Hepatocellular carcinoma common cause of cancer death （HCC） is the third most worldwide （1）. Most patients present with intermediate or advanced disease that is not amenable to curative treatment, and the median s...Hepatocellular carcinoma common cause of cancer death （HCC） is the third most worldwide （1）. Most patients present with intermediate or advanced disease that is not amenable to curative treatment, and the median survival in this group is 6-8 months （2）. Several studies and well- designed randomized trials have shown a positive effect of transcatheter arterial chemoembolization （TACE） on patient outcome and survival （3-8）. As nicely described in the present article from Wring et al., assessment of tumor response is of extreme importance in patients undergoing locoregional treatments of liver cancer （9）. Early assessment of the effectiveness of TACE and monitoring of tumor response are paramount to the identification of treatment failure, guidance of future therapy, and determination of the interval for repeat treatment.展开更多
Independent of their etiology, all chronic liver diseases ultimately lead to liver cirrhosis, which is a majorhealth problem worldwide. The underlying molecular mechanisms are still poorly understood and no efficient ...Independent of their etiology, all chronic liver diseases ultimately lead to liver cirrhosis, which is a majorhealth problem worldwide. The underlying molecular mechanisms are still poorly understood and no efficient treatment strategies are available. This paper introduces the sinusoidal pressure hypothesis(SPH), which identifies an elevated sinusoidal pressure(SP) as cause of fibrosis. SPH has been mainly derived from recent studies on liver stiffness. So far, pressure changes have been exclusively seen as a consequ-ence of cirrhosis. According to the SPH, however, an elevated SP is the major upstream event that initiates fibrosis via biomechanic signaling by stretching of perisinusoidal cells such as hepatic stellate cells or fibroblasts(SPH part?Ⅰ: initiation). Fibrosis progression is determined by the degree and time of elevated SP. The SPH predicts that the degree of extracellular matrix eventually matches SP with critical thresholds > 12 mmH g and > 4 wk. Elevated arterial flow and final arterialization of the cirrhotic liver represents the self-perpetuating key event exposing the low-pressure-organ to pathologically high pressures(SPH part?Ⅱ: perpetuation). It also defines the "point of no return" where fibrosis progression becomes irreversible. The SPH is able to explain the macroscopic changes of cirrhotic livers and the uniform fibrotic response to various etiologies. It also opens up new views on the role of fat and disease mechanisms in other organs. The novel concept will hopefully stimulate the search for new treatment strategies.展开更多
We studied the effects of angiotensin-converting enzyme inhibitor on the response of arterial intima after balloon denudation.Captopril（3mg.kg/d）was administered to 4miniature pigs after abdominal aortic balloon den...We studied the effects of angiotensin-converting enzyme inhibitor on the response of arterial intima after balloon denudation.Captopril（3mg.kg/d）was administered to 4miniature pigs after abdominal aortic balloon denudation.展开更多
文摘Hepatocellular carcinoma common cause of cancer death （HCC） is the third most worldwide （1）. Most patients present with intermediate or advanced disease that is not amenable to curative treatment, and the median survival in this group is 6-8 months （2）. Several studies and well- designed randomized trials have shown a positive effect of transcatheter arterial chemoembolization （TACE） on patient outcome and survival （3-8）. As nicely described in the present article from Wring et al., assessment of tumor response is of extreme importance in patients undergoing locoregional treatments of liver cancer （9）. Early assessment of the effectiveness of TACE and monitoring of tumor response are paramount to the identification of treatment failure, guidance of future therapy, and determination of the interval for repeat treatment.
文摘Independent of their etiology, all chronic liver diseases ultimately lead to liver cirrhosis, which is a majorhealth problem worldwide. The underlying molecular mechanisms are still poorly understood and no efficient treatment strategies are available. This paper introduces the sinusoidal pressure hypothesis(SPH), which identifies an elevated sinusoidal pressure(SP) as cause of fibrosis. SPH has been mainly derived from recent studies on liver stiffness. So far, pressure changes have been exclusively seen as a consequ-ence of cirrhosis. According to the SPH, however, an elevated SP is the major upstream event that initiates fibrosis via biomechanic signaling by stretching of perisinusoidal cells such as hepatic stellate cells or fibroblasts(SPH part?Ⅰ: initiation). Fibrosis progression is determined by the degree and time of elevated SP. The SPH predicts that the degree of extracellular matrix eventually matches SP with critical thresholds > 12 mmH g and > 4 wk. Elevated arterial flow and final arterialization of the cirrhotic liver represents the self-perpetuating key event exposing the low-pressure-organ to pathologically high pressures(SPH part?Ⅱ: perpetuation). It also defines the "point of no return" where fibrosis progression becomes irreversible. The SPH is able to explain the macroscopic changes of cirrhotic livers and the uniform fibrotic response to various etiologies. It also opens up new views on the role of fat and disease mechanisms in other organs. The novel concept will hopefully stimulate the search for new treatment strategies.
文摘We studied the effects of angiotensin-converting enzyme inhibitor on the response of arterial intima after balloon denudation.Captopril（3mg.kg/d）was administered to 4miniature pigs after abdominal aortic balloon denudation.
