中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Menu
Volume 40 Issue 5
May  2024
Turn off MathJax
Article Contents
Abstract
References
Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(5): 1068-1072

Pathogenesis, diagnosis, and treatment of pancreatogenic diabetes

DOI: 10.12449/JCH240532
  • 1.

    The First Clinical Medical College of Henan University of Chinese Medicine，Zhengzhou 450000，China

  • 2.

    Spleen，Stomach and Hepatobiliary Department，The First Affiliated Hospital of Henan University of Chinese Medicine，Zhengzhou 450000，China

Research funding:

Henan Characteristic Backbone Discipline Construction Project of Traditional Chinese Medicine (STG-ZYX02-202116);

Special Project of Traditional Chinese Medicine in Henan Province (2019JDZX2050)

More Information
  • Corresponding author: WANG Xiao， wangxiao1113@126.com （ORCID： 0000-0002-4676-2487）
  • Received Date: 2023-08-02
  • Accepted Date: 2023-09-14
  • Published Date: 2024-05-25
    Abstract
  • Pancreatogenic diabetes is a type of diabetes mellitus secondary to exocrine pancreatic disease， and it was officially proposed by the American Diabetes Association in 2014， with chronic pancreatitis as the most common etiology， followed by pancreatic cancer. At present， the misdiagnosis rate of this disease is extremely high， and patients with pancreatogenic diabetes have a higher risk of death and readmission than patients with type 2 diabetes. Therefore， it is of great significance to fully understand， correctly identify， and diagnose pancreatogenic diabetes in the early state， so as to reduce the disability rate and mortality rate of this disease. This article reviews the advances in the possible pathogenesis， diagnosis， treatment， and management of pancreatic diabetes secondary to pancreatitis and pancreatic cancer.

     

    • FullText(HTML)
    • References(56)
  • [1]
    XIAO AY, TAN MLY, WU LM, et al. Global incidence and mortality of pancreatic diseases: A systematic review, meta-analysis, and meta-regression of population-based cohort studies[J]. Lancet Gastroenterol Hepatol, 2016, 1( 1): 45- 55. DOI: 10.1016/S2468-1253(16)30004-8.
    [2]
    PETROV MS, BASINA M. DIAGNOSIS OF ENDOCRINE DISEASE: Diagnosing and classifying diabetes in diseases of the exocrine pancreas[J]. Eur J Endocrinol, 2021, 184( 4): R151- R163. DOI: 10.1530/EJE-20-0974.
    [3]
    HART PA, BELLIN MD, ANDERSEN DK, et al. Type 3c(pancreatogenic) diabetes mellitus secondary to chronic pancreatitis and pancreatic cancer[J]. Lancet Gastroenterol Hepatol, 2016, 1( 3): 226- 237. DOI: 10.1016/S2468-1253(16)30106-6.
    [4]
    CHO J, SCRAGG R, PETROV MS. Risk of mortality and hospitalization after post-pancreatitis diabetes mellitus vs type 2 diabetes mellitus: A population-based matched cohort study[J]. Am J Gastroenterol, 2019, 114( 5): 804- 812. DOI: 10.14309/ajg.0000000000000225.
    [5]
    WOODMANSEY C, MCGOVERN AP, MCCULLOUGH KA, et al. Incidence, demographics, and clinical characteristics of diabetes of the exocrine pancreas(type 3c): A retrospective cohort study[J]. Diabetes Care, 2017, 40( 11): 1486- 1493. DOI: 10.2337/dc17-0542.
    [6]
    SANTOS R, COLEMAN HG, CAIRNDUFF V, et al. Clinical prediction models for pancreatic cancer in general and at-risk populations: A systematic review[J]. Am J Gastroenterol, 2023, 118( 1): 26- 40. DOI: 10.14309/ajg.0000000000002022.
    [7]
    LIAO WC, CHEN PR, HUANG CC, et al. Relationship between pancreatic cancer-associated diabetes and cachexia[J]. J Cachexia Sarcopenia Muscle, 2020, 11( 4): 899- 908. DOI: 10.1002/jcsm.12553.
    [8]
    DONATH MY. Targeting inflammation in the treatment of type 2 diabetes: Time to start[J]. Nat Rev Drug Discov, 2014, 13( 6): 465- 476. DOI: 10.1038/nrd4275.
    [9]
    LI GQ, SUN JF, ZHANG J, et al. Identification of inflammation-related biomarkers in diabetes of the exocrine pancreas with the use of weighted gene co-expression network analysis[J]. Front Endocrinol(Lausanne), 2022, 13: 839865. DOI: 10.3389/fendo.2022.839865.
    [10]
    ZHANG Y, ZHANG WQ, LIU XY, et al. Immune cells and immune cell-targeted therapy in chronic pancreatitis[J]. Front Oncol, 2023, 13: 1151103. DOI: 10.3389/fonc.2023.1151103.
    [11]
    CASU AN, GRIPPO PJ, WASSERFALL C, et al. Evaluating the immunopathogenesis of diabetes after acute pancreatitis in the diabetes RElated to acute pancreatitis and its mechanisms study: From the type 1 diabetes in acute pancreatitis consortium[J]. Pancreas, 2022, 51( 6): 580- 585. DOI: 10.1097/MPA.0000000000002076.
    [12]
    PONDUGALA PK, SASIKALA M, GUDURU VR, et al. Interferon-γ decreases nuclear localization of pdx-1 and triggers β-cell dysfunction in chronic pancreatitis[J]. J Interferon Cytokine Res, 2015, 35( 7): 523- 529. DOI: 10.1089/jir.2014.0082.
    [13]
    ELSHARKAWI I, PARAMBATH D, SABER-AYAD M, et al. Exploring the effect of epigenetic modifiers on developing insulin-secreting cells[J]. Hum Cell, 2020, 33( 1): 1- 9. DOI: 10.1007/s13577-019-00292-y.
    [14]
    QIN WJ, KANG MX, LI C, et al. VNN1 overexpression in pancreatic cancer cells inhibits paraneoplastic islet function by increasing oxidative stress and inducing β-cell dedifferentiation[J]. Oncol Rep, 2023, 49( 6): 120. DOI: 10.3892/or.2023.8557.
    [15]
    HU FL, LOU N, JIAO JY, et al. Macrophages in pancreatitis: Mechanisms and therapeutic potential[J]. Biomed Pharmacother, 2020, 131: 110693. DOI: 10.1016/j.biopha.2020.110693.
    [16]
    ANDERSEN DK, KORC M, PETERSEN GM, et al. Diabetes, pancreatogenic diabetes, and pancreatic cancer[J]. Diabetes, 2017, 66( 5): 1103- 1110. DOI: 10.2337/db16-1477.
    [17]
    LIAO WC, HUANG BS, YU YH, et al. Galectin-3 and S100A9: Novel diabetogenic factors mediating pancreatic cancer-associated diabetes[J]. Diabetes Care, 2019, 42( 9): 1752- 1759. DOI: 10.2337/dc19-0217.
    [18]
    HU YF, ZENG N, GE YQ, et al. Identification of the shared gene signatures and biological mechanism in type 2 diabetes and pancreatic cancer[J]. Front Endocrinol(Lausanne), 2022, 13: 847760. DOI: 10.3389/fendo.2022.847760.
    [19]
    XU TT, XU XX, LIU PC, et al. Transcriptomic analyses and potential therapeutic targets of pancreatic cancer with concomitant diabetes[J]. Front Oncol, 2020, 10: 563527. DOI: 10.3389/fonc.2020.563527.
    [20]
    OLDFIELD L, EVANS A, RAO RG, et al. Blood levels of adiponectin and IL-1Ra distinguish type 3c from type 2 diabetes: Implications for earlier pancreatic cancer detection in new-onset diabetes[J]. EBioMedicine, 2022, 75: 103802. DOI: 10.1016/j.ebiom.2021.103802.
    [21]
    LEE SH, PARK SY, CHOI CS. Insulin resistance: From mechanisms to therapeutic strategies[J]. Diabetes Metab J, 2022, 46( 1): 15- 37. DOI: 10.4093/dmj.2021.0280.
    [22]
    GILLIES N, PENDHARKAR SA, ASRANI VM, et al. Interleukin-6 is associated with chronic hyperglycemia and insulin resistance in patients after acute pancreatitis[J]. Pancreatology, 2016, 16( 5): 748- 755. DOI: 10.1016/j.pan.2016.06.661.
    [23]
    OLESEN SS, SVANE HML, NICOLAISEN SK, et al. Clinical and biochemical characteristics of postpancreatitis diabetes mellitus: A cross-sectional study from the Danish nationwide DD2 cohort[J]. J Diabetes, 2021, 13( 12): 960- 974. DOI: 10.1111/1753-0407.13210.
    [24]
    ASLAM M, VIJAYASARATHY K, TALUKDAR R, et al. Reduced pancreatic polypeptide response is associated with early alteration of glycemic control in chronic pancreatitis[J]. Diabetes Res Clin Pract, 2020, 160: 107993. DOI: 10.1016/j.diabres.2019.107993.
    [25]
    HENNIG R, KEKIS PB, FRIESS H, et al. Pancreatic polypeptide in pancreatitis[J]. Peptides, 2002, 23( 2): 331- 338. DOI: 10.1016/s0196-9781(01)00605-2.
    [26]
    CAI DS, YUAN MS, FRANTZ DF, et al. Local and systemic insulin resistance resulting from hepatic activation of IKK-beta and NF-kappaB[J]. Nat Med, 2005, 11( 2): 183- 190. DOI: 10.1038/nm1166.
    [27]
    HEO YJ, CHOI SE, JEON JY, et al. Visfatin induces inflammation and insulin resistance via the NF-κB and STAT3 signaling pathways in hepatocytes[J]. J Diabetes Res, 2019, 2019: 4021623. DOI: 10.1155/2019/4021623.
    [28]
    CHEANG JY, MOYLE PM. Glucagon-like peptide-1(GLP-1)-based therapeutics: Current status and future opportunities beyond type 2 diabetes[J]. ChemMedChem, 2018, 13( 7): 662- 671. DOI: 10.1002/cmdc.201700781.
    [29]
    TUDURÍ E, LÓPEZ M, DIÉGUEZ C, et al. Glucagon-like peptide 1 analogs and their effects on pancreatic islets[J]. Trends Endocrinol Metab, 2016, 27( 5): 304- 318. DOI: 10.1016/j.tem.2016.03.004.
    [30]
    DRUCKER DJ. Mechanisms of action and therapeutic application of glucagon-like peptide-1[J]. Cell Metab, 2018, 27( 4): 740- 756. DOI: 10.1016/j.cmet.2018.03.001.
    [31]
    SALGAÇO MK, OLIVEIRA LGS, COSTA GN, et al. Relationship between gut microbiota, probiotics, and type 2 diabetes mellitus[J]. Appl Microbiol Biotechnol, 2019, 103( 23-24): 9229- 9238. DOI: 10.1007/s00253-019-10156-y.
    [32]
    TILG H, ZMORA N, ADOLPH TE, et al. The intestinal microbiota fuelling metabolic inflammation[J]. Nat Rev Immunol, 2020, 20( 1): 40- 54. DOI: 10.1038/s41577-019-0198-4.
    [33]
    TAO J, CHEEMA H, KESH K, et al. Chronic pancreatitis in a caerulein-induced mouse model is associated with an altered gut microbiome[J]. Pancreatology, 2022, 22( 1): 30- 42. DOI: 10.1016/j.pan.2021.12.003.
    [34]
    TALUKDAR R, SARKAR P, JAKKAMPUDI A, et al. The gut microbiome in pancreatogenic diabetes differs from that of Type 1 and Type 2 diabetes[J]. Sci Rep, 2021, 11( 1): 10978. DOI: 10.1038/s41598-021-90024-w.
    [35]
    JANDHYALA SM, MADHULIKA A, DEEPIKA G, et al. Altered intestinal microbiota in patients with chronic pancreatitis: Implications in diabetes and metabolic abnormalities[J]. Sci Rep, 2017, 7: 43640. DOI: 10.1038/srep43640.
    [36]
    ZOU WB, TANG XY, ZHOU DZ, et al. SPINK1, PRSS1, CTRC, and CFTR genotypes influence disease onset and clinical outcomes in chronic pancreatitis[J]. Clin Transl Gastroenterol, 2018, 9( 11): 204. DOI: 10.1038/s41424-018-0069-5.
    [37]
    LIU QC, ZHUANG ZH, ZENG K, et al. Prevalence of pancreatic diabetes in patients carrying mutations or polymorphisms of the PRSS1 gene in the Han population[J]. Diabetes Technol Ther, 2009, 11( 12): 799- 804. DOI: 10.1089/dia.2009.0051.
    [38]
    KIMURA H, KLEIN AP, HRUBAN RH, et al. The role of inherited pathogenic CDKN2A variants in susceptibility to pancreatic cancer[J]. Pancreas, 2021, 50( 8): 1123- 1130. DOI: 10.1097/MPA.0000000000001888.
    [39]
    YIN LD, WEI JS, LU ZP, et al. Prevalence of germline sequence variations among patients with pancreatic cancer in China[J]. JAMA Netw Open, 2022, 5( 2): e2148721. DOI: 10.1001/jamanetworkopen.2021.48721.
    [40]
    MCWILLIAMS R, HIGHSMITH WE, RABE KG, et al. Cystic fibrosis transmembrane regulator gene carrier status is a risk factor for young onset pancreatic adenocarcinoma[J]. Gut, 2005, 54( 11): 1661- 1662. DOI: 10.1136/gut.2005.074534.
    [41]
    ABE K, KITAGO M, KITAGAWA Y, et al. Hereditary pancreatic cancer[J]. Int J Clin Oncol, 2021, 26( 10): 1784- 1792. DOI: 10.1007/s10147-021-02015-6.
    [42]
    ASSOCIATION AD. 2. classification and diagnosis of diabetes: Standards of medical care in diabetes-2021[J]. Diabetes Care, 2021, 44( Suppl 1): S15- S33. DOI: 10.2337/dc21-S002.
    [43]
    LÖHR JM, DOMINGUEZ-MUNOZ E, ROSENDAHL J, et al. United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis(HaPanEU)[J]. United European Gastroenterol J, 2017, 5( 2): 153- 199. DOI: 10.1177/2050640616684695.
    [44]
    UC A, ANDERSEN DK, BELLIN MD, et al. Chronic pancreatitis in the 21st century-research challenges and opportunities: Summary of a national institute of diabetes and digestive and kidney diseases workshop[J]. Pancreas, 2016, 45( 10): 1365- 1375. DOI: 10.1097/MPA.0000000000000713.
    [45]
    CUI YF, ANDERSEN DK. Pancreatogenic diabetes: Special considerations for management[J]. Pancreatology, 2011, 11( 3): 279- 294. DOI: 10.1159/000329188.
    [46]
    BELLIN MD. Pancreatogenic diabetes in children with recurrent acute and chronic pancreatitis: Risks, screening, and treatment(mini-review)[J]. Front Pediatr, 2022, 10: 884668. DOI: 10.3389/fped.2022.884668.
    [47]
    WU K, WANG WL, CHEN H, et al. Insulin promotes proliferation of pancreatic ductal epithelial cells by increasing expression of PLK1 through PI3K/AKT and NF-κB pathway[J]. Biochem Biophys Res Commun, 2019, 509( 4): 925- 930. DOI: 10.1016/j.bbrc.2018.12.182.
    [48]
    YANG X, XU ZP, ZHANG CL, et al. Metformin, beyond an insulin sensitizer, targeting heart and pancreatic β cells[J]. Biochim Biophys Acta Mol Basis Dis, 2017, 1863( 8): 1984- 1990. DOI: 10.1016/j.bbadis.2016.09.019.
    [49]
    WANG CC, ZHANG TP, LIAO Q, et al. Metformin inhibits pancreatic cancer metastasis caused by SMAD4 deficiency and consequent HNF4G upregulation[J]. Protein Cell, 2021, 12( 2): 128- 144. DOI: 10.1007/s13238-020-00760-4.
    [50]
    CHEN K, QIAN WK, JIANG ZD, et al. Metformin suppresses cancer initiation and progression in genetic mouse models of pancreatic cancer[J]. Mol Cancer, 2017, 16( 1): 131. DOI: 10.1186/s12943-017-0701-0.
    [51]
    MAIDA A, LAMONT BJ, CAO X, et al. Metformin regulates the incretin receptor axis via a pathway dependent on peroxisome proliferator-activated receptor-α in mice[J]. Diabetologia, 2011, 54( 2): 339- 349. DOI: 10.1007/s00125-010-1937-z.
    [52]
    GOODARZI MO, PETROV MS. Diabetes of the exocrine pancreas: Implications for pharmacological management[J]. Drugs, 2023, 83( 12): 1077- 1090. DOI: 10.1007/s40265-023-01913-5.
    [53]
    CAMPAGNOLA P, de PRETIS N, ZORZI A, et al. Chronic pancreatitis and nutritional support[J]. Best Pract Res Clin Gastroenterol, 2023, 62-63: 101823. DOI: 10.1016/j.bpg.2023.101823.
    [54]
    DUGGAN SN, SMYTH ND, MURPHY A, et al. High prevalence of osteoporosis in patients with chronic pancreatitis: A systematic review and meta-analysis[J]. Clin Gastroenterol Hepatol, 2014, 12( 2): 219- 228. DOI: 10.1016/j.cgh.2013.06.016.
    [55]
    DYTZ MG, MARCELINO PAH, de CASTRO SANTOS O, et al. Clinical aspects of pancreatogenic diabetes secondary to hereditary pancreatitis[J]. Diabetol Metab Syndr, 2017, 9: 4. DOI: 10.1186/s13098-017-0203-7.
    [56]
    DUGGAN SN, EWALD N, KELLEHER L, et al. The nutritional management of type 3c(pancreatogenic) diabetes in chronic pancreatitis[J]. Eur J Clin Nutr, 2017, 71( 1): 3- 8. DOI: 10.1038/ejcn.2016.127.
    • Relative Articles

  • Relative Articles

    [1]Qian ZHAO, Yongliang FENG, Yan WANG, Zhigang WEI. Clinical characteristics of patients with pancreatic cancer combined with new onset diabetes mellitus[J]. Journal of Clinical Hepatology, 2022, 38(12): 2780-2786. doi: 10.3969/j.issn.1001-5256.2022.12.018
    [2]Xue WU, Yilian ZHANG, Ping LI, Yuqiang MI. Influence of type 2 diabetes mellitus and fasting insulin level on the risk of spontaneous peritonitis in patients with cirrhotic ascites[J]. Journal of Clinical Hepatology, 2022, 38(7): 1548-1553. doi: 10.3969/j.issn.1001-5256.2022.07.017
    [3]Yuanzhen HAO, Rui CHENG, Shutian ZHANG. Application of endoscopic ultrasound in the diagnosis and treatment of pancreatic diseases[J]. Journal of Clinical Hepatology, 2022, 38(12): 2681-2686. doi: 10.3969/j.issn.1001-5256.2022.12.001
    [4]Shengchen NAN, Qiao SHI, Chen CHEN, Weixing WANG. Association between pancreatic cancer and diabetes[J]. Journal of Clinical Hepatology, 2022, 38(12): 2882-2886. doi: 10.3969/j.issn.1001-5256.2022.12.039
    [5]Kai XU, Chuanling WU, Fengjiao YIN, Wendeng LI, Wang HU, Chuchu LIU, Haijiu WANG, Zhixin WANG. Clinical features, diagnosis, and treatment of autoimmune pancreatitis[J]. Journal of Clinical Hepatology, 2021, 37(6): 1477-1480. doi: 10.3969/j.issn.1001-5256.2021.06.054
    [7]Wen QIN, Taiwen CHEN, Haiping ZHENG, Xianing HUANG, Xiaodong ZHU. Serum expression of angiopoietin-like protein 2 in pancreatic cancer patients with or without diabetes and its association with prognosis[J]. Journal of Clinical Hepatology, 2021, 37(6): 1398-1403. doi: 10.3969/j.issn.1001-5256.2021.06.034
    [8]Yang Fan, Yang Fei, Sun SiYu. Endoscopic ultrasound diagnosis of space-occupying lesions in the pancreas[J]. Journal of Clinical Hepatology, 2020, 36(8): 1704-1709. doi: 10.3969/j.issn.1001-5256.2020.08.005
    [9]Zhao Juan, Hui Wei, Dou AiHua, Wei LinLin, Liu Mei, Dong GuiFang, Xu Bin. A clinical analysis of hypoglycemia in patients with liver cirrhosis and diabetes mellitus[J]. Journal of Clinical Hepatology, 2020, 36(2): 329-332. doi: 10.3969/j.issn.1001-5256.2020.02.019
    [10]Li ZhaoShen. Difficulties and research advances in endoscopic management of pancreatic diseases[J]. Journal of Clinical Hepatology, 2020, 36(8): 1681-1687. doi: 10.3969/j.issn.1001-5256.2020.08.001
    [11]Guo XiaoZhong. Diagnosis and treatment strategies for pancreatic diseases in patients with inflammatory bowel disease[J]. Journal of Clinical Hepatology, 2020, 36(7): 1454-1460. doi: 10.3969/j.issn.1001-5256.2020.07.004
    [12]Peng Li, Peng Yan, Tang XiaoWei, Tang ChuanKang, Chen Xia, Ma YuFan, Pu YinQuan. An analysis of the 100 most influential articles in the field of pancreatic diseases in the world from 1990 to 2017[J]. Journal of Clinical Hepatology, 2019, 35(5): 1027-1031. doi: 10.3969/j.issn.1001-5256.2019.05.018
    [13]Sun LiQi, Jin ZhenDong. Application of new endoscopic techniques in diagnosis of pancreaticobiliary diseases[J]. Journal of Clinical Hepatology, 2018, 34(3): 467-472. doi: 10.3969/j.issn.1001-5256.2018.03.003
    [14]Yang Shuo, Jiang XiaoDi. Clinical effect of linagliptin combined with insulin aspart 50 in treatment of hepatogenous diabetes[J]. Journal of Clinical Hepatology, 2017, 33(5): 928-931. doi: 10.3969/j.issn.1001-5256.2017.05.028
    [15]Zhang YiXi, Qiao Xin, Liu Bin, Qiao ShiXing. Application of minimally invasive technique in surgical treatment of pancreatic diseases[J]. Journal of Clinical Hepatology, 2015, 31(5): 681-683. doi: 10.3969/j.issn.1001-5256.2015.05.011
    [16]Liu HongXia, Cheng Min, Wang XiMing, Lei Ding. Clinical effect of combination therapy with NovoRapid 30 and modified Yinchenhao decoction in treatment of chronic hepatitis B with diabetes[J]. Journal of Clinical Hepatology, 2014, 30(4): 311-313. doi: 10.3969/j.issn.1001-5256.2014.04.006
    [17]He XiangYi, Yuan YaoZong. Research advances in relationship between diabetes and pancreatic cancer[J]. Journal of Clinical Hepatology, 2014, 30(8): 737-739. doi: 10.3969/j.issn.1001-5256.2014.08.009
    [18]Yu MingXia, Yin WeiMin, Li YingJin, Wu Yang. The treatment status of hepatogenous diabetes[J]. Journal of Clinical Hepatology, 2011, 27(7): 779-782.
    [19]Chong JingDong, Ding RuJun, Qian ZhuYin, Miao Yi. The diagnosis and treadment of constitutional tuberculosis of the pancreas (Four reports)[J]. Journal of Clinical Hepatology, 2010, 26(5): 554-555.
    • Supplements(0)
    • Cited By

  • Cited by

    Periodical cited type(2)

    1. 黄楠，朱慧敏，王慧，黄?，李玲. 胰腺再生蛋白在糖尿病预警及诊疗中的应用价值. 中国临床研究. 2024(07): 993-997 .
    2. 田恬，吴兆荣，李雯，王静，陈婷，王倩. 胰源性糖尿病早期筛查及血糖管理的最佳证据总结. 护理学杂志. 2024(23): 18-23 .

    Other cited types(0)

  • Created with Highcharts 5.0.7Amount of accessChart context menuAbstract Views, HTML Views, PDF Downloads StatisticsAbstract ViewsHTML ViewsPDF Downloads2024-042024-052024-062024-072024-082024-092024-102024-112024-122025-012025-022025-03050100150200
    Created with Highcharts 5.0.7Chart context menuAccess Class DistributionFULLTEXT: 24.3 %FULLTEXT: 24.3 %META: 69.4 %META: 69.4 %PDF: 6.3 %PDF: 6.3 %FULLTEXTMETAPDF
    Created with Highcharts 5.0.7Chart context menuAccess Area Distribution其他: 8.1 %其他: 8.1 %其他: 0.3 %其他: 0.3 %Central District: 0.2 %Central District: 0.2 %Lewisburg: 0.1 %Lewisburg: 0.1 %Tartu: 0.1 %Tartu: 0.1 %Tiruchi: 0.1 %Tiruchi: 0.1 %Yakutsk: 0.2 %Yakutsk: 0.2 %上海: 7.8 %上海: 7.8 %伊斯兰堡: 0.1 %伊斯兰堡: 0.1 %克卢日-纳波卡: 0.1 %克卢日-纳波卡: 0.1 %北京: 3.9 %北京: 3.9 %南京: 2.1 %南京: 2.1 %南宁: 0.4 %南宁: 0.4 %南拉纳克郡: 0.6 %南拉纳克郡: 0.6 %南昌: 0.1 %南昌: 0.1 %卡斯托里亚: 0.1 %卡斯托里亚: 0.1 %卡纳塔克: 0.1 %卡纳塔克: 0.1 %厦门: 0.2 %厦门: 0.2 %台北: 0.1 %台北: 0.1 %合肥: 0.1 %合肥: 0.1 %吉隆坡: 0.4 %吉隆坡: 0.4 %咸阳: 0.1 %咸阳: 0.1 %哥伦布: 0.1 %哥伦布: 0.1 %嘉兴: 0.1 %嘉兴: 0.1 %四平: 0.1 %四平: 0.1 %圣地亚哥: 0.1 %圣地亚哥: 0.1 %大连: 0.1 %大连: 0.1 %天津: 0.5 %天津: 0.5 %太原: 0.6 %太原: 0.6 %安康: 0.1 %安康: 0.1 %安德森: 0.1 %安德森: 0.1 %安顺: 0.1 %安顺: 0.1 %官坑: 0.1 %官坑: 0.1 %宣城: 0.1 %宣城: 0.1 %密蘇里城: 0.1 %密蘇里城: 0.1 %山景城: 0.1 %山景城: 0.1 %布尔萨: 0.1 %布尔萨: 0.1 %希尔弗瑟姆: 0.1 %希尔弗瑟姆: 0.1 %常州: 0.1 %常州: 0.1 %常德: 0.1 %常德: 0.1 %广州: 0.4 %广州: 0.4 %廊坊: 0.1 %廊坊: 0.1 %张家口: 2.3 %张家口: 2.3 %德罕: 0.1 %德罕: 0.1 %恩施: 0.2 %恩施: 0.2 %成都: 0.3 %成都: 0.3 %扬州: 0.2 %扬州: 0.2 %新余: 0.1 %新余: 0.1 %新加坡: 0.1 %新加坡: 0.1 %昆明: 0.5 %昆明: 0.5 %杭州: 1.2 %杭州: 1.2 %格兰特县: 0.1 %格兰特县: 0.1 %桂林: 0.1 %桂林: 0.1 %桃园: 0.1 %桃园: 0.1 %梅州: 0.1 %梅州: 0.1 %武汉: 0.6 %武汉: 0.6 %沈阳: 0.1 %沈阳: 0.1 %法兰克福: 0.1 %法兰克福: 0.1 %洛阳: 0.2 %洛阳: 0.2 %济南: 0.4 %济南: 0.4 %济宁: 0.1 %济宁: 0.1 %海得拉巴: 0.1 %海得拉巴: 0.1 %淄博: 0.1 %淄博: 0.1 %深圳: 0.1 %深圳: 0.1 %湘潭: 0.1 %湘潭: 0.1 %湛江: 0.1 %湛江: 0.1 %漯河: 0.1 %漯河: 0.1 %濮阳: 0.1 %濮阳: 0.1 %珠海: 0.2 %珠海: 0.2 %班加罗尔: 0.3 %班加罗尔: 0.3 %盐城: 0.1 %盐城: 0.1 %眉山: 0.1 %眉山: 0.1 %石家庄: 0.4 %石家庄: 0.4 %科泽科德: 0.1 %科泽科德: 0.1 %纽约: 0.1 %纽约: 0.1 %芒廷维尤: 40.5 %芒廷维尤: 40.5 %芝加哥: 1.5 %芝加哥: 1.5 %苏州: 0.4 %苏州: 0.4 %莫斯科: 0.2 %莫斯科: 0.2 %萍乡: 0.1 %萍乡: 0.1 %衡阳: 0.2 %衡阳: 0.2 %西宁: 6.4 %西宁: 6.4 %西安: 0.8 %西安: 0.8 %西雅图: 0.1 %西雅图: 0.1 %诺沃克: 0.2 %诺沃克: 0.2 %贵阳: 0.1 %贵阳: 0.1 %资阳: 0.1 %资阳: 0.1 %运城: 0.5 %运城: 0.5 %遂宁: 0.2 %遂宁: 0.2 %遵义: 0.1 %遵义: 0.1 %邯郸: 0.1 %邯郸: 0.1 %郑州: 2.8 %郑州: 2.8 %重庆: 0.4 %重庆: 0.4 %金奈: 0.1 %金奈: 0.1 %铁岭: 0.1 %铁岭: 0.1 %长春: 5.4 %长春: 5.4 %长沙: 1.7 %长沙: 1.7 %长治: 0.1 %长治: 0.1 %阜新: 0.1 %阜新: 0.1 %阿菲永卡拉希萨尔: 0.1 %阿菲永卡拉希萨尔: 0.1 %青岛: 0.4 %青岛: 0.4 %马德里: 0.1 %马德里: 0.1 %其他其他Central DistrictLewisburgTartuTiruchiYakutsk上海伊斯兰堡克卢日-纳波卡北京南京南宁南拉纳克郡南昌卡斯托里亚卡纳塔克厦门台北合肥吉隆坡咸阳哥伦布嘉兴四平圣地亚哥大连天津太原安康安德森安顺官坑宣城密蘇里城山景城布尔萨希尔弗瑟姆常州常德广州廊坊张家口德罕恩施成都扬州新余新加坡昆明杭州格兰特县桂林桃园梅州武汉沈阳法兰克福洛阳济南济宁海得拉巴淄博深圳湘潭湛江漯河濮阳珠海班加罗尔盐城眉山石家庄科泽科德纽约芒廷维尤芝加哥苏州莫斯科萍乡衡阳西宁西安西雅图诺沃克贵阳资阳运城遂宁遵义邯郸郑州重庆金奈铁岭长春长沙长治阜新阿菲永卡拉希萨尔青岛马德里

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (978) PDF downloads(89) Cited by(2)
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[2539]YesterdayPV[4261]TodayIP[2017]TodayPV[3906]Online[80]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return