Aug17 ,08肝指數正常≠沒肝癌 為何會得肝癌？normal liver index of liver cancer will not have liver cancer +馬可福音Mark6:49-52

馬可福音

6:49	但門徒看見他在海面上走，以為是鬼怪，就喊叫起來。
6:50	因為他們都看見了他，且甚驚慌。耶穌連忙對他們說：“你們放心，是我，不要怕！”
6:51	於是到他們那裡上了船，風就住了，他們心裡十分驚奇。
6:52	這是因為他們不明白那分餅的事，心裡還是愚頑。

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我怕、我很孤單……誰會來關心我？
6:49　耶穌在水面上往門徒那裡走去，門徒看見，驚慌不已。其實，他們應該曉得在困難時，耶穌會幫助他們。雖然他們看不見耶穌，耶穌卻看見他們，祂對門徒的關懷克服了他們信心的不足。若你在“深水”中，要記著基督明白你的掙扎，祂關心你。

你現在怕著甚麼嗎？聽聽耶穌對你說：“放心，是我，不要怕！”
6:49-50　門徒害怕，不過知道耶穌來了就平靜下來。我們遇上駭人的事，是自己應付，還是讓耶穌來應付？恐懼疑惑時，知道基督常在我們身邊（參太28:20），可使我們安靜下來。認識基督的同在就是恐懼的良藥。

從聖經，你認識祂的話語；從生活經驗，你可經歷祂話語的真實？
6:52　門徒難以相信，可能因為：（1）不能接受這個叫耶穌的人真是神的兒子；（2）不敢相信彌賽亞竟會揀選他們作門徒；（3）仍然不明白耶穌來到世上的真正目的。他們對耶穌的誤解，顯出了他們猜疑的心態。
　　門徒雖然看過耶穌給五千人吃飽，仍然不能夠踏出信心的一步，相信祂是神的兒子。他們沒有把對耶穌的認識應用在生活上。我們雖然知道耶穌能在水面上走，然而，卻時常奇怪耶穌竟能在我們的生命中工作。我們不要只相信神蹟真的發生過，也要把真理應用在生活上。
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Mark

6:49		But when they saw him walking upon the sea, they supposed it had been a spirit, and cried out:
6:50		For they all saw him, and were troubled. And immediately he talked with them, and saith unto them, Be of good cheer: it is I; be not afraid.
6:51		And he went up unto them into the ship; and the wind ceased: and they were sore amazed in themselves beyond measure, and wondered.
6:52		For they considered not the miracle of the loaves: for their heart was hardened.

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I am afraid, I am very lonely…… who to care about me »
6:49 Jesus to the disciples of the water going there, the disciples see that panic不已. In fact, they should know the difficulties, Jesus will help them. Although they can not see Jesus, Jesus is to see them, the disciples of the care he has overcome their lack of confidence. If you in "Deep Water", it is necessary to remember Christ understand your struggle and you care about him.

You are afraid of what? » You listen to Jesus, said: "rest assured that I will not be afraid!"
6:49-50 disciples fear, but know that Jesus came to calm down. We encounter terrifying thing is to cope with their own, or allow Jesus to meet » Fear, doubt, to know Christ often around us (the Senate too 28:20), will enable us to quiet down. Recognizing Christ is the same fear in the medicine.

From the Bible, you know he's words, from life experience, you can experience the true words he »
6:52 disciples hard to believe, probably because: (1) can not accept the call of Jesus is the Son of God, (2) not believe that the Messiah竟会selected for their disciples, (3) still do not understand that Jesus came to the The real purpose of the world. Jesus on the misunderstanding, showing the mentality of their suspicion.
Although the disciples of Jesus read to feed 5,000 people, still can not take the step of confidence, I believe he is the Son of God. They do not have the right understanding of Jesus in their daily lives. Although we know that Jesus can the water away, however, they often wonder Jesus could have in our life work. We must not only believe that miracles really happened, but also to use the truth in their daily lives.

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肝指數正常≠沒肝癌 為何會得肝癌？ ●肝癌，正式名稱是肝細胞癌，一直對中國人健康、生命帶來極大的威脅。肝癌成因十分複雜，但大致而言，與早年感染Ｂ型、Ｃ型肝炎脫不了關係，此外，致癌因子如攝取遭黃麴毒素汙染的食物，酗酒、抽菸、嚼檳榔等都是危險因子。 B、C型肝炎：台大醫院胃腸肝膽科醫師陳健弘指出，在台灣死於肝癌者，約80%是Ｂ型肝炎引起，約10%至15%是Ｃ型肝炎所引起的。感染Ｂ肝或Ｃ肝之後，部分人變成慢性肝炎，再演變為肝硬化，最後再形成肝癌。 酒精：酒精會破壞肝細胞，初期只是脂肪肝，再進展到酒精性肝炎，久而久之甚至變成肝硬化或肝癌，所以千萬不可酗酒。 藥物：藥物進入人體後，多半靠肝臟代謝，如果用藥不當，肝臟就可能受到傷害，引起藥物性肝炎，也會步入肝硬化、肝癌的後塵。 黃麴毒素：黃麴毒素也是造成肝癌的重要因素。陳健弘表示，可能會遭黃麴毒素汙染的食物，包括花生、豆類發酵製品，建議少吃花生製品、豆瓣醬、豆腐乳、豆豉、臭豆腐等發酵製品。 菸和檳榔：菸和檳榔也是引發肝癌的危險因子，肝功能異常的Ｂ型肝炎患者，如嗜菸酒、檳榔，惡化為肝硬化、肝貜滬滅I是肝功能正常、沒有這三種習慣的19倍。 根據台灣衛生署最新公布2007年十大主要癌症死亡原因中，肝癌佔據男性癌症十大死因第一名，同時是女性第二名，台灣去年死於肝癌7809人（男性5650人、女性2159人），等於是每天平均超過21人死於肝癌。 為什麼肝癌初期不易察覺？ 「醫師，有沒有驗錯？ 」許多人被宣布得肝癌時，睜大眼睛難以置信，自認肝功能很正常。 「沒錯！」陳健弘表示：「有太多人都迷信肝功能指數，以為指數正常就一切OK。」他就碰過不少病人剛做過健檢，而肝功能指數（GOT、GPT）都在正常值範圍內，「怎麼可能才短短的一年就長肝癌？ 」面對這樣的質疑，連醫師也覺得「這就是肝病防治的盲點，也是被誤解最深的一項。」 陳健弘指出，肝癌最主要的初期症狀，就是「沒有症狀」，或「沒有特異性的症狀」，因此如果肝功能檢查報告顯示為「正常」，並不代表肝臟是健康的。何況在肝癌初期，肝指數也不會高，因為肝癌在生長時，只有在肝癌周圍被肝癌壓迫侵犯的肝細胞才會壞死，因此，GOT、GPT仍可能是正常的，即使會升高，也不會太高。 也有人以為肝病會有黃疸症狀，但陳健弘表示「這種觀念也是似是而非」，因為黃疸所表現的症狀，除了肝病之外，還有膽結石、胰臟炎的問題。陳健弘說，如果要從皮膚變黃、眼白變黃或尿液呈茶褐色，甚至容易疲勞、腹脹，來回推是否肝臟有問題，也易有誤。 值得一提的是，由於肝臟本身幾乎沒有神經，所以肝癌通常不會痛；如果腫瘤體積不是很大，多半還不至於影響肝臟的功能，也還不會對血管、膽管造成壓迫，所以病人多半不會感到任何異常現象。 哪一種方式 最能查出肝癌？ 由於肝癌的早期症狀不明顯，往往讓患者不以為意，因此，專家建議，即使是健康的Ｂ型肝帶原者及有Ｃ肝抗體者，成年之後應每年接受腹部超音波檢查，並搭配胎兒蛋白（AFP）血清學檢查，以便早期發現、早期治療。 肝臟超音波檢查：台大醫學院內科教授許金川專研肝臟超音波，他說，超音波掃描已被醫界證實是診斷肝癌最佳的利器，最大的好處就是方便，且不具侵襲性，病人也不會有痛苦。尤其是有經驗的醫師，小至1公分的肝臟腫瘤，也可以偵測出來。更別是說是已侵犯到鄰近的血管或膽管，有沒有腹水，都可以從超音波看出來。 他建議，Ｂ肝帶原者及早年曾感染Ｃ型肝炎者，最好每年定期接受超音波檢查。至於非Ｂ肝帶原者，如果不是因接種Ｂ肝疫苗而產生自然免疫的抗體，而是從小是由母體垂直感染，卻幸運痊癒而轉化為抗體者，由於體內仍殘存一些極少量的病毒，也要在40歲以後，每隔2至3年接受肝臟超音波檢查。 胎兒蛋白：抽血檢驗胎兒蛋白也是早期診斷肝癌的方法之一。許金川表示，胎兒蛋白在臨床上是肝癌的腫瘤標記，但胎兒蛋白正常也不表示沒有肝癌，因此只能作為參考的指標。 電腦斷層或核磁共振：懷孕婦女的胎兒蛋白也會異常升高。所以，如果驗血發現胎兒蛋白異常升高，也不能因此斷定是罹患肝癌，應該再配合影像檢查，包括電腦斷層或核磁共振才能準確地判斷。（詹建富） 2008-08-09

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normal liver index of liver cancer will not have liver cancer ?

● liver cancer, hepatocellular carcinoma is the official name, has been on the health of the Chinese people, great threat to life. Causes of liver cancer is very complex, but generally speaking, and the early days of B-, C-type hepatitis from relations can not be, in addition, factors such as uptake by the carcinogenic aflatoxin contaminated food, alcohol, smoking and chewing betel nut, and so are Risk factors.
B, C hepatitis: National Taiwan University Hospital doctor Chen Jianhong gastrointestinal liver and gallbladder, died of liver cancer in Taiwan, about 80 percent of hepatitis B is caused, about 10 to 15 percent of hepatitis C is caused by. Infected with hepatitis B or C liver, some people become chronic hepatitis, Zaiyan into cirrhosis, liver cancer and then formed.

Alcohol: Alcohol will destroy liver cells, initially only fatty liver, and then progress to alcoholic hepatitis, cirrhosis or the passage of time or even turned into liver cancer, should not alcohol.

Drugs: drug use, mostly by the liver metabolism, if inappropriate medication, liver damage may be caused drug-induced hepatitis, cirrhosis will be entered, HCC's footsteps.

Aflatoxin: Aflatoxin is also an important factor in causing liver cancer. Chen Jianhong, may be aflatoxin contaminated food, including peanuts, beans fermented products, the proposed eat peanut products, Douban Jiang, Dou Furu, tempeh, stinky tofu, and other fermented products.

Cigarettes and betel nut: cigarettes and betel nuts also cause liver cancer risk factors, abnormal liver function of patients with hepatitis B, such as嗜alcoholic drinks and tobacco, betel nut, for the deterioration of liver cirrhosis, liver Shanghai Jue out I was normal liver function, not the three habit 19 times.

According to the Taiwan Department of Health announced in 2007 as the 10 major causes of death in cancer, liver cancer men occupy the first ten leading causes of death, while the second is a woman, died of liver cancer in Taiwan last year, 7,809 people (5,650 men, women 2159), is tantamount to a daily average more than 21 people died of liver cancer.

Why not detect liver cancer early »

"Doctor, there are no post-mortem wrong» "A lot of people were declared in liver cancer, eyes wide open incredible, self normal liver function.

"That's right!" Chen Jianhong, said: "There are too many people have blind faith in liver function that the normal index on all OK." Touched on many patients he has just done-seizure, and liver function index (GOT, GPT) in Within the normal range, "how could only a short period of a year of liver cancer» "In the face of such a challenge, even the doctors feel that" this is the blind spot of liver disease, is also one of the most misunderstood. "

Chen Jianhong, the most important of the early symptoms of liver cancer, is "no symptoms" or "no specific symptoms", so if the report shows that liver function tests for "normal" does not mean that the liver is healthy. Moreover, in the early liver cancer, liver index will not be high, because the growth in liver cancer, liver cancer only in liver cancer around the oppression of the liver cells before necrosis, therefore, GOT, GPT still may be normal, even at the Increased, not too high.

It was also thought that liver disease have symptoms of jaundice, but Chen Jianhong said that "this concept is specious," because the symptoms shown by jaundice, in addition to liver disease, there are gallstones, pancreatitis problems. Chen Jianhong, if from the skin to turn yellow, Yanbai turn yellow or urine was Chahe Se, or even easy fatigue, abdominal distention, pushing it back and forth liver problems, but also easy is wrong.

It is worth mentioning that, because the liver itself almost no nerve, liver cancer is usually not the pain, if tumor size is not great, most not go so far as the impact of liver function, but also do not have blood vessels, causing bile duct oppression, so patients Most will not feel any abnormal phenomenon.

What a way to identify the most liver cancer »

Since the early symptoms of liver cancer was not obvious, so that patients often do not think that Italy, and therefore, experts suggest that even a healthy liver with the original type B and C have antibodies to the liver, adult should be followed by annual abdominal ultrasonography, and with Fetoprotein (AFP) serological examination for early detection and early treatment.

Liver ultrasound examination: National Taiwan University College of Medicine, Professor Hsu Chin-chuan of the inquiry liver ultrasound, he said, ultrasound scanning has been confirmed that the medical community is the best weapon of liver cancer, the biggest advantage is that easy, do not have an aggressive, Patients would not be painful. In particular, is an experienced physician, to 1 cm of small liver tumors, can also detect out. Another is that more has been violated to neighboring blood vessels or bile duct, has ascites, can be seen from the ultrasound.

He suggested that, B and liver with the early years had hepatitis C infection, the best annual regular ultrasound examination. As for non-hepatitis B carriers, if not due to hepatitis B vaccines and vaccination have a natural immune antibodies, but from the vertical transmission from mother, but fortunately recovered and converted into antibody, because the body is still some very small amounts of residual virus , But also in the 40-year-old after every 2-3 years receiving liver ultrasound.

Fetoprotein: fetal blood test early diagnosis of liver cancer is also one of the ways. Hsu Chin-chuan said that fetal protein in clinical liver cancer is the tumor marker, but normal fetal protein does not mean that no liver cancer, it can only as a reference guide.

CT or MRI: the fetus in pregnant women will be abnormal increase. Therefore, if the abnormal blood tests found elevated fetal protein, we can not therefore conclude that this was liver cancer, should be coupled with imaging, including CT or MRI in order to judge accurately. (Zhan Jian Fu)
2008-08-09

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