Ran Wang

• Dr
• Medical Doctor at General Hospital of Shenyang Military Region

Lopinavir/ritonavir, an anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) drug, may be associated with the development of liver injury. In this paper, we reported an elderly female patient with drug-induced liver injury secondary to lopinavir/ritonavir, which was evaluated for their causality using the updated Roussel Uclaf Causalit...

Background Endoscopy is important for the diagnosis and treatment of acute upper gastrointestinal bleeding (AUGIB), especially acute variceal bleeding (AVB), in liver cirrhosis. However, the optimal timing of endoscopy remains controversial, primarily because the currently available evidence is of poor quality, and the definition of early endoscopy...

Rationale In China, herbal traditional Chinese medicine products are readily obtained without any requirement of prescription and widely used in real life, thereby increasing the incidence of their related herb-induced liver injury (HILI). However, the diagnosis of HILI is still challenging because its clinical manifestations are variable due to la...

Non-selective beta-blockers (NSBBs) are the cornerstone of management of liver cirrhosis and its complications. They decrease portal vein blood flow and portal vein pressure via antagonism of β1 and β2 receptors, thereby improving the hyperdynamic circulatory status and reducing the risk of decompensated events in cirrhotic patients with portal hyp...

Background Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) is frequently accompanied with type 1 autoimmune pancreatitis (AIP). Isolated IgG4-SC which is not accompanied with AIP is uncommon in clinical practice, and its manifestations are similar to those of hilar cholangiocarcinoma. Case presentation A 55-year-old male presented with...

Isolated splenic vein thrombosis (ISVT) is a very rare venous thromboembolism in the absence of pancreatic diseases, which can cause acute abdominal pain and chronic left-side portal hypertension. Herein, we reported a 40-year-old female patient who developed ISVT after taking oral contraceptives. Anticoagulation with oral rivaroxaban was the first...

Acute portal vein thrombosis (PVST), a serious complication of liver cirrhosis, is characterized as abdominal pain secondary to intestinal ischemia, and even intestinal necrosis. Anticoagulation is recommended for the treatment of acute PVST, but is often postponed in cirrhotic patients with acute variceal bleeding or those at a high risk of varice...

Background and aims: Tolvaptan has been approved for the management of cirrhosis-related complications according to the Japanese and Chinese practice guidelines, but not the European or American practice guidelines in view of FDA warning about its hepatotoxicity. This study aimed to systematically evaluate its efficacy and safety in cirrhosis. Me...

There is a risk of post-polypectomy bleeding (PPB) in patients undergoing a colonoscopic polypectomy, especially in those taking warfarin. Undoubtedly, the use of warfarin can raise the risk of bleeding, but its withdrawal increases the risk of thrombosis. Therefore, the management of warfarin during a colonoscopic polypectomy is particularly impor...

Background Human albumin infusion is effective for controlling systemic inflammation, thereby probably managing some liver cirrhosis-related complications, such as spontaneous bacterial peritonitis (SBP), hepatic encephalopathy (HE), and hepatorenal syndrome. However, its clinical benefits remain controversial.MethodsEMBASE, PubMed, and Cochrane Li...

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired clonal hematopoietic stem cell disorder, characterized by hemolytic anemia, bone marrow failure and thrombosis. Portal vein thrombosis (PVT) is relatively rare in patients with PNH. In this paper, we reported PVT as the first clinical presentation of PNH in a female patient. PVT related...

Background Liver cirrhosis is a major global health burden worldwide due to its high risk of morbidity and mortality. Role of terlipressin for the management of liver cirrhosis–related complications has been recognized during recent years. This article aims to develop evidence-based clinical practice guidance on the use of terlipressin for liver ci...

Background The association of endoscopic variceal treatment (EVT) with portal venous system thrombosis (PVST) in liver cirrhosis is still unclear. Methods PVST was assessed by contrast-enhanced CT or MRI in 406 cirrhotic patients from our prospective database. Case and control groups, which are defined as patients with and without PVST, respective...

Diuretics are widely used medications for the treatment of ascites in patients with cirrhosis. There are some different types of diuretics, such as aldosterone antagonists (i.e., spironolactone), loop diuretics (i.e., furosemide), and vasopressin V2 receptor antagonists (i.e., tolvaptan). Spironolactone is recommended for patients with first on-set...

Objectives: Endoscopy is the mainstay treatment option for acute variceal bleeding (AVB) in liver cirrhosis. However, the optimal timing of endoscopy in such patients remains unclear. Methods: PubMed, EMBASE and Cochrane Library databases were searched. We compared the mortality, incidence of rebleeding, length of stay, endoscopic hemostasis, ne...

Gastroesophageal varices are the most common complication of portal hypertension and associated with a worse prognosis. Endoscopy is the gold standard method to diagnose gastroesophageal varices. However, endoscopy is an invasive method with potential complications and is not well adhered by patients. Non-invasive methods, including serum markers o...

Portal venous system thrombosis (PVST), a common complication of liver cirrhosis, is closely associated with thrombophilia. To explore the association of homocysteine (Hcy), anticardiolipin antibody (aCL), and anti-β2 glycoprotein I antibody (aβ2GPI), which are possible thrombophilic factors, with PVST in liver cirrhosis. Overall, 654 non-malignant...

Acute variceal bleeding (AVB) is one of the most common complications of liver cirrhosis with a high morbidity and mortality. Despite the improved management strategy, the mortality of patients with AVB is still very high. An adequate selection of high-risk patients could help to optimize the management strategy and further improve the outcomes. Ma...

Immunoglobulin G4 (IgG4) related disease is a rare autoimmune disease involving multiple organs and tissues. A diagnosis of IgG4-related disease (IgG4-RD) is mainly based on serum IgG4 concentration, imaging, pathology, and effective glucocorticoids therapy. In this paper, we report a 53-year-old male with typical signs and symptoms of IgG4-RD succ...

Liver cirrhosis is an increasing cause of morbidity and mortality in most countries, being the 13th most common cause of death worldwide. Survival decreases with the appearance of complications, such as ascites, gastroesophageal variceal bleeding, hepatic encephalopathy, and hepatocellular carcinoma, etc. In this chapter, we review the current know...

Background and Aims. Liver fibrosis blood tests, platelet count/spleen diameter ratio (PSR), and contrast-enhanced CT are diagnostic alternatives for gastroesophageal varices, but they have heterogeneous diagnostic performance among different study populations. Our study is aimed at evaluating their diagnostic accuracy for esophageal varices (EVs)...

Background: The role of human albumin infusion for the prevention and treatment of overt hepatic encephalopathy (HE) in liver cirrhosis remains unclear. Results: Among the 708 patients without pre-existing overt HE, albumin infusion significantly decreased the incidence of overt HE (4.20% versus 12.70%, P<0.001) and in-hospital mortality (1.70%...

Acute portomesenteric vein thrombosis is potentially lethal. In the present paper, a cirrhotic patient with a previous history of esophageal variceal bleeding presented with acute occlusive portomesenteric vein thrombosis, but achieved complete recanalization by low-molecular-weight heparin followed by rivaroxaban. Notably, no bleeding episode occu...

Objectives: Patients with acute upper gastrointestinal bleeding (AUGIB) often manifest as hematemesis and melena. Theoretically, hematemesis will carry worse outcomes of AUGIB. However, there is little real-world evidence. We aimed to compare the outcomes of hematemesis versus no hematemesis as a clinical manifestation of AUGIB at admission in cir...

Unfortunately, the fourteenth author’s name was incorrectly published in the Original Article. The correct author name is Cen Hong.

Background and Aims Endoscopy is necessary for assessment of esophageal varices (EVs) in cirrhotic patients, but its use is limited because of the poor compliance of patients and shortage of public health resources at primary hospitals or rural areas, especially in less well developed countries. A multicenter cross-sectional study aimed to establis...

Acute variceal hemorrhage (AVH) is a devastating complication of liver cirrhosis. Endoscopic variceal ligation (EVL) is a useful endoscopic treatment for AVH with few complications. However, the issue regarding management of early re-bleeding after EVL still needs to be concerned. Furthermore, the dietary principle after EVL is unclear. There is no...

Background and aims: Acute upper gastrointestinal bleeding (AUGIB) is a lethal complication of liver cirrhosis. We aimed to compare the outcomes of patients with liver cirrhosis and AUGIB who were admitted to hospital on regular hours and off-hours. Methods: This retrospective study screened all cirrhotic patients with AUGIB who were admitted to...

Background: Hepatic encephalopathy is associated with altered gut microbiota. Proton pump inhibitors increase the risk of small bowel bacterial overgrowth. Objectives: This was a case-control study aimed at exploring the relationship of proton pump inhibitor use with the risk of hepatic encephalopathy during hospitalization in liver cirrhosis....

Background and Aim Spontaneous bacterial peritonitis (SBP) is one of the most common complications of liver cirrhosis. Antibiotics are the main treatment regimen of SBP. Traditional Chinese medicine Xuebijing injection has been used in such patients. Our study aimed to overview the efficacy of Xuebijing injection combined with antibiotics for the t...

Supplementary Figure 1: risk of bias assessment.

Supplementary Figure 2: comparison of overall response between Xuebijing injection and control groups in subgroup analyses of cephalosporin and non-cephalosporin group.

Supplementary Figure 5: comparison of the incidence of gastrointestinal bleeding between Xuebijing injection and control groups.

Supplementary Figure 8: comparison of the incidence of septic shock between Xuebijing injection and control groups.

Supplementary Figure 3: comparison of complete response between Xuebijing injection and control groups in subgroup analyses of cephalosporin and non-cephalosporin group.

Supplementary Figure 4: comparison of no response between Xuebijing injection and control groups in subgroup analyses of cephalosporin and non-cephalosporin group.

Supplementary Figure 6: comparison of the incidence of hepatic encephalopathy between Xuebijing injection and control groups.

Supplementary Figure 7: comparison of the incidence of hepatorenal syndrome between Xuebijing injection and control groups.

Introduction: Spider nevus and subcutaneous collateral vessel of the chest/abdominal wall are common in liver cirrhosis. This prospective study aimed to evaluate the impact of spider nevus and subcutaneous collateral vessel of the chest/abdominal wall on the outcomes of cirrhotic patients. Material and methods: We prospectively enrolled patients...

Backgrounds: Traditional Chinese medicine (TCM) is becoming increasingly popular and related adverse events are often ignored or underestimated. Aims: This systematic review aimed to evaluate the clinical characteristics and outcomes of TCM-induced liver injury (TCM-ILI) and to estimate the proportion of TCM-ILI in all drug-induced liver injuries (...

Ascites is among the most common complications of liver cirrhosis and is associated with a high mortality rate. The present retrospective study aimed to evaluate the potential correlation between in-hospital mortality of liver cirrhosis and volume of ascites. Patients with liver cirrhosis who were admitted to the General Hospital of Shenyang Milita...

Background This is a retrospective observational study evaluating the prevalence and clinical characteristics of spontaneous splenorenal shunt in liver cirrhosis. Material/Methods We included a total of 105 cirrhotic patients who were admitted to our hospital between June 2012 and December 2013 and underwent contrast-enhanced CT and/or MRI scans a...

Objectives: To identify the value of liver-to-abdominal area ratio (LAAR) score for predicting the in-hospital mortality in advanced cirrhotic patients. Methods: All cirrhotic patients with Child-Pugh class B or C who were admitted between July 2012 and June 2014 and underwent abdominal-pelvic CT scans were considered in this retrospective observat...

Background: D-dimer is produced during the fibrinolysis. A retrospective study was conducted to assess the association between D-dimer and inflammatory parameters in unselected patients with digestive diseases. Methods: All patients who were consecutively admitted to our department between January 2016 and October 2016 and underwent D-dimer tests w...

Peutz-Jeghers syndrome (PJS) is characterized by scattered black pigmentations on fingers and lips and multiple polyps in the gastrointestinal tract. Patients with PJS often have severe complications secondary to multiple large polyps. Herein, we present a young woman complicated with a large polyp in her colon without any clinical symptoms. We als...

Background and aims: Umbilical hernia is a common abdominal complication in cirrhotic patients with ascites. Our study aimed to evaluate the correlation of umbilical hernia with the volume of ascites. Methods: Cirrhotic patients that underwent axial abdomino-pelvic computed tomography (CT) scans at our hospital between June 2012 and June 2014 we...

Background Portal venous system thrombosis (PVST) is a life-threatening complication of liver cirrhosis. We conducted a retrospective study to comprehensively analyze the prevalence and risk factors of PVST in liver cirrhosis. Material/Methods All cirrhotic patients without malignancy admitted between June 2012 and December 2013 were eligible if t...

The ORs for splenectomy in the development of PVST according to the severity of PVST.

The proportions of degree of esophageal varices in cirrhotic patients with and without PVST. (A) All patients. (B) Patients after excluding splenectomy.

Objectives: Our study aimed to evaluate the discriminative abilities of Child-Pugh, model for end-stage liver disease (MELD), and albumin-bilirubin (ALBI) scores in predicting the in-hospital mortality in cirrhotic patients with acute-on-chronic liver failure (ACLF). Methods: Cirrhotic patients with ACLF admitted between 2010 January and 2014 Ju...

Peutz-Jeghers syndrome (PJS) is a rare, but life-threatening, familial inherited disease, characterized by mucocutaneous pigmentation and hamartomatous polyps. The estimated incidence of PJS ranges from 1/50,000 to 1/200,000. PJS can significantly increase the risk of malignancies, and especially gastrointestinal malignancies. Reported here are 4 c...