(1) This progress report presents research on cirrhosis conducted at Lanzhou University Second Hospital's Gastroenterology Department. (2) Cirrhosis is a major cause of morbidity and mortality in developed countries, being the 14th most common cause of death. It accounts for over 5,500 liver transplants per year in Europe. (3) Cirrhosis has distinct clinical prognostic stages with 1-year mortality ranging from 1% to 57% depending on the stage. Infections and renal failure in advanced cirrhosis result in 67% 1-year mortality.

1. 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

2. 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

3. 最常见的疾病出现在病房。
• Patients with most common Gastrointestinal
diseases presented to ward

4. 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

5. 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）

6. Liver
Cholestasis
Cirrhosis
Fatty Liver Disease
Gallstones
Hepatitis A
Hepatitis B
Hepatitis C
Hemochromatosis
Polycystic Liver Disease
Liver Cancer

7. 肝硬化

8. Cirrhosis
• A brief study report on Cirrhosis

9. 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)

12. 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

13. 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

15. 肝损害阶段。

16. 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),

17. 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)

18. Clinical features临床表现。

22. 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.。。。。。

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