肝性腦病英文教學

肝性腦病英文教學演講人：日期：目錄OverviewofHepaticEncephalopathyPathophysiologyofhepaticencephalopathyAnalysisofEnglishterminologyforthematiccoherenceClinicaldiagnosisandtreatmentprocessforhepaticencephalopathyProgressindrugtherapyforhepaticencephalopathyOverviewofHepaticEncephalopathy01DefinitionHepaticcoherence(HE)isasyndromecharacterizedbycentralnervoussystemdysfunctioncausedbymultipleliverdiseases,leadingtometabolicdisordersPathogenesisThepathogensisofHEinvolvementmultiplefactors,includingammoniatoxicity,neurotransmitterimbalances,andoxidativestress,whichcontributetothedevelopmentofneurologicalsymptomsDefinitionandpathogenesisHEisacommonapplicationofcirchosisandothermultiplelivediseases,affectingasignificantportofthepatientpopulationEpidemiologyRiskfactorsforHEincludeadvancedlivedisease,portalhypertension,andfactorsthatcantriggerthecondition,suchasgastrointestinalbleeding,infections,andelectrolyteimbalancesRiskfactorsEpidemiologyandriskfactorsClinicalpresentationsCommonsymptomsincludefusion,differentiation,lethargy,andastrologyClassificationHEisclassifiedintodifferentgradesbasedontheseverityofsymptoms,rangingfromminimalHE(subneuropsychiatricchanges)tooverHE(marketcoherence)ClinicalpresentationsandclassificationThediagnosisofHEisbasedonclinicalfindings,laboratorytests(suchasammonialevels),andneuroimagingstudiesAdetailedhistoryandphysicalexaminationareessentialtoidentifytheunderlyinglivediseaseandexcludeothercausesofepilepsyDiagnosticcriteriaDifferentialdiagnosisofHEincludesothercausesofcoherencesuchasmetabolicdisorders,infectionsofthecentralnervoussystem,anddrugindicationsItisimportanttoconsiderthesealternativestoensureaccuratediagnosisandappropriatetreatmentDifferentialdiagnosisDiagnosticcriteriaanddifferentialdiagnosisPathophysiologyofhepaticencephalopathy02AmmoniaproductionandabsorptionInthecaseoflifefailure,ammoniaproducedbytheintentionsisnoteffectivelymetabolizedbythelife,leadingtoelevatedbloodammonialevelsAmmoniatoxicitytothebrainHighlevelsofammoniacancrossthebloodbrainbarrierandinterferewithbrainfunction,leadingtothesymptomsofhepaticencephalopathyFactorsaffectingammoniametabolismFactorssuchasgastrointestinalbleeding,infections,andelectrolyteimbalancescanfurtherexaggerateammoniatoxicityAmmoniacounselingtheoryElevatedammonialevelscanleadtoanincreaseinGABA(gammaaminobutyricacid)production,whichbundlestoBenzodiazepinereceiversinthebrainandcausesinhibitionofneuralfunctionsGABA/BenzodiazepinereceivercomplexInadditiontoGABA,GlutamateisanotherimportantneurotransmitterthatcanbeaffectedbyhepaticencephalopathyElevatedammonialevelscanleadtoglutamateexcitotoxicity,furthercontributingtoneurologicaldysfunctionsGlutamateexcitotoxicityNeurotransmitterbalancetheoryInflammatorycytokinesHepaticencephalopathyisassociatedwithanincreaseininflammatorycytokinesinthebrain,whichcanleadtoneurologicaldamageanddysfunction0102OxidativestressOxidativestressresultsfromanimbalancebetweenantagonistsandreactiveoxygenspecies(ROS)havealsobeenimpliedinthepathophysiologyofhepaticencephalopathyROScandamagecellularcomponentssuchaslips,proteins,andDNA,leadingtocellulardysfunctionsanddeathInflammatoryresponseandoxidativestresstheoryOtherrelatedfactorsManganeseaccumulationintheBasalgangliahasbeenobservedinpatientswithhepaticencephalopathy,likelyduetoincreasedmanganesemetabolismassociatedwithlivediseaseTheactualmechanismbywhichmanganesedepositioncontributionstothesymptomsofhepaticencephalopathyremainsunclearlyManganesedepositionHormoneandmetabolicchangesareassociatedwithlivedisease,suchashyperglycemia,hyponatremia,andalternativethyroidhormonelevels,mayalsocontributetothedevelopmentofhepaticencephalopathyThesechangescanaffectneurologicalfunctionsandexaggeratethesymptomsoftheconditionHormoneandmetabolicchangesAnalysisofEnglishterminologyforthematiccoherence03EncephalopathyAgeneraltermreferringtoanydiffusediseaseofthebrainthataltersthebrainfunctionorstructureVocabularyofCommonEnglishTermsHepatic01PersistingtotheliverHepaticEncephalopathy(HE)02Aspectrumofneuropsychiatricabnormalitiesseeninpatientswithliverdysfunction,rangingfromsubtitlealterationsinmoodoralignmenttocometAmmonia03Atoxicsubstanceproducedinthebodythatisnormallyreducedbytheliver;AccumulationofammoniainthebloodcanleadtoHEVocabularyofCommonEnglishTermsExamplesentence"Patientswithcirchosisareatriskofdevelopinghepaticencephalopathyduetopaidlivefunction."AnalysisInthispresence,"hepaticencephalopathy"isusedtodescribeapotentialapplicationofcirchosis,achronicliverdiseaseTheterm"paidlifefunction"referstothelife'sinabilitytoperformitsnormalpurificationfunctions,leadingtoabuildoftoxicsubstanceslikeammoniainthebloodExamplesandanalysisofterminalusageUsemnemonicdevicessuchasacronymsorrhymestohelpremembercomplextermsForexample,"HE"canbeassociatedwith"happyending"tohelprememberthatpathologicalpathologyisapotentialapplicationthatneedstobemanagedappropriatelyRepeatingtermsoverandoveragaincanhelpsolidifytheminyourmemoryTrywritingthemdownmultipletimesorsayingthemoutloudUnderstandingthecontextinwhichtermsareusedcanhelpmakethemmorememorableForinstance,knowingthatHEisrelatedtolivedysfunctionsandammoniaaccumulationcanhelpyourememberthetermmoreeasilyMnemonicdevicesRepetitionContextlearningTerminologymemoryskillssharingWhenreadingaboutthematiccoherence,it'simportanttoselectreliablesourcessuchaspeer-reviewedjournalsortextbookswrittenbyexpertsinthefieldDifferenttypesofstudiesprovidedifferentlevelsofevidenceForexample,randomizedcontrolledtrials(RCTs)areconsideredthegoldstandardforevaluatingtreatmentsbutmaynotalwaysbeavailableforrayconditionslikeHEWhenreadingprofessionalliterature,it'simportanttoreadcriticallyandevaluatetheinformationpresentedAdvisortheauthors'credentials,potentialbiases,andboththeconclusionsaresupportedbythedatapresentedSelectreliablesourcesUnderstandthelevelofevidenceReadcriticallyProfessionalliteraturereadingguidanceClinicaldiagnosisandtreatmentprocessforhepaticencephalopathy04PreliminaryevaluationandselectionofauxiliaryexaminationsSuchasultrasound,CT,orMRIoftheliverandbraintodetectstructuralchangesandassesstheseverityofthediseaseImagingexaminationsTounderstandthepatient'smedicalhistory,symptoms,andsignsrelatedtothematiccoherenceDetailedhistorytakingandphysicalexaminationIncludingbloodbiochemistry,lifefunction,ammoniaconcentration,andotherrelevantindicatorstoassesslifefunctionandmetabolicstatusLaboratorytestsIndividualizedtreatmentplansTailoredtothepatient'sspecificcondition,takingintoaccountfactorssuchasage,comorbidities,andseverityofthediseaseComprehensivetreatmentCombiningmedicaltreatment,nutritionalsupport,andlifestylemodificationstoaddresstheunderlyingcausesandsymptomsofhepaticencephalopathyTimelyadjustmentoftreatmentplansBasedonthepatient'sresponsetotreatmentandchangesintheircondition,thetreatmentplanshouldbeadjustedinatimelymannerPrinciplesforformulatingandadjustingtreatmentplansPreventionofinfectionsStrictalkalinetechnologiesshouldbefollowedduringmedicalprocedures,andpatientsshouldbeadvisedonpersonalhygieneandavoidanceofinfectiousdiseasesManagementofelectrolyteandacidbasedbalanceClosemonitoringofelectrolytelevelsandtimelycorrectionofbalancestopreventcomplicationssuchasarrhythmiasandencephalopathyPreventionofgastrointestinalbleedingMeasuressuchasdietarymodifications,medicaluse,andendoscopicprocedurescanbetakentoreducetheriskofgastrointestinalbleedingPreventionandmanagementstrategiesforapplicationsDietaryguidancePatientsshouldbeadvisedonalowproteindietoreducetheproductionoftoxicmetalsinthegutAdditionally,theyshouldavoidfoodhighinammoniaandothertoxinsLifestylemodificationsPatientsshouldbesurroundedtoquitsmoking,avoidalcoholconsumption,andmaintainahealthyweightthroughregularexerciseCompliancewithmedicinePatientsshouldbeinstructedontheimportanceoftakingtheirmedicineassubscribedandthepotentialsideeffectstowatchoutforRegularfollow-upRegularvisitstothehospitalforfollow-upexaminationsandconsultationsareessentialformonitoringthepatient'sconditionsandadjustingthetreatmentplanasnecessaryPatientdailymanagementandeducationalguid