Xingshun Qi

By Xingshun Qi and Andrea Mancuso

Venous thromboembolism (VTE) carries a high morbidity and mortality and leads to a substantial economic burden. From the traditional perspectives, liver cirrhosis tends to bleeding but not VTE. However, modern concepts suggest that liver cirrhosis is also at a risk of VTE. The pooled incidence and prevalence of VTE in liver cirrhosis are 1% (95% confidence interval: 0.7–1.3%) and 1% (95% confidence interval: 0.7–1.2%), respectively. Evidence indicates that a higher international normalized ratio and a lower albumin should be associated with a higher probability of VTE in liver cirrhosis. Additionally, the presence of VTE significantly worsens the outcomes of liver cirrhosis.

Part of the book: Embolic Diseases

By Xingshun Qi, Qiang Zhu and Ye Tian

Routine screening for gastroesophageal varices in liver cirrhosis is necessary. At present, upper gastrointestinal endoscopy is the golden diagnostic test of gastroesophageal varices. However, the use of upper gastrointestinal endoscopy is restricted because of its poor compliance and adverse events. In this chapter, we reviewed the recent evidence regarding the value of noninvasive or less invasive tests for the diagnosis of gastroesophageal varices in liver cirrhosis.

Part of the book: Liver Cirrhosis

By Xingshun Qi, Fernando Gomes Romeiro and Yiling Li

Acute upper gastrointestinal bleeding (UGIB) is a potentially lethal and frequent digestive disease. It is mainly divided into the nonvariceal UGIB and variceal bleeding according to the source of bleeding. Red blood cell transfusion is the core therapeutic option for the management of acute UGIB. In this chapter, we reviewed the primary evidence from meta‐analyses and large‐scale randomized controlled trials regarding red blood cell transfusion strategy for acute UGIB.

Part of the book: Transfusion Medicine and Scientific Developments

By Xinmiao Zhou, Lichun Shao, Tingxue Song, Wenchun Bao, Xiaozhong Guo and Xingshun Qi

This retrospective observational study aimed to investigate the risk of serum sodium concentration in patients treated with terlipressin and attempted to explore the factors associated with serum sodium concentration. We included 17 patients with portal hypertension treated with terlipressin (Group 1), 7 with portal hypertension treated with somatostatin/octreotide (Group 2), 20 with acute non-variceal gastrointestinal bleeding treated with somatostatin/octreotide (Group 3), and 19 with acute pancreatitis treated with somatostatin/octreotide (Group 4). In all groups, serum sodium concentration at baseline was not significantly different from the lowest value during the infusion of terlipressin, somatostatin, or octreotide (Group 1: 136.95 ± 4.68 versus 135.52 ± 4.79, p = 0.426; Group 2: 139.64 ± 3.86 versus 138.41 ± 5.34, p = 0.813; Group 3: 138.02 ± 4.08 versus 137.69 ± 3.11, p = 0.630; Group 4: 135.96 ± 6.87 versus 134.60 ± 3.40, p = 0.098). The rate of serum sodium concentration reduction in Group 1 (8/17) was not significantly different from Group 2 (3/7, p = 1.000), Group 3 (11/20, p = 0.746), or Group 4 (14/19, p = 0.171). Age, sex, baseline MELD and Child-Pugh scores, cDDD value and duration of terlipressin, blood transfusion, and diuretics and paracentesis during terlipressin were not significantly associated with serum sodium concentration reduction in Group 1. In conclusion, serum sodium concentration is often reduced in patients treated with terlipressin. However, the association of sodium concentration reduction with terlipressin should be clarified.

Part of the book: Digestive System

By Kexin Zheng, Xiaozhong Guo, Xinhong Wang and Xingshun Qi

Stroke and liver cirrhosis are common in our everyday clinical practice, both of which can lead to serious complications. Their association is unclear. In this chapter, we briefly summarized the epidemiology of liver cirrhosis in stroke, reviewed the current evidence regarding the association between liver cirrhosis and stroke, and discussed the potential mechanisms for explaining such an association, such as coagulopathy, hypoperfusion, cardiac diseases, diabetes, and dyslipidemia.

Part of the book: Liver Pathology

By Ran Wang, Xiaozhong Guo and Xingshun Qi

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 or scores, computed tomography, ultrasonographic, and elastography-based methods, have been explored for the diagnosis of gastroesophageal varices. In the current chapter, we will briefly review non-invasive methods for the prediction of gastroesophageal varices.

Part of the book: Portal Hypertension

By Xingshun Qi and Xiaodong Shao

Part of the book: Anticoagulation

By Di Sun, Min Ding, Mengfan Ruan, Li Yang and Xingshun Qi

Hepatitis C virus (HCV), an oncogenic virus, is a well-known risk factor for hepatocellular carcinoma. Some studies have shown an increased risk of extrahepatic tumors in HCV patients, but the risk of different types of extrahepatic tumors remains controversial. Early prevention of extrahepatic tumors in HCV patients should be further explored. Therefore, this chapter aims to explore the association between HCV infection and extrahepatic tumors.

Part of the book: Hepatitis C

By Ran Wang, Xiaozhong Guo and Xingshun Qi

Part of the book: Liver Cirrhosis and Its Complications

By Qinke Wu, Ting Wang, Qianqian Li, Fei Gao, Chenghai Liu and Xingshun Qi

Drug-induced liver injury (DILI) refers to a type of liver dysfunction induced by various drugs or their metabolites, which can be life-threatening. Its incidence is increasing gradually, and it has become a non-negligible global health burden. In daily life, many common medications can lead to DILI. However, there is still no single indicator which is specific for the diagnosis of DILI, and the medications for the treatment of DILI are clinically diverse. In addition, pharmacological therapy also faces additional challenges in some special populations with DILI, such as elderly people, children, and pregnant women. This chapter aims to summarize the current overview of various drugs to treat DILI in clinical practice.

Part of the book: Understanding Hepatotoxicity