk food, individuals may suffer from deficiencies that can affect their immune system, bone health, and overall well-being.Moreover, the impact of junk food extends to mental health. Studies have shown that a diet high in processed foods can affect mood and cognitive function. The absence of essential nutrients can lead to feelings of fatigue and depression,while the sugar crashes that follow consuming high-sugar junk foods can cause irritability and mood swings.Furthermore, the long-term effects of a diet high in junk food can be severe. Obesity, a common consequence of consuming too much junk food, is linked to numerous health problems, including certain types of cancer, stroke, andliver disease. Moreover, the development of chronic diseases at a younger age can significantly reduce life expectancy and quality of life.To mitigate these risks, it is crucial to adopt a balanced diet that includes a variety of fresh, unprocessed foods. Educating the public about the dangers of junk food and promoting healthier eating habits are essential steps in combating the negative effects of junk food on society.In conclusion, while junk food may offer a quick fix for hunger or a temporary satisfaction for taste buds, its impact on health is profound and lasting. By making informed choices about our diets and prioritizing whole foods over processed ones, we can significantly improve our health and well-being.。
吲哚菁绿注射剂说明书（英语）
IC-GREEN™(Indocyanine Green for Injection, USP)SterileDescription: IC-GREEN™ is a sterile, lyophilized green powder containing 25 mg of indocyanine green with no more than 5 % sodium iodide. It is packaged with an Aqueous Solvent consisting of Sterile Water for Injection used to dissolve the indocyanine green. IC-GREEN™ is to be administered intravenously.Idocyanine green is a water soluble, tricarbocyanine dye with peak spectral absorption at 800 nm. The chemical name for Indocyanine Green is 1 H-Benz[e]indolium,2-[7[1,3-dihydro-1,1-dimethyl-3-(-4-sulfobutyl)-2H-benz[e]indo-2-ylidene]-1,3,5-heptatrienyl]-1,1-dimethyl-3-(4-sulfobutyl)-,hydroxide, innersalt, sodium. 2-[7-[1,1-Dimethyl-3-(4-sulfobuttyl)benz[e]indolin-2-ylidene]-1,3,5-heptatrienyl]-1,1-dimethyl-3-(4-sulfobutyl)-1Hbenz[e]indolium hydroxide , inner salt, sodium salt. IC-GREEN™ has a pH pf approximately 6.5 when reconstituted. Each vial of IC-GREEN™ contains 25 mg of indocyanine green as a sterile lyophilized powder.Clinical Pharmacology: Following intravenous injection, IC-GREEN™ is rapidly bound to plasma protein, of which albumin is the principle carrier (95%). IC-GREEN™ undergoes no significant extrahepatic or enterohepatic circulation; simultaneous arterial and venous blood estimations have shown negligible renal, peripheral, lung or cerebro-spinal uptake of the dye. IC-GREEN™ is taken up from the plasma almost exclusively by the hepatic parenchymal cells and is secreted entirely into the bile. After biliary obstruction, the dye appears in the hepatic lymph, independently of the bile, suggesting that the biliary mucosa is sufficiently intact to prevent diffusion of the dye, though allowing diffusion of bilirubin. These characteristics make IC-GREEN™ a helpful index of hepatic function. The plasma fractional disappearance rate at the recommended 0.5 mg/kg dose has been reported to be significantly greater in women than in men, although there was no significant difference in the calculated value for clearance.Indications and Usage: For determining cardiac output, hepatic function and liver blood flow, and for ophthalmic angiography.Contraindications: IC-GREEN™ contains sodium iodide and should be used with caution in patients who have a history of allergy to iodides.Warnings: Anaphylactic deaths have been reported following IC-GREEN™ administration during cardiac catheterization.Precautions: General: IC-GREEN™ Powder and Solution: IC-GREEN™ is unstable in aqueous solution and must be used within 6 hours. However, the dye is stable in plasma and whole blood so that samples obtained in discontinuous sampling techniques may be read hours later. Sterile techniques should be used in handling the dye solution as well as in the performance of the dilution curves.IC-GREEN™ (indocyanine green for injection) powder may cling to the vial or lump together because it is freeze-dried in the vials.Drug Interactions: Heparin preparations containing sodium bisulfate reduce the absorption peak of IC-GREEN™ in blood and, therefore, should not be used as an anticoagulant for the collection of samples for analysis.Drug/Laboratory Test Interactions: Radioactive iodine uptake studies should not be performed for at least a week following the use of IC-GREEN™.Carcinogenesis, Mutagenesis, Impairment of Fertility: No studies have been performed to evaluate the carcinogenicity, mutagenicity, or impairment of fertility.Pregnancy: Teratogenic Effects: Pregnancy Category C: Animal Reproduction studies have not been conducted with IC-GREEN™. It is also not known whether IC-GREEN™ can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. IC-GREEN™ should be given to a pregnant woman only if clearly indicated.Nursing Mothers: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when IC-GREEN™ is administered to a nursing woman.Pediatric Use: Safety and effectiveness in pediatric patients have been established.Adverse Reactions: Anaphylactic or urticarial reactions have been reported in patients with or without history of allergy to iodides. If such reactions occur, treatment with the appropriate agents, e.g., epinephrine, antihistamines, and corticosteroids should be administered.Overdosage: There are no data available describing the signs, symptoms, or laboratory findings accompanying overdosage. The LD 50 after I.V. administration ranges between 60 and 80 mg/kg in mice, 50 and 70 mg/kg in rats and 50 and 80 mg/kg in rabbits.Dosage and Administration: INDICATOR-DILUTION STUDIES: IC-GREEN™ permits recording of the indicator-dilution curves for both diagnostic and research purpose independently of fluctuations in oxygen saturation. In the performance of dye dilution curves, a known amount of dye is usually injected as a single bolus as rapidly as possible via a cardiac catheter into selected sites in the vascular system. A recording instrument (oximeter or densitometer) is attached to a needle or catheter for sampling of the dye-blood mixture from a systemic arterial sampling site.Under sterile conditions, the IC-GREEN™ powder should be dissolved with the Aqueous Solvent provided for this product, and the solution used within 6 hours after it is prepared. If a precipitate is present, discard the solution. The amount of solvent to be used can be calculated from the dosage form which follows. It is recommended that the syringe used for injection of the dye be rinsed with this diluent. Saline is used in all other parts of the catheterization procedure.This matter of rinsing the dye syringe with distilled water may not be critical, since it is known that an amount of sodium chloride sufficient to make an isotonic solution may be added to dye that has first been dissolved in distilled water. This procedure has been used for constant-rate injection techniques without precipitation of the dye.The usual doses of IC-GREEN™ which have been used for dilution curves are as follows:Adults -5.0 mgChildren -2.5 mgInfants -1.25 mgThese doses of the dye are usually injected in a mL volume. An average of five dilution curves are required in the performance of a diagnostic cardiac catheterization. The total dose of dye injected should be kept below 2 mg/kg.Calibrating Dye Curves: To quantitate the dilution curves, standard dilutions of IC-GREEN™ in whole blood are made as follows. It is strongly recommended that the same dye that was used for the injections be used in the preparation of these standard dilutions. The most concentrated dye solution is made by accurately diluting 1 mL of the 5 mg/ mL dye with 7 mL of distilled water. This concentration is then successively halved by diluting 4 mL of the previous concentration with 4 mL of distilled water. (If a 2.5 mg/ mL concentration was used for the dilution curves, 1 mL of the 2.5 mg/ mL dye is added to 3 mL of distilled water to make the most concentrated "standard" solution. This concentration is then successively halved by diluting 2 mL of the previous concentration with 2 mL of distilled water.) Then 0.2 mL portions (accurately measured from a calibrated syringe) of these dye solutions are added to 5 mL aliquots of the subject's blood, giving final concentrations of the dye in blood beginning with 24.0 mg/liter, approximately (actual concentration depends on the exact volume of dye added). This concentration is, of course, successively halved in the succeeding aliquots of the subject's blood. These aliquots of blood containing known amounts of dye, as well as a blank sample of which 0.2 mL of saline containing no dye has been added, are then passed through the detecting instrument and a calibration curve is constructed from the deflections recorded.HEPATIC FUNCTION STUDIES: Due to its absorption spectrum, changing concentrations of IC-GREEN™ (indocyanine green for injection) in the blood can be monitored by ear densitometry or by obtaining blood specimens at timed intervals. The technique for both methods is as follows.The patient should be studied in a fasting, basal state. The patient should be weighed and the dosage calculated on the basis of 0.5 mg/kg of body weight.Under sterile conditions, the IC-GREEN™ powder should be dissolved with the Aqueous Solvent provided. Exactly 5 mL of aqueous solvent should be added to the 25 mg vial giving 5 mg of dye per mL of solution.Inject the correct amount of dye into the lumen of an arm vein as rapidly as possible, without allowing the dye to escape outside the vein. (If the photometric method is used, prior to injecting IC-GREEN™, withdraw 6 mL of venous blood from the patient's arm for serum blank and standard curve construction, and through the same needle, inject the correct amount of dye )Ear Densitometry: Ear oximetry has also been used and makes it possible to monitor the appearance and disappearance of IC-GREEN™ without the necessity of withdrawal and spectrophotometric analysis of blood samples for calibration. An ear densitometer which has a compensatory photo-electric cell to correct for changes in blood volume and hematocrit, and a detection photocell which registers levels has been described. This device permits simultaneous measurement of cardiac output, blood volume and hepatic clearance of IC-GREEN™∗ and was found to provide a reliable index of plasma removal kinetics after single injections or continuous intrusions of IC-GREEN™. This technique was employed in newborn infants, healthy adults and in children and adults with liver disease. The normal subject has a removal rate of 18-24% per minute. Due to the absence of extra-hepatic removal, IC-GREEN™ was found to be ideally suited for serial study of severe chronic liver disease and to provide a stable measurement of hepatic blood flow. In larger doses, IC-GREEN™ has proven to be particularly valuable in detecting drug-induced alterations of hepatic function and in the detection of mild liver injury.Using the ear densitometer, a dosage of 0.5 mg/kg in normal subjects gives the following clearance pattern.Photometric Method-Determination Using Percentage Retention of Dye:A typical curve obtained by plotting dye concentration versus optical density is shown below. Percent retention can be read from this plot.∗Dichromatic earpiece densitometer supplied by The Waters Company, Rochester, Minnesota.If more accurate results are desired, a curve using the patient's blood and the vial of IC-GREEN™ being used in the determination can be constructed as follows:1.Take 6 mL of non-dye-containing venous blood from the patient's arm. Place in a test tube andallow the blood to clot. The serum is separated by centrifugation.2.Pipette 1 mLof the serum into a microcuvette.3.Add 1 lambda ((lambda)) of the 5 mg/mL aqueous IC-GREEN™ (sterile indocyanine green)solution to the serum, giving a dilution of 5 mg/liter, the standard for 50% retention. (Theaddition of 2 lambda (lambda) of the 5 mg/mL IC-GREEN™ solution would give 100%retention; however, this concentration cannot be read on the spectrophotometer.)4.The optical density of this solution is read at 805 nm, using normal serum as the blank.5.Plot the 50% figure obtained in Step 4, and draw a line connecting this point with the zerocoordinates.Percentage Retention: A single 20-minute sample (withdrawn from a vein in the opposite arm to that injected) is allowed to clot, centrifuged and its optical density is determined at 805 nm using the patient's normal serum as the blank. Dye concentration is read from the curve above. A single 20-minute sample of serum in healthy subjects should contain no more than 4% of the initial concentration of the dye. The use of percentage retention is less accurate than percentage disappearance rate, but provides reproducible results. Hemolysis does not interfere with a reading.Determination Using Disappearance Rate of Dye: To calculate the percentage disappearance rate, obtain samples at 5, 10, 15 and 20 minutes after injecting the dye. Prepare the sample as in the previous section and measure the optical densities at 805 nm, using the patient's normal serum as the blank. The IC-GREEN™ concentration in each timed specimen can be determined by using the concentration curve illustrated. Plot values on semilogarithmic paper.Specimens containing IC-GREEN™ should be read at the same temperature since its optical density is influenced by temperature variations.Normal Values: Percentage disappearance rate in healthy subjects is 18-24% per minute. Normal biological half-time is 2.5-3.0 minutes.OPHTHALMIC ANGIOGRAPHY STUDIES: The excitation and emission spectra (Figure 1) and the absorption spectra (Figure 2) of IC-GREEN™ make it useful in ophthalmic angiography. The peak absorption and emission of IC-GREEN™ lie in a region (800-850 nm) where transmission of energy by the pigment epithelium is more efficient than in the region of visible light energy. IC-GREEN™ also has the property of being nearly 98% bound to blood protein, and therefore, excessive dye extravasation does not take place in the highly fenestrated choroidal vasculature It is, therefore, useful in both absorption and fluorescence infrared angiography of the choroidal vasculature when using appropriate filters and film in a fundus camera.Dosages up to 40 mg IC-GREEN™ dye in 2 mL of aqueous solvent have been found to give optimal angiograms, depending on the imaging equipment and technique used. The antecubital vein injected IC-GREEN™ dye bolus should immediately be followed by a 5 mL bolus of normal saline.Clinically, angiograms of uniformly good quality can be assured only after taking care to optimize the contributions of all possible factors such as, patient cooperation and dye injection. The foregoing injection regimen is designed to provide delivery of a spatially limited dye bolus of optimal concentration to the choroidal vasculature following intravenous injection.How Supplied: IC-GREEN™ is supplied in a kit (NDC 17478-701-02) containing six 25 mg IC-GREEN™ vials and six 10mL Aqueous Solvent ampules:NDC 17478-701-25 IC-Green vial. 25 mg fill in 50 mL vial.NDC 17478-701-10 Aqueous Solvent ampule. 10 mL fill in 10 mL ampule.Storage: Store at 15° to 25° C (59° to 77°).Rx OnlyManufactured for:Akorn, IncBuffalo Grove, IL 60089IGGON Rev 03/06Proposed Container Label for IC-GREEN (not actual size)Proposed Kit Carton Label for IC-GREEN (not actual size)。
不健康的生活方式所导致危害英语作文
不健康的生活方式所导致危害英语作文全文共3篇示例，供读者参考篇1The Harm Caused by Unhealthy LifestyleIn today's fast-paced world, many people are leading unhealthy lifestyles due to a variety of factors such as work pressure, lack of exercise, and poor dietary habits. These unhealthy lifestyles can have a negative impact on a person's physical, mental, and emotional well-being. In this article, we will discuss the various ways in which an unhealthy lifestyle can harm an individual.First and foremost, an unhealthy lifestyle can lead to a range of physical health issues. For example, lack of exercise and poor dietary habits can result in obesity, which in turn increases the risk of developing chronic diseases such as diabetes, heart disease, and stroke. Additionally, smoking and excessive alcohol consumption can damage the lungs, liver, and other vital organs, increasing the likelihood of developing life-threatening conditions like cancer and liver disease.Moreover, an unhealthy lifestyle can also have a detrimental effect on a person's mental health. Studies have shown that individuals who do not engage in regular physical activity are more likely to experience feelings of depression and anxiety. Similarly, poor dietary habits can lead to nutritional deficiencies that can affect brain function and mood regulation. Furthermore, substance abuse, such as drug addiction or alcoholism, can exacerbate existing mental health problems and lead to a vicious cycle of self-destructive behavior.In addition to physical and mental health issues, an unhealthy lifestyle can also impact a person's emotionalwell-being. For example, poor dietary habits can result in low energy levels and fatigue, making it difficult to cope with daily stressors. Substance abuse can also lead to strained relationships with family and friends, as well as legal troubles that can further exacerbate feelings of guilt and shame. Ultimately, these emotional struggles can have a profound impact on a person's overall quality of life and sense of self-worth.In conclusion, it is clear that an unhealthy lifestyle can have far-reaching consequences on an individual's health andwell-being. By making positive changes to our diet, exercise routine, and habits, we can safeguard ourselves against theharmful effects of an unhealthy lifestyle. It is never too late to start making healthier choices and prioritizing our well-being. By taking control of our lifestyle choices, we can lead happier, healthier lives for years to come.篇2The Hazards Caused by Unhealthy LifestylesIn today's fast-paced society, more and more people are leading unhealthy lifestyles, which can have serious consequences on their physical and mental well-being. Unhealthy habits such as poor diet, lack of exercise, smoking, excessive drinking, and lack of sleep can all contribute to a host of health problems.One of the most common unhealthy habits is a poor diet. Many people consume too much unhealthy food such as fast food, processed snacks, sugary drinks, and foods high in saturated fats and sugars. This can lead to obesity, high cholesterol, high blood pressure, and type 2 diabetes. A poor diet can also deprive the body of essential nutrients, vitamins, and minerals, leading to deficiencies and weakened immune function.Lack of exercise is another major contributor to poor health. Sedentary lifestyles have become increasingly common with the rise of technology and desk jobs. Lack of physical activity can increase the risk of heart disease, stroke, obesity, diabetes, and certain types of cancer. Regular exercise is essential for maintaining a healthy weight, improving cardiovascular health, strengthening muscles and bones, and reducing stress.Smoking is a harmful habit that can have serious repercussions on one's health. Smoking is a leading cause of lung cancer, respiratory diseases, heart disease, stroke, and other chronic conditions. Secondhand smoke is also harmful to those around smokers, including family members, friends, and colleagues. Quitting smoking is one of the best things a person can do to improve their health and reduce their risk of developing serious illnesses.Excessive drinking is another unhealthy habit that can have detrimental effects on one's health. Alcohol abuse can lead to liver disease, heart disease, digestive problems, neurological disorders, and an increased risk of accidents and injuries.Long-term alcohol misuse can also contribute to mental health issues such as depression, anxiety, and addiction.Finally, lack of sleep is a common problem in today's society, with many people struggling to get enough rest due to busy schedules, stress, and technology. Sleep deprivation can have serious consequences on physical and mental health, including impaired cognitive function, weakened immune system, increased risk of obesity, diabetes, heart disease, and mental health disorders.In conclusion, leading an unhealthy lifestyle can have serious consequences on one's health and well-being. It is important for individuals to make healthy choices such as eating a balanced diet, exercising regularly, avoiding smoking and excessive drinking, and getting enough sleep. By adopting a healthy lifestyle, people can reduce their risk of developing chronic diseases, improve their quality of life, and live longer, happier lives.篇3The Hazards Caused by Unhealthy LifestylesIn today's fast-paced world, it is easy for individuals to fall into unhealthy habits and lifestyles. Whether it is due to stress, lack of time, or simply not prioritizing their health, many people engage in behaviors that can have serious consequences on theirwell-being. From poor diet choices to lack of exercise, the hazards of unhealthy lifestyles are numerous and can lead to a host of health issues.One of the most common consequences of an unhealthy lifestyle is obesity. With the rise of fast food and sedentary lifestyles, many individuals are consuming more calories than they are burning, leading to weight gain and ultimately obesity. Obesity is a major risk factor for a variety of health conditions, including heart disease, diabetes, and certain types of cancer. It can also have a negative impact on mental health, leading to feelings of low self-esteem and depression.In addition to obesity, unhealthy lifestyles can also lead to other chronic health conditions such as high blood pressure, high cholesterol, and diabetes. These conditions can have serious implications for one's health and can increase the risk of heart attacks, strokes, and other cardiovascular issues. They can also lead to complications such as kidney disease, nerve damage, and vision problems.Furthermore, unhealthy lifestyles can have a negative impact on mental health. Poor diet choices and lack of exercise can contribute to feelings of fatigue, irritability, and anxiety. These behaviors can also lead to poor sleep quality, which can furtherexacerbate mental health issues. In severe cases, unhealthy lifestyles can contribute to conditions such as depression and eating disorders.Not only do unhealthy lifestyles have consequences for individuals, but they also have wider implications for society as a whole. The rising rates of obesity and chronic health conditions put a strain on healthcare systems, resulting in increased healthcare costs and decreased productivity. This can have economic repercussions and can ultimately impact the quality of life for everyone.In order to combat the hazards of unhealthy lifestyles, it is important for individuals to prioritize their health and well-being. This includes making conscious choices about diet and exercise, as well as managing stress and getting enough sleep. By adopting healthy habits and making positive lifestyle changes, individuals can reduce their risk of developing chronic health conditions and improve their overall quality of life.In conclusion, the hazards of unhealthy lifestyles are vast and can have serious consequences for individuals and society as a whole. By making an effort to prioritize health and well-being, individuals can reduce their risk of developing chronic health conditions and improve their quality of life. It is important foreveryone to take responsibility for their health and make positive lifestyle choices in order to live a long and healthy life.。
裸花紫珠颗粒治疗慢性乙型肝炎疗效及对生活质量影响
裸花紫珠颗粒治疗慢性乙型肝炎疗效及对生活质量影响李 娜1，王云丽2，郭亚平3，刘 莉4（保定市第一中心医院，1.感染科；2.中医科；3.检验科；4.妇产科，河北保定 071000）【摘要】目的 观察裸花紫珠颗粒治疗慢性乙型肝炎的的疗效及对生活质量的影响。
方法 选取我院2015年1月～2017年2月收治的患者120例随机分为对照组和观察组各60例，对照组予恩替卡韦治疗，观察组加用裸花紫珠颗粒。
24周为一疗程。
比较临床疗效，血清HBe Ag、HBV DNA，肝功能，慢性肝病问卷（CLDQ）评价生活质量评定，记录不良反应。
结果 治疗后，观察组患者应答率和中医证候疗效分别为85.7%和75.0%，均明显高于对照组的67.2%和51.7%（P＜0.05）；观察组肝功能指标ALT、AST、TBIL明显低于对照组，CLDQ量表中腹部症状、疲乏、系统症状明显高于对照组，差异有统计学意义（P＜0.05）。
两组不良反应发生率组间比较；差异无统计学意义（P＞0.05）。
结论 裸花紫珠颗粒治疗慢性乙型肝炎安全有效，且可提高患者生活质量。
【关键词】裸花紫珠颗粒；慢性乙型肝炎；疗效；生活质量【中图分类号】R575.1 【文献标识码】A【文章编号】ISSN.2095-8242.2018.19.28.05Clinical effects of and influence on quality of life of Luohuazizhu particles on patients with chronic hepatitis BLI Na1, WANG Yun-li2, GUO Ya-ping3, LIU Li4(1.Infection department of the first central hospital of baoding city;2.Chinese medicine;boratory;4.Obstetrics and gynecology,hebei baoding 071000,China)【Abstract】Objective To observe the clinical effects of Luohuazizhu particles on patients with chronic hepatitis B, and its influence on quality of life. Methods The 120 patients admitted by our hospital from January 2015 to February 2017 were randomly divided into the control group and the observation group in 60 cases.the study group (60 cases) received Luohuazizhu particles additionally,the treatment cycle was 24 weeks.Clinical effects,serum level of HBe Ag and HBV DNA,and liver function were compared;chronic liver disease questionnaire (CLDQ) was used to evaluate the quality of life,the adverse reactions were recorded. Results After treatment, the response rate and traditional Chinese medicine symptoms were 85.7% and 75.0% in study group, respectively, both were higher than those of 67.2% and51.7% in control group (P＜0.05). For the study group, the liver fucntion parameters of ALT, AST and TBIL were lower, the abdominal symptoms, fatigue and systemic symptoms in CLDQ were higher, and there were significant differences between the two groups (P＜0.05). There was no significant difference between two groups for the incidence of adverse reactions. Conclusion Luohuazizhu particles was effective and safe for patients with chronic hepatitis B, and could improve their quality of life.【Key words】Nude purple beads; Chronic hepatitis b; Curative effect; The quality of life慢性乙型肝炎（Chronic hepatitis B，CHB）是由乙肝病毒（HBV）感染引起的临床常见病，具有传染性、嗜肝性、潜伏性等特点，后期可进展为肝纤维化、肝硬化甚至肝癌，据不完全统计，全球约有4亿人感染HBV，每年约100万人死于HBV感染引起的各种肝病[1-2]，HBV严重威胁广大患者健康。
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健康和不健康的习惯英语作文
健康和不健康的习惯英语作文英文回答：Healthy and Unhealthy Habits.Maintaining healthy habits is essential for our overall well-being. These habits include regular exercise, a balanced diet, sufficient sleep, and stress management. On the other hand, unhealthy habits such as excessive smoking, alcohol consumption, poor eating habits, and sedentary lifestyle can lead to various health problems. In this essay, I will discuss the importance of healthy habits and the consequences of unhealthy habits.To begin with, engaging in regular exercise is crucial for a healthy lifestyle. Exercise helps to improve cardiovascular health, strengthen muscles, and enhance flexibility. It also helps in maintaining a healthy weight and reducing the risk of chronic diseases such as heart disease, diabetes, and obesity. For instance, I make it ahabit to go for a jog every morning, which not only keeps me physically fit but also boosts my energy levels throughout the day.In addition to exercise, having a balanced diet is equally important. Consuming a variety of fruits, vegetables, whole grains, and lean proteins provides the body with essential nutrients. This helps in boosting the immune system, improving digestion, and preventing nutrient deficiencies. On the contrary, consuming excessive amounts of processed foods, sugary drinks, and unhealthy snacks can lead to weight gain, diabetes, and heart problems. For example, I always make sure to include a serving of vegetables and fruits in every meal, which not only adds nutritional value but also makes the meal more colorful and appealing.Furthermore, getting sufficient sleep is crucial for our overall health and well-being. During sleep, the body repairs and rejuvenates itself. Lack of sleep can lead to fatigue, decreased cognitive function, and increased risk of accidents. On the other hand, a good night's sleepimproves mood, enhances memory, and boosts the immune system. For instance, I make it a habit to maintain a consistent sleep schedule and create a relaxing bedtime routine, such as reading a book or listening to soothing music, to ensure a restful sleep.Moreover, managing stress is essential for maintaining good mental and physical health. Chronic stress can lead to various health problems, including high blood pressure, weakened immune system, and mental disorders. Engaging in stress-reducing activities such as meditation, yoga, and spending time with loved ones can help in managing stress effectively. For example, I practice deep breathing exercises whenever I feel overwhelmed, which helps me relax and refocus.In contrast, unhealthy habits such as smoking and excessive alcohol consumption can have severe consequences on our health. Smoking increases the risk of lung cancer, heart disease, and respiratory problems. Excessive alcohol consumption can lead to liver damage, addiction, and impaired judgment. It is important to avoid these habitsand seek help if necessary.In conclusion, maintaining healthy habits is crucialfor our overall well-being. Regular exercise, a balanced diet, sufficient sleep, and stress management are essential for a healthy lifestyle. On the other hand, unhealthyhabits such as smoking and excessive alcohol consumptioncan have severe consequences on our health. It is important to make conscious choices and prioritize our health to lead a fulfilling life.中文回答：健康和不健康的习惯。
医学英语(住院医师规范化培训)
Primary Care Medicine Recommendations目录1 Principles of Primary Care 基本医疗原则 4 Practice of Primary Care 基本医疗的实践Diagnostic Tests 诊断性试验Health Maintenance and Role of Screening 保健和筛查Risk and Prognosis 风险和预后Choosing Treatment Options 治疗的选择Immunization 免疫接种2 Systemic Problems 全身性问题 22 Chronic Fatigue 慢性疲劳Fever 发热HIV-1 Infection HIV感染Lymphadenopathy 淋巴结病Overweight and Obesity 超重和肥胖Weight loss 消瘦3 Cardiovascular Problems 心血管问题 30 Aortic Regurgitation主动脉瓣反流Aortic Stenosis主动脉瓣狭窄Arterial Insufficiency动脉供血不足Asymptomatic Systolic Murmur 无症状的收缩期杂音Atrial Fibrillation心房颤动Bacterial Endocarditis细菌性心内膜炎Cardiovascular Rehabilitation心血管疾病康复Chest Pain 胸痛Congestive Heart Failure充血性心力衰竭Deep Vein Thrombophlebitis 深静脉血栓Exercise锻炼Hypercholesterolemia高胆固醇血症Hypertension 高血压Leg Edema 下肢水肿Mitral Regurgitation二尖瓣返流Rheumatic Fever风湿热Stable Angina稳定型心绞痛Stress Testing应激试验Superficial Thrombophlebitis血栓性浅静脉炎Syncope晕厥Valvular Heart Disease心脏瓣膜疾病Varicose Veins静脉曲张Venous Insufficiency静脉机能不全Ventricular Irritability心室激惹状态4 Respiratory Problems 呼吸问题 34 Asthma 哮喘Bronchitis and Pneumonia 气管炎和肺炎Chronic Cough 慢性咳嗽Chronic Dyspnea 慢性呼吸困难Chronic Obstructive Pulmonary Disease慢性阻塞性肺疾患Clubbing杵状指Common Cold普通感冒Hemoptysis 咯血Interstitial Lung Disease间质性肺病Occupational and Environment Respiatory Disease 职业和环境性肺疾病Pleural Effusions 胸腔积液Sarcoidosis结节病Sleep Apnea 睡眠呼吸暂停Smoking Cessation 戒烟Solitary Pulmonary Nodule 孤立性肺结节Tuberculosis 肺结核5 Gastrointestinal Problems 胃肠道问题 36 Abdominal Pain 腹痛Anorectal Complaints肛门直肠不适Cirrhosis and Chronic Liver Failure肝硬化和慢性肝衰竭Constipation便秘Diarrhea腹泻Diverticular Disease憩室病Dysphagia吞咽困难External Hernia外疝Gallstones胆结石Gastrointestinal Bleeding胃肠道出血Heartburn and Reflux烧心和反流Inflammatory Bowel Disease炎性肠病Irritable Bowel Syndrome肠应激综合征Jaundice黄疸Nausea and Vomiting恶心和呕吐Nonulcer Dyspepsia无溃疡性消化不良Pancreatitis胰腺炎Peptic Ulcer Disease消化性溃疡病Serum Transaminase(Aminotransferase)Elevation血清转氨酶升高Viral Hepatitis病毒性肝炎6 Hematologic Problems血液系统问题 39 Anticoagulant Therapy抗凝治疗Anemia贫血Bleeding Problems出血问题Erythrocytosis红细胞增多Sickle Cell Disease镰状细胞(贫血)病7 Oncologic Problems肿瘤学问题 40 Bladder Cancer膀胱癌Breast Cancer乳腺癌Cancer(General)癌症(总论)Cervical Cancer子宫颈癌Colorectal Cancer结肠直肠癌Endometrial Cancer子宫内膜癌Esophageal Cancer食管癌Gastric Cancer胃癌Hodgkin’s Disease霍奇金病Lung Cancer肺癌Non-Hodgkin’a Lymphoma非霍奇金淋巴瘤Oral Cancer口腔癌Ovarian Cancer卵巢癌Pancreatic Cancer胰腺癌Renal Cell Carcinoma(Hypernephroma)肾细胞癌(肾上腺样瘤)Skin Cancer皮肤癌Testicular Cancer睾丸癌Thyroid Nodules and Thyroid Cancer甲状腺结节和甲状腺癌Tumor of Unknown Origin起源不明的肿瘤Vaginal Cancer阴道癌Vulvar Cancer外阴癌8 Endocrinologic Problems内分泌学问题Diabetes Insipidus尿崩症Diabetes Mellitus糖尿病Galactorrhea and Hyperprolactinemia乳头溢液高催乳素血症Glucocorticoid Therapy糖皮质激素治疗Gynecomastia男子女性型乳房Hirsutism多毛症Hypercalcemia高钙血症Hyperthyroidism甲状腺机能亢进Hypoglycemia低血糖Hypothyroidism甲状腺机能减退9 Gynecologic Problems妇产科学问题Breast Masses and Nipple Discharge乳房肿块和乳头溢液Fertility Control节育Infertility不育症Menopause绝经Menstrual or Pelvic Pain月经或痛经Secondary Amenorrhea继发性闭经Unplanned Pregnancy计划外妊娠Vaginal Bleeding阴道出血Vaginal Discharge阴道分泌物Vulvar Pruritus外阴搔痒10 Genitourinary Problems泌尿生殖器问题Benign Prostatic Hyperplasia良性前列腺增生Chlamydial Infection衣原体感染Gonorrhea淋病Hematuria血尿Incontinence and Lower Urinary Tract Dysfunction尿失禁和下尿路功能不全Nephrolithiasis肾结石Prostatitis前列腺炎Proteinuria蛋白尿Renal Failure肾衰Scrotal Pain,Masses,and Swelling阴囊痛、肿块和肿胀Sexually Transmitted Diseases性传播疾病Syphilis梅毒Urethritis in Men男性尿道炎Urinar Tract Infection尿路感染11 Musculoskeletal Problems肌肉与骨骼问题 42 Asymptomatic Hyperuricemia无症状性高尿酸血症Back Pain背痛Elbow,Wrist,and Hand Pain肘,腕和手痛Fibromyalgia纤维肌痛Foot and Ankle Pain脚和踝痛Giant Cell Arteritis巨细胞性动脉炎Gout痛风Hip Pain髋痛Knee Pain膝痛Lyme Disease莱姆病Monoarticular Arthritis单关节的关节炎Muscle Cramps肌肉痛性痉挛Neck Pain颈痛Osteoarthritis骨关节炎Paget’s Disease佩吉特病Polyarticular Complaints多关节的问题Polymyalgia Rheumatica风湿性多发性肌痛Raynaud’s Phenomenon雷诺现象Rheumatoid Arthritis类风湿性关节炎Shoulder Pain肩痛12 Neurologic Problems神经病学问题Bell’s Palsy面瘫Dementia痴呆Dizziness头晕Focal Neurologic Complaints局部神经的主诉Headache头痛Multiple Sclerosis多发性硬化Parkinson’s Disease震颤麻痹Seizures癫痫发作Transient Ischemic Attack and Asymptomatic Carotid Bruit短暂性缺血发作和无症状性颈动脉杂音Tremor震颤Trigeminal Neuralgia(Tic Douloureux) 三叉神经痛13 Dermatologic Problems皮肤病学问题 47 Acne痤疮Aphthous Stomatitis溃疡性口炎Bites(Animal and Human)咬伤(动物和人)Cellulitis蜂窝织炎Corns and calluses鸡眼和胼胝Dermatitis(Atopic or Contact) 皮炎(过敏或接触性) Dermatitis(Seborrheic) 皮炎(脂溢性)Dry Skin干性皮肤Excessive Sweating出汗过多Fungal Infections霉菌感染Hair Loss脱发Herpes Simplex单纯疱疹Herpes Zoster带状疱疹Intertrigo and Intertriginous Dermatoses间擦疹和擦烂性皮肤病Minor Burns轻度烧伤Pigmentation Disturbances色素沉着障碍Pruritus搔痒症Psoriasis银屑病Purpura紫癜Pyoderma脓皮病Rosacea and Other Acneiform Dermatoses酒渣鼻和其它痤疮样的皮肤病Scabies and Pediculosis疥疮和虱病Skin Ulceration皮肤溃疡Urticaria and Angioedema荨麻疹和血管性水肿Warts疣14 Ophthalmologic Problems眼科学问题Age-Related Macular Degeneration与年龄相关的黄斑退行性改变Cataracts白内障Contact Lenses接触镜Diabetic Retinopathy糖尿病性视网膜病Dry Eyes干眼Excessive Tearing多泪Exophthalmos眼球突出Eye Pain目痛Glaucoma青光眼Impaired Vision视觉损伤Red Eye红眼Refractive Surgery屈光手术Visual Disturbances视觉障碍15 Ear,Nose,and Throat Problems耳鼻喉问题 48 Epistaxis鼻衄Facial Pain and Swelling面痛和肿胀Halitosis口臭Hearing Loss听力损失Hiccups呃逆Hoarseness声嘶Nasal Congestion and Discharge鼻充血和分泌物Otitis耳炎Pharyngitis咽炎Sinusitis鼻窦炎Smell Disturbances嗅觉障碍Snoring打鼾Taste Disturbances味觉障碍Temporomandibular Joint Dysfunction颞下颌关节功能障碍Tinnitus耳鸣16 Psychiatric and Behavioral Problems精神病学和行为问题Alcohol Abuse酗酒Angry Patient生气的病人Anxiety焦虑Depression抑郁Eating Disorders进食障碍疾患Insomnia失眠Nonmalignant Pain非恶性的痛Sexual Dysfunction性功能障碍Somatization Disorders躯体化障碍Substance Abuse精神性药物滥用17 Allied Fields相关领域Adolescents青春期Alternative Therapies替代疗法Practice of Primary Care基本医疗的实践Management处理Organize PCP practice to provide coordinated, comprehensive, and personal care, available on first contact and continuous basis.Tasks of primary care include组织初级保健医生行医以提供协调的、全面的、个体化的保健服务，具有首诊的可及性和以连续性为基础的服务。
(精品)医学课件：肝细胞癌(英文版)
医学课件：肝细胞癌(英文版) xx年xx月xx日CATALOGUE目录•INTRODUCTION•ETIOLOGY AND RISK FACTORS•CLINICAL MANIFESTATIONS ANDDIAGNOSIS•TREATMENT AND MANAGEMENTCATALOGUE目录•PROGNOSTICATION AND PROGRESSION •OUTCOMES AND FUTURE PERSPECTIVES01 INTRODUCTIONDefinition of Hepatocellular Carcinoma (HCC)Hepatocellular carcinoma (HCC) is a primary malignancy of the liver, accounting for approximately 90% of all primary liver cancers.It is a highly heterogeneous disease with multiple etiologies, including hepatitis B virus (HBV), hepatitis C virus (HCV), alcohol, and other factors.HCC is the third leading cause of cancer-related death worldwide.Global Burden and Importance of HCCThe incidence of HCC is increasing, with over 700,000 new cases diagnosed each year.The highest incidence rates are observed in Asia and sub-Saharan Africa, although the reasons forthis are not fully understood.HCC Classification and Staging02ETIOLOGY AND RISK FACTORSHepatit…The most common cause of HCC worldwide Hepatit…The second most commoncause of HCCOther v…Hepatitis A, D, and E virusesmay also lead to HCCdevelopmentEtiology of HCCRisk Factors for HCC DevelopmentChronic liver diseaseChronic hepatitis, cirrhosis, and other chronic liver diseases increase the risk of HCC developmentMetabolic syndromeConditions such as obesity, diabetes mellitus, and hyperlipidemia may increase the risk of HCCGenetic factorsHereditary factors may also contribute to HCC developmentGenetic mutations and polymorphisms mayincrease the risk of HCC development GeneticsExposure to aflatoxins, vinyl chloride, arsenic, and other environmental carcinogens mayincrease the risk of HCC development Environmental factors Genetic and Environmental Factors in HCCCLINICAL MANIFESTATIONS ANDDIAGNOSISHCC tumors cancompress or invadenearby tissues, causingpain.Abdominal pain Symptoms and Signs of HCC Fatigue Weight loss JaundiceA liver biopsy is necessary to confirm the diagnosis of HCC.Diagnostic Workup for HCCImaging studies such as ultrasound, CT, MRI, andangiography are used to detectthe tumor size, location, and vascularity.BiopsyImaging Serum Markers01Ultrasound Imaging Modalities in HCC Diagnosis02CT Scanning 03MRI 04AngiographyTREATMENT AND MANAGEMENTSurgical OPTIONS FOR HCCLiver transplant…Resection Radiofrequency a…SorafenibThis is the only drug that has been shown to increase survival in patients with advanced HCC. It works by blocking the blood supply to the tumor and slowing its growth.Other chemotherapeu…Chemotherapeutic agents such as cisplatin, gemcitabine, and fluorouracil may be used in combination with sorafenib or alone in patients who are not candidates for sorafenib.CHEMOTHERAPEUTIC AGENTS IN HCC TREATMENTTARGETED THERAPIES AND IMMUNOTHERAPIES IN HCCTargeted therapies Immunotherapies05 PROGNOSTICATION AND PROGRESSIONPrognostic Factors for HCCLiver functionThe amount ofhealthy liver tissue remaining andany cirrhosis or scarring presentare important factors in assessingprognosis.Serial imagingRegular MRI or CT scans are used to monitor the size and number of tumors and any changes in their characteristics.Monitoring HCC ProgressionAlpha-fetoprotein (AFP)A blood test that measures the level of AFP, a protein produced by HCC cells. An increasing AFP level may suggest disease progression.Staging systemsUsed to classify the disease stage at diagnosis and help predict prognosis and plan treatment.Survival Rates and Prognostic Tools in HCC06OUTCOMES AND FUTURE PERSPECTIVESSurgica…Liver t… can be curative for small HCC and is associated with good survival ratesLocal a…Systemi…Outcomes of HCC TreatmentEarly det…diagnosis often made at advanced stage, with limited treatment options Resistanc…HCC is often refractory totreatment, with high rates ofrecurrence and metastasisComorbiditiesQuality o…treatment side effects cansignificantly impact quality oflifeChallenges in HCC Management01020304Improving out…Future Perspectives and ConclusionPersonalize d …Improving acc…Strategies to…THANKS谢谢您的观看。
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WJGWorld Journal of
Gastroenterology
Submit a Manuscript: https://www.f6publishing.comWorld J Gastroenterol 2019 July 28; 25(28): 3669-3683DOI: 10.3748/wjg.v25.i28.3669ISSN 1007-9327 (print) ISSN 2219-2840 (online)OPINION REVIEW
Importance of fatigue and its measurement in chronic liver disease
Lynn H Gerber, Ali A Weinstein, Rohini Mehta, Zobair M YounossiORCID number: Lynn H Gerber
(0000-0001-7525-680x); Ali AWeinstein (0000-0002-3371-6086);Rohini Mehta(0000-0001-5046-336x); Zobair MYounossi (0000-0001-9313-577x).
Author contributions: Gerber LH,
Weinstein AA and Younossi ZMparticipated in theconceptualization of the paper;Gerber LH, Weinstein AA andRohini M drafted the manuscript;Gerber LH, Weinstein AA, RohiniM and Younossi ZM edited andfinalized the manuscript.
Conflict-of-interest statement:Authors have no conflict of interestto disclose.
Open-Access: This is an open-
access article that was selected byan in-house editor and fully peer-reviewed by external reviewers. Itis distributed in accordance withthe Creative Commons AttributionNon Commercial (CC BY-NC 4.0)license, which permits others todistribute, remix, adapt, buildupon this work non-commercially,and license their derivative workson different terms, provided theoriginal work is properly cited andthe use is non-commercial. See:http://creativecommons.org/licenses/by-nc/4.0/
Manuscript source: Invited
manuscript
Received: April 6, 2019
Peer-review started: April 8, 2019
First decision: May 30, 2019
Revised: June 10, 2019
Accepted: June 22, 2019
Article in press: June 23, 2019
Published online: July 28, 2019
P-Reviewer: Akbulut S
Lynn H Gerber, Zobair M Younossi, Department of Medicine, Beatty Center for Liver andObesity Research, Inova Health System, Falls Church, VA 22042, United States
Ali A Weinstein, Center for the Study of Chronic Illness and Disability, George MasonUniversity, Fairfax, VA 22030, United States
Rohini Mehta, Beatty Center for Liver and Obesity Research, Inova Health System, FallsChurch, VA 22042, United States
Corresponding author: Lynn H Gerber, MD, Professor, Department of Medicine, FairfaxMedical Campus, Inova Health System, 3300 Gallows Rd, Falls Church, VA 22042, UnitedStates. ngerber1@gmu.eduTelephone: +1-703-7764027Fax: +1-703-7764388
AbstractThe mechanisms of fatigue in the group of people with non-alcoholic fatty liverdisease and non-alcoholic steatohepatitis are protean. The liver is central in thepathogenesis of fatigue because it uniquely regulates much of the storage, releaseand production of substrate for energy generation. It is exquisitely sensitive to thefeedback controlling the uptake and release of these energy generation substrates.Metabolic contributors to fatigue, beginning with the uptake of substrate fromthe gut, the passage through the portal system to hepatic storage and release ofenergy to target organs (muscle and brain) are central to understanding fatigue inpatients with chronic liver disease. Inflammation either causing or resulting fromchronic liver disease contributes to fatigue, although inflammation has not beendemonstrated to be causal. It is this unique combination of factors, the nexus ofmetabolic abnormality and the inflammatory burden of non-alcoholic fatty liverdisease and non-alcoholic steatohepatitis that creates pathways to different typesof fatigue. Many use the terms central and peripheral fatigue. Central fatigue ischaracterized by a lack of self-motivation and can manifest both in physical andmental activities. Peripheral fatigue is classically manifested by neuromusculardysfunction and muscle weakness. Therefore, the distinction is often seen as adifference between intention (central fatigue) versus ability (peripheral fatigue).New approaches to measuring fatigue include the use of objective measures aswell as patient reported outcomes. These measures have improved the precisionwith which we are able to describe fatigue. The measures of fatigue severity andits impact on usual daily routines in this population have also been improved,and they are more generally accepted as reliable and sensitive. Severalapproaches to evaluating fatigue and developing endpoints for treatment haverelied of biosignatures associated with fatigue. These have been used singly or incombination and include: physical performance measures, cognitive performance
WJGhttps://www.wjgnet.comJuly 28, 2019Volume 25Issue 283669