Cemento-ossifying fibroma (COF) of maxilla is comparatively rare lesion of the maxillofacial region. There is often a misdiagnosis in the category of fibroosseous lesions, owing to an overlap of clinical, histological...Cemento-ossifying fibroma (COF) of maxilla is comparatively rare lesion of the maxillofacial region. There is often a misdiagnosis in the category of fibroosseous lesions, owing to an overlap of clinical, histological and radiographic features amongst the separate entities. We present a case of giant maxillary COF causing extensive disfiguration of the face, along with extensive review of the clinico-pathologic and treatment aspects of the fibro-osseous lesions.展开更多
目的探讨瞬时弹性成像技术(Fibro Scan)、天冬氨酸氨基转移酶和血小板比率指数(aspartate aminotransferase-to-platelet ratio index,APRI)及其二者联合检测肝硬化患者合并食管胃底静脉曲张破裂出血风险的相关性和诊断预测价值.方法将...目的探讨瞬时弹性成像技术(Fibro Scan)、天冬氨酸氨基转移酶和血小板比率指数(aspartate aminotransferase-to-platelet ratio index,APRI)及其二者联合检测肝硬化患者合并食管胃底静脉曲张破裂出血风险的相关性和诊断预测价值.方法将210例病毒性肝炎肝炎后肝硬化患者根据2015年《肝硬化门静脉高压食管胃静脉曲张出血的防治指南》分为无、有出血组,分别为153、57例;搜集患者在1 wk内的Fibro Scan值[肝脏硬度值(liver stiffness measurement,L S M)]和A P R I值.组间比较采用t检验,利用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析LSM、APRI、LSM+APRI对肝硬化患者出血风险的预测价值,并比较LSM、APRI及LSM+APRI的ROC曲线下面积(area under curve,AUC).结果有、无出血组的LSM值分别是28.49 k Pa±9.46 k Pa,22.87 k Pa±6.95 k Pa,APRI值分别是2.99±1.11,2.13±1.01,有明显的统计学意义.有无出血风险的LSM、APRI、LSM+APRI的AUC分别是0.669、0.727、0.722,表明APRI、LSM+APRI对食管胃底静脉曲张破裂出血具有良好的诊断效果.结论APRI及Fibro Scan联合APRI对肝硬化患者合并食管胃底静脉曲张破裂出血风险存在有效的预测价值.展开更多
AIM: To investigate whether expression of selected mi RNAs obtained from fibrotic liver biopsies correlate with fibrosis stage.METHODS: Altogether, 52 patients were enrolled in the study representing various etiologic...AIM: To investigate whether expression of selected mi RNAs obtained from fibrotic liver biopsies correlate with fibrosis stage.METHODS: Altogether, 52 patients were enrolled in the study representing various etiologic backgrounds of fibrosis: 24 cases with chronic hepatitis infections(types B, C), 19 with autoimmune liver diseases(autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, overlapping syndrome cases), and 9 of mixed etiology(alcoholic and nonalcoholic steatosis, cryptogenic cases). Severity of fibrosis was determined by both histologic staging using the METAVIR scoring system and noninvasive transient elastography. Following RNAisolation, expression levels of mi R-21, mi R-122, mi R-214, mi R-221, mi R-222, and mi R-224 were determined using Taq Man Micro RNA Assays applying mi R-140 as the reference. Selection of mi RNAs was based on their characteristic up- or downregulation observed in hepatocellular carcinoma. Relative expression of mi RNAs was correlated with fibrosis stage and liver stiffness(LS) value measured by transient elastography, as well as with serum alanine aminotransferase(ALT) level.RESULTS: The expression of individual mi RNAs showed deregulated patterns in stages F1-F4 as compared with stage F0, but only the reduced level of mi R-122 in stage F4 was statistically significant(P < 0.04). When analyzing mi RNA expression in relation to fibrosis, levels of mi R-122 and mi R-221 showed negative correlations with fibrosis stage, and mi R-122 was found to correlate negatively and mi R-224 positively with LS values(all P < 0.05). ALT levels displayed a positive correlation with mi R-21(P < 0.04). Negative correlations were observed in the fibrosis samples of mixed etiology between mi R-122 and fibrosis stage and LS values(P < 0.05), and in the samples of chronic viral hepatitis, between mi R-221 and fibrosis stage(P < 0.01), whereas mi R-21 showed positive correlation with ALT values in the samples of autoimmune liver diseases(P < 0.03). The results also revealed a strong correlation between fibrosis stage and LS values(P < 0.01) when etiology of fibrosis was not taken into account.CONCLUSION: Reduced expression of mi R-122 in advanced fibrosis and its correlation with fibrosis stage and LS values seem to be characteristic of hepatic fibrosis of various etiologies.展开更多
Juvenile Aggressive Ossifying Fibroma (JAOF) is a benign but locally aggressive fibro-osseous lesion. It is a rapidly growing non-odontogenic neoplasm of the jaws, generally occurring in children and young adults. It ...Juvenile Aggressive Ossifying Fibroma (JAOF) is a benign but locally aggressive fibro-osseous lesion. It is a rapidly growing non-odontogenic neoplasm of the jaws, generally occurring in children and young adults. It is often confused with malignant condition because of its clinical behaviour. Long term follow-up is necessary, considering the high recurrence nature of this tumour. The reconstruction of affected patients, particularly the younger, is often challenging since it has to be done in stages, to keep up with the developing face. We report a case of maxillary JAOF in a 6-month-old female who was referred to our department. Histopathological examination of a resected specimen revealed a trabecular type of JAOF. The patient was followed up for a period of 2 years.展开更多
<strong>Background:</strong> Fibrous dysplasia mainly presents in its monostotic form in the cranio-facial region with serious cosmetic disfigurement and functional derangement of the affected and adjacent...<strong>Background:</strong> Fibrous dysplasia mainly presents in its monostotic form in the cranio-facial region with serious cosmetic disfigurement and functional derangement of the affected and adjacent structures putting both patient and the attending surgeon in great dilemma. Surgical treatment is the only rewarding and generally accepted treatment option, however, controversy over the surgical technique to be adopted still exists. While in the past, surgeons generally adopted conservative shaving or contouring technique, over the recent years, advocates of radical surgery are winning more disciples. <strong>Objective:</strong> To highlight the locally destructive, functionally degrading nature of a neglected or poorly excised (shaved) lesion in patients and highlight the outcome of total excision and surgical technique adopted to obviate the need for autologous bone grafting and two-staged surgery. <strong>Subjects and Method:</strong> We present case series of three patients with giant monostotic fibrous dysplasia of the maxilla, surgically treated in our Centre, who were part of a total of eight cases managed over the past fifteen years in our department of Ear, Nose and Throat-Head and Neck Surgery. The pre-operative clinical assessment, relevant investigations and post-operative outcome are presented. Our surgical technique is highlighted. All the patients had unilateral lesion of the maxilla with gross cosmetic and functional defects. Two of the patients had ischaemic (pressure) atrophy of the cheek soft tissue and skin leading to skin metaplastic changes including leukoplakia, hyperpigmentation. Post-operative follow-up showed satisfactory cosmetic outcome and significant reversal of malocclusion and dental anarchy. There was no recorded recurrence throughout the follow-up period ranging from four to eleven years. Nasal airway was re-established bilaterally in all the cases. <strong>Conclusion:</strong> Total or near total excision surgical technique with periosteal preservation is our treatment of choice in the management of monostotic cranio-facial fibrous dysplasia. Given the fact that the growth of the tumours often does not cease after puberty against general belief, shaving or contouring technique should be relegated to the background. Our technique of no grafting which reduced cost and morbidity to the patient should be encouraged.展开更多
目的探讨Fibro Touch~?无创肝脏硬度测定值与血清学标志物对慢性乙型肝炎病毒(hepatitis B virus,HBV)感染者肝纤维化程度评估的临床应用价值及其与各评估指标间的相关性.方法纳入105例于我院感染科病房就诊且进行肝穿刺活检的慢性乙型...目的探讨Fibro Touch~?无创肝脏硬度测定值与血清学标志物对慢性乙型肝炎病毒(hepatitis B virus,HBV)感染者肝纤维化程度评估的临床应用价值及其与各评估指标间的相关性.方法纳入105例于我院感染科病房就诊且进行肝穿刺活检的慢性乙型肝炎患者,依据肝穿结果进行分组:无纤维化组44例(S0)、早期肝纤维化组26例(S1-2)和进展性肝纤维化组35例(S3-4).在肝穿后1 wk内进行Fibro Touch~?检测获得肝脏硬度测定(liver stiffiness measurement,LSM)值,并于TE检测当日空腹行血样采集,进行肝功能、血脂、空腹血糖、血常规及肝纤四项检测,应用计算公式获得各肝纤维化诊断模型如Hui氏评分、Forns指数、基于4因子的纤维化指数(fibrosis index based on the 4 factor,FIB-4)及非酒精性脂肪肝纤维化积分(NAFLD fibrosis score,NFS),同时测量身高(cm)、体重(kg),计算体质量指数水平.应用Spearman秩检验分析LSM值与各血清学肝纤维化标志物的相关性,比较LSM值及各血清学标志物的受试者工作特征曲线下面积(area under curve,AUC),并比较相应的截断点值及其灵敏度和特异度.结果无纤维化组、早期肝纤维化组及进展期纤维化组患者的LSM值分别为8.48(7.00-9.85)kPa、9.4(6.4-11.30)kPa、12.75(9.80-20.75)kPa,差别有统计学意义(P<0.01);除血清LN外,LSM值与肝纤四项余指标及Hui氏评分、Forns指数、FIB-4及NFS均有较好的相关性(P<0.05);Forns指数与hui氏评分、FIB-4呈正相关(r=0.810、r=0.898,P<0.01),NFS与hui氏评分、Forns指数、FIB-4呈正相关(r=0.844、r=0.893、r=0.899,P<0.01);LSM值诊断进展性肝纤维化的临床效用价值最高,在cut-off值为11.65kPa时,LSM值诊断进展性肝纤维化的AUC=0.764,特异度和灵敏度分别是91%和60%,符合度为82%;其次为NFS,在截断点为-1.25时,诊断进展性肝纤维化的灵敏度和特异度分别为54%和89%,符合率为78%.结论Fibro Touch~?无创肝脏硬度测定在慢性HBV感染患者肝纤维化程度具有良好的应用价值,与各肝纤维化血清学指标具有较好的相关性,值得临床进一步推广应用.展开更多
AIM:To construct and evaluate a new non-invasive fibrosis index for assessment of the stage of liver f ibrosis. METHODS:A new f ibrosis index (Fibro-Stiffness index) was developed in 165 of 285 patients with chronic h...AIM:To construct and evaluate a new non-invasive fibrosis index for assessment of the stage of liver f ibrosis. METHODS:A new f ibrosis index (Fibro-Stiffness index) was developed in 165 of 285 patients with chronic hepatitis C, and was validated in the other 120 patients where liver biopsy was performed. Its usefulness was compared with liver stiffness (LS) measured by FibroScan, the aminotransferase-to-platelet ratio index, the Forns index and the FibroIndex. RESULTS: The Fibro-Stiffness index consists of LS,platelet count and prothrombin time. The values of the Fibro-Stiffness index differed signif icantly between neighboring f ibrosis stages except F0-F1. The area under the receiver operating characteristics curves of the Fibro-Stiffness index for prediction of F≥2 (0.90), F≥ 3 (0.90) and F= 4(0.92) in the estimation group and those for F≥ 3 (0.93) and F =4 (0.97) in the validation group were the highest among the 5 methods examined. The accuracy of the Fibro-Stiffness index had highest values for F≥2, F≥3 and F=4 in both the estimation and validation groups. The diagnostic performance for F= 4 was improved by a combination of the Fibro-Stiffness index with serum hyaluronic acid level. CONCLUSION: The Fibro-Stiffness index was constructed and validated. It showed superior diagnostic performance to other indices for F ≥ 2,3 and 4.展开更多
Chronic intake of alcohol undoubtedly overwhelms the structural and functional capacity of the liver by initiating complex pathological events characterized by steatosis,steatohepatitis,hepatic fibrosis and cirrhosis....Chronic intake of alcohol undoubtedly overwhelms the structural and functional capacity of the liver by initiating complex pathological events characterized by steatosis,steatohepatitis,hepatic fibrosis and cirrhosis.Subsequently,these initial pathological events are sustained and ushered into a more complex and progressive liver disease,increasing the risk of fibrohepatocarcinogenesis.These coordinated pathological events mainly result from buildup of toxic metabolic derivatives of alcohol including but not limited to acetaldehyde(AA),malondialdehyde(MDA),CYP2E1-generated reactive oxygen species,alcohol-induced gut-derived lipopolysaccharide,AA/MDA protein and DNA adducts.The metabolic derivatives of alcohol together with other comorbidity factors,including hepatitis B and C viral infections,dysregulated iron metabolism,abuse of antibiotics,schistosomiasis,toxic drug metabolites,autoimmune disease and other non-specific factors,have been shown to underlie liver diseases.In view of the multiple etiology of liver diseases,attempts to delineate the mechanism by which each etiological factor causes liver disease has always proved cumbersome if not impossible.In the case of alcoholic liver disease(ALD),it is even more cumbersome and complicated as a result of the many toxic metabolic derivatives of alcohol with their varying liver-specific toxicities.In spite of all these hurdles,researchers and experts in hepatology have strived to expand knowledge and scientific discourse,particularly on ALD and its associated complications through the medium of scientific research,reviews and commentaries.Nonetheless,the molecularmechanisms underpinning ALD,particularly those underlying toxic effects of metabolic derivatives of alcohol on parenchymal and non-parenchymal hepatic cells leading to increased risk of alcohol-induced fibrohepatocarcinogenesis,are still incompletely elucidated.In this review,we examined published scientific findings on how alcohol and its metabolic derivatives mount cellular attack on each hepatic cell and the underlying molecular mechanisms leading to disruption of core hepatic homeostatic functions which probably set the stage for the initiation and progression of ALD to fibro-hepatocarcinogenesis.We also brought to sharp focus,the complex and integrative role of transforming growth factor beta/small mothers against decapentaplegic/plasminogen activator inhibitor-1 and the mitogen activated protein kinase signaling nexus as well as their cross-signaling with toll-like receptormediated gut-dependent signaling pathways implicated in ALD and fibro-hepatocarcinogenesis.Looking into the future,it is hoped that these deliberations may stimulate new research directions on this topic and shape not only therapeutic approaches but also models for studying ALD and fibro-hepatocarcinogenesis.展开更多
Mediastinal lipomatous tumors with additional malignant soft tissue components are exceedingly rare. Patients can have substantially large sized tumors with long duration of symptoms and can be misinterpreted on radio...Mediastinal lipomatous tumors with additional malignant soft tissue components are exceedingly rare. Patients can have substantially large sized tumors with long duration of symptoms and can be misinterpreted on radiographs. Enhancing soft tissue component within a fat density lesion within the mediastinum is alarming and should raise the suspicion of sarcomatous component. Along with diagnostic imaging, selective CT guided biopsy/FNAC from the enhancing soft tissue component can help in making correct diagnosis.展开更多
Epidemiological and clinical data point to a close association between chronic hepatitis B virus infection or chronic hepatitis C virus infection and development of hepatocellular carcinoma(HCC).HCC develops over seve...Epidemiological and clinical data point to a close association between chronic hepatitis B virus infection or chronic hepatitis C virus infection and development of hepatocellular carcinoma(HCC).HCC develops over several decades and is associated with fibrosis.This sequence suggests that persistent viral infection and chronic inflammation can synergistically induce liver fibrosis and hepatocarcinogenesis.The transforming growth factor-β(TGF-β) signaling pathway plays a pivotal role in diverse cellular processes and contributes to hepatic fibro-carcinogenesis under inflammatory microenvironments during chronic liver diseases.The biological activities of TGF-β are initiated by the binding of the ligand to TGF-β receptors,which phosphorylate Smad proteins.TGF-β typeⅠreceptor activates Smad3 to create COOH-terminally phosphorylated Smad3(pSmad3C),while pro-inflammatory cytokine-activated kinases phosphorylates Smad3 to create the linker phosphorylated Smad3(pSmad3L).During chronic liver disease progression,virus components,together with pro-inflammatory cytokines and somatic mutations,convert the Smad3 signal from tumor-suppressive pS-mad3C to fibro-carcinogenic pSmad3 L pathways,accelerating liver fibrosis and increasing the risk of HCC.The understanding of Smad3 phosphorylation profiles may provide new opportunities for effective chemoprevention and personalized therapy for patients with hepatitis virus-related HCC in the future.展开更多
AIM:To evaluate the hepatoprotective roles of (Z)5-(4-methoxybenzylidene)thiazolidine-2,4-dione (SKLB010) against carbon tetrachloride (CCl 4)-induced acute and chronic liver injury and its underlying mechanisms of ac...AIM:To evaluate the hepatoprotective roles of (Z)5-(4-methoxybenzylidene)thiazolidine-2,4-dione (SKLB010) against carbon tetrachloride (CCl 4)-induced acute and chronic liver injury and its underlying mechanisms of action.METHODS:In the first experiment,rats were weighed and randomly divided into 5 groups (five rats in each group) to assess the protective effect of SKLB010 on acute liver injury.For induction of acute injury,rats were administered a single intraperitoneal injection of 2 mL/kg of 50% (v/v) CCl 4 dissolved in olive oil (1:1).Group 1 was untreated and served as the control group;group 2 received CCl 4 for induction of liver injury and served as the model group.In groups 3,4 and 5,rats receiving CCl 4 were also treated with SKLB010 at doses of 25,50 and 100 mg/kg,respectively.Blood samples were collected at 6,12 and 24 h after CCl 4 intoxication to determine the serum activity of alanine amino transferase.Tumour necrosis factor-α (TNF-α),interleukin-1β (IL-1β) were determined using enzyme-linked immunosorbent assay.At 24 h after CCl 4 injection,liver fibrogenesis was evaluated by hematoxylin-eosin (HE) staining and immunohistochemical analyses.Cytokine transcript levels of TNF-α,IL-1β and inducible nitric oxide synthase in the liver tissues of rats were measured using a reverse transcriptase reverse transcription-polymerase chain reaction technique.In the second experiment,rats were randomly divided into 2 groups (15 rats in each group),and liver injury in the CCl 4-administered groups was induced by a single intraperitoneal injection of 2 mL/kg of 50% (v/v) CCl 4 dissolved in olive oil (1:1).The SKLB010-treated groups received oral 100 mg/kg SKLB010 before CCl 4 administration.Five rats in each group were sacrificed at 2 h,6 h,12 h after CCl 4 intoxication and small fortions of livers were rapidly frozen for extraction of total RNA,hepatic proteins and glutathione (GSH) assays.In the hepatic fibrosis model group,rats were randomly divided into 2 groups (5 rats each group).Rats were injected intraperitoneally with a mixture of CCl 4 (1 mL/kg body weight) and olive oil [1:1 (v/v)] twice a week for 4 wk.In the SKLB010-treated groups,SKLB010 (100 mg/kg) was given once daily by oral gavage for 4 wk after CCl 4 administration.The rats were sacrificed one week after the last injection and the livers from each group were harvested and fixed in 10% formalin for HE and immunohistochemical staining.RESULTS:In this rat acute liver injury model,oral administration of SKLB010 blocked liver tissue injury by down-regulating the serum levels of alanine aminotransferase,suppressing inflammatory infiltration to liver tissue,and improving the histological architecture of liver.SKLB010 inhibited the activation of NF-κB by suppressing the degradation of IκB,and prevented the secretion of pro-inflammatory mediators such as tumor necrosis factor-α,interleukin-1β,and the reactive free radical,nitric oxide,at the transcriptional and translational levels.In this chronic liver fibrosis model,treatment with 100 mg/kg per day SKLB010 attenuated the degree of hepatic fibrosis and area of collagen,and blocked the accumulation of smooth-muscle actinexpressed cells.CONCLUSION:These results suggest that SKLB010 is a potent therapeutic agent for the treatment of CCl 4 induced hepatic injury.展开更多
Fibro-muscular dysplasia(FMD)is a rare but well documented disease with multiple arterial aneurysms. The patients,usually women,present with various clinical manifestations according to the specific arteries that are ...Fibro-muscular dysplasia(FMD)is a rare but well documented disease with multiple arterial aneurysms. The patients,usually women,present with various clinical manifestations according to the specific arteries that are affected.Typical findings are aneurysmatic dilatations of medium-sized arteries.The renal and the internal carotid arteries are most frequently affected, but other anatomical sites might be affected too.The typical angiographic picture is that of a"string of beads". Common histological features are additionally described. Here we present a case of a 47-year-old woman,who was hospitalized due to intractable abdominal pain.A routine work-up revealed a liver mass near the portal vein.Before a definite diagnosis was reached,the patient developed massive upper gastrointestinal bleeding.In order to control the hemorrhage,celiac angiography was performed revealing features of FMD in several arteries, including large aneurysms of the hepatic artery.Active bleeding from one of these aneurysms into the biliary tree indicated selective embolization of the hepatic artery.The immediate results were satisfactory,and the 5 years follow-up revealed absence of any clinical symptoms.展开更多
文摘Cemento-ossifying fibroma (COF) of maxilla is comparatively rare lesion of the maxillofacial region. There is often a misdiagnosis in the category of fibroosseous lesions, owing to an overlap of clinical, histological and radiographic features amongst the separate entities. We present a case of giant maxillary COF causing extensive disfiguration of the face, along with extensive review of the clinico-pathologic and treatment aspects of the fibro-osseous lesions.
文摘目的探讨瞬时弹性成像技术(Fibro Scan)、天冬氨酸氨基转移酶和血小板比率指数(aspartate aminotransferase-to-platelet ratio index,APRI)及其二者联合检测肝硬化患者合并食管胃底静脉曲张破裂出血风险的相关性和诊断预测价值.方法将210例病毒性肝炎肝炎后肝硬化患者根据2015年《肝硬化门静脉高压食管胃静脉曲张出血的防治指南》分为无、有出血组,分别为153、57例;搜集患者在1 wk内的Fibro Scan值[肝脏硬度值(liver stiffness measurement,L S M)]和A P R I值.组间比较采用t检验,利用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析LSM、APRI、LSM+APRI对肝硬化患者出血风险的预测价值,并比较LSM、APRI及LSM+APRI的ROC曲线下面积(area under curve,AUC).结果有、无出血组的LSM值分别是28.49 k Pa±9.46 k Pa,22.87 k Pa±6.95 k Pa,APRI值分别是2.99±1.11,2.13±1.01,有明显的统计学意义.有无出血风险的LSM、APRI、LSM+APRI的AUC分别是0.669、0.727、0.722,表明APRI、LSM+APRI对食管胃底静脉曲张破裂出血具有良好的诊断效果.结论APRI及Fibro Scan联合APRI对肝硬化患者合并食管胃底静脉曲张破裂出血风险存在有效的预测价值.
基金Supported by Grant from the National Scientific Research Fund,OTKA K101435 and K108548
文摘AIM: To investigate whether expression of selected mi RNAs obtained from fibrotic liver biopsies correlate with fibrosis stage.METHODS: Altogether, 52 patients were enrolled in the study representing various etiologic backgrounds of fibrosis: 24 cases with chronic hepatitis infections(types B, C), 19 with autoimmune liver diseases(autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, overlapping syndrome cases), and 9 of mixed etiology(alcoholic and nonalcoholic steatosis, cryptogenic cases). Severity of fibrosis was determined by both histologic staging using the METAVIR scoring system and noninvasive transient elastography. Following RNAisolation, expression levels of mi R-21, mi R-122, mi R-214, mi R-221, mi R-222, and mi R-224 were determined using Taq Man Micro RNA Assays applying mi R-140 as the reference. Selection of mi RNAs was based on their characteristic up- or downregulation observed in hepatocellular carcinoma. Relative expression of mi RNAs was correlated with fibrosis stage and liver stiffness(LS) value measured by transient elastography, as well as with serum alanine aminotransferase(ALT) level.RESULTS: The expression of individual mi RNAs showed deregulated patterns in stages F1-F4 as compared with stage F0, but only the reduced level of mi R-122 in stage F4 was statistically significant(P < 0.04). When analyzing mi RNA expression in relation to fibrosis, levels of mi R-122 and mi R-221 showed negative correlations with fibrosis stage, and mi R-122 was found to correlate negatively and mi R-224 positively with LS values(all P < 0.05). ALT levels displayed a positive correlation with mi R-21(P < 0.04). Negative correlations were observed in the fibrosis samples of mixed etiology between mi R-122 and fibrosis stage and LS values(P < 0.05), and in the samples of chronic viral hepatitis, between mi R-221 and fibrosis stage(P < 0.01), whereas mi R-21 showed positive correlation with ALT values in the samples of autoimmune liver diseases(P < 0.03). The results also revealed a strong correlation between fibrosis stage and LS values(P < 0.01) when etiology of fibrosis was not taken into account.CONCLUSION: Reduced expression of mi R-122 in advanced fibrosis and its correlation with fibrosis stage and LS values seem to be characteristic of hepatic fibrosis of various etiologies.
文摘Juvenile Aggressive Ossifying Fibroma (JAOF) is a benign but locally aggressive fibro-osseous lesion. It is a rapidly growing non-odontogenic neoplasm of the jaws, generally occurring in children and young adults. It is often confused with malignant condition because of its clinical behaviour. Long term follow-up is necessary, considering the high recurrence nature of this tumour. The reconstruction of affected patients, particularly the younger, is often challenging since it has to be done in stages, to keep up with the developing face. We report a case of maxillary JAOF in a 6-month-old female who was referred to our department. Histopathological examination of a resected specimen revealed a trabecular type of JAOF. The patient was followed up for a period of 2 years.
文摘<strong>Background:</strong> Fibrous dysplasia mainly presents in its monostotic form in the cranio-facial region with serious cosmetic disfigurement and functional derangement of the affected and adjacent structures putting both patient and the attending surgeon in great dilemma. Surgical treatment is the only rewarding and generally accepted treatment option, however, controversy over the surgical technique to be adopted still exists. While in the past, surgeons generally adopted conservative shaving or contouring technique, over the recent years, advocates of radical surgery are winning more disciples. <strong>Objective:</strong> To highlight the locally destructive, functionally degrading nature of a neglected or poorly excised (shaved) lesion in patients and highlight the outcome of total excision and surgical technique adopted to obviate the need for autologous bone grafting and two-staged surgery. <strong>Subjects and Method:</strong> We present case series of three patients with giant monostotic fibrous dysplasia of the maxilla, surgically treated in our Centre, who were part of a total of eight cases managed over the past fifteen years in our department of Ear, Nose and Throat-Head and Neck Surgery. The pre-operative clinical assessment, relevant investigations and post-operative outcome are presented. Our surgical technique is highlighted. All the patients had unilateral lesion of the maxilla with gross cosmetic and functional defects. Two of the patients had ischaemic (pressure) atrophy of the cheek soft tissue and skin leading to skin metaplastic changes including leukoplakia, hyperpigmentation. Post-operative follow-up showed satisfactory cosmetic outcome and significant reversal of malocclusion and dental anarchy. There was no recorded recurrence throughout the follow-up period ranging from four to eleven years. Nasal airway was re-established bilaterally in all the cases. <strong>Conclusion:</strong> Total or near total excision surgical technique with periosteal preservation is our treatment of choice in the management of monostotic cranio-facial fibrous dysplasia. Given the fact that the growth of the tumours often does not cease after puberty against general belief, shaving or contouring technique should be relegated to the background. Our technique of no grafting which reduced cost and morbidity to the patient should be encouraged.
文摘目的探讨Fibro Touch~?无创肝脏硬度测定值与血清学标志物对慢性乙型肝炎病毒(hepatitis B virus,HBV)感染者肝纤维化程度评估的临床应用价值及其与各评估指标间的相关性.方法纳入105例于我院感染科病房就诊且进行肝穿刺活检的慢性乙型肝炎患者,依据肝穿结果进行分组:无纤维化组44例(S0)、早期肝纤维化组26例(S1-2)和进展性肝纤维化组35例(S3-4).在肝穿后1 wk内进行Fibro Touch~?检测获得肝脏硬度测定(liver stiffiness measurement,LSM)值,并于TE检测当日空腹行血样采集,进行肝功能、血脂、空腹血糖、血常规及肝纤四项检测,应用计算公式获得各肝纤维化诊断模型如Hui氏评分、Forns指数、基于4因子的纤维化指数(fibrosis index based on the 4 factor,FIB-4)及非酒精性脂肪肝纤维化积分(NAFLD fibrosis score,NFS),同时测量身高(cm)、体重(kg),计算体质量指数水平.应用Spearman秩检验分析LSM值与各血清学肝纤维化标志物的相关性,比较LSM值及各血清学标志物的受试者工作特征曲线下面积(area under curve,AUC),并比较相应的截断点值及其灵敏度和特异度.结果无纤维化组、早期肝纤维化组及进展期纤维化组患者的LSM值分别为8.48(7.00-9.85)kPa、9.4(6.4-11.30)kPa、12.75(9.80-20.75)kPa,差别有统计学意义(P<0.01);除血清LN外,LSM值与肝纤四项余指标及Hui氏评分、Forns指数、FIB-4及NFS均有较好的相关性(P<0.05);Forns指数与hui氏评分、FIB-4呈正相关(r=0.810、r=0.898,P<0.01),NFS与hui氏评分、Forns指数、FIB-4呈正相关(r=0.844、r=0.893、r=0.899,P<0.01);LSM值诊断进展性肝纤维化的临床效用价值最高,在cut-off值为11.65kPa时,LSM值诊断进展性肝纤维化的AUC=0.764,特异度和灵敏度分别是91%和60%,符合度为82%;其次为NFS,在截断点为-1.25时,诊断进展性肝纤维化的灵敏度和特异度分别为54%和89%,符合率为78%.结论Fibro Touch~?无创肝脏硬度测定在慢性HBV感染患者肝纤维化程度具有良好的应用价值,与各肝纤维化血清学指标具有较好的相关性,值得临床进一步推广应用.
文摘AIM:To construct and evaluate a new non-invasive fibrosis index for assessment of the stage of liver f ibrosis. METHODS:A new f ibrosis index (Fibro-Stiffness index) was developed in 165 of 285 patients with chronic hepatitis C, and was validated in the other 120 patients where liver biopsy was performed. Its usefulness was compared with liver stiffness (LS) measured by FibroScan, the aminotransferase-to-platelet ratio index, the Forns index and the FibroIndex. RESULTS: The Fibro-Stiffness index consists of LS,platelet count and prothrombin time. The values of the Fibro-Stiffness index differed signif icantly between neighboring f ibrosis stages except F0-F1. The area under the receiver operating characteristics curves of the Fibro-Stiffness index for prediction of F≥2 (0.90), F≥ 3 (0.90) and F= 4(0.92) in the estimation group and those for F≥ 3 (0.93) and F =4 (0.97) in the validation group were the highest among the 5 methods examined. The accuracy of the Fibro-Stiffness index had highest values for F≥2, F≥3 and F=4 in both the estimation and validation groups. The diagnostic performance for F= 4 was improved by a combination of the Fibro-Stiffness index with serum hyaluronic acid level. CONCLUSION: The Fibro-Stiffness index was constructed and validated. It showed superior diagnostic performance to other indices for F ≥ 2,3 and 4.
基金Supported by National Natural Science Foundation of China,No.81374012 and No.81573652
文摘Chronic intake of alcohol undoubtedly overwhelms the structural and functional capacity of the liver by initiating complex pathological events characterized by steatosis,steatohepatitis,hepatic fibrosis and cirrhosis.Subsequently,these initial pathological events are sustained and ushered into a more complex and progressive liver disease,increasing the risk of fibrohepatocarcinogenesis.These coordinated pathological events mainly result from buildup of toxic metabolic derivatives of alcohol including but not limited to acetaldehyde(AA),malondialdehyde(MDA),CYP2E1-generated reactive oxygen species,alcohol-induced gut-derived lipopolysaccharide,AA/MDA protein and DNA adducts.The metabolic derivatives of alcohol together with other comorbidity factors,including hepatitis B and C viral infections,dysregulated iron metabolism,abuse of antibiotics,schistosomiasis,toxic drug metabolites,autoimmune disease and other non-specific factors,have been shown to underlie liver diseases.In view of the multiple etiology of liver diseases,attempts to delineate the mechanism by which each etiological factor causes liver disease has always proved cumbersome if not impossible.In the case of alcoholic liver disease(ALD),it is even more cumbersome and complicated as a result of the many toxic metabolic derivatives of alcohol with their varying liver-specific toxicities.In spite of all these hurdles,researchers and experts in hepatology have strived to expand knowledge and scientific discourse,particularly on ALD and its associated complications through the medium of scientific research,reviews and commentaries.Nonetheless,the molecularmechanisms underpinning ALD,particularly those underlying toxic effects of metabolic derivatives of alcohol on parenchymal and non-parenchymal hepatic cells leading to increased risk of alcohol-induced fibrohepatocarcinogenesis,are still incompletely elucidated.In this review,we examined published scientific findings on how alcohol and its metabolic derivatives mount cellular attack on each hepatic cell and the underlying molecular mechanisms leading to disruption of core hepatic homeostatic functions which probably set the stage for the initiation and progression of ALD to fibro-hepatocarcinogenesis.We also brought to sharp focus,the complex and integrative role of transforming growth factor beta/small mothers against decapentaplegic/plasminogen activator inhibitor-1 and the mitogen activated protein kinase signaling nexus as well as their cross-signaling with toll-like receptormediated gut-dependent signaling pathways implicated in ALD and fibro-hepatocarcinogenesis.Looking into the future,it is hoped that these deliberations may stimulate new research directions on this topic and shape not only therapeutic approaches but also models for studying ALD and fibro-hepatocarcinogenesis.
文摘Mediastinal lipomatous tumors with additional malignant soft tissue components are exceedingly rare. Patients can have substantially large sized tumors with long duration of symptoms and can be misinterpreted on radiographs. Enhancing soft tissue component within a fat density lesion within the mediastinum is alarming and should raise the suspicion of sarcomatous component. Along with diagnostic imaging, selective CT guided biopsy/FNAC from the enhancing soft tissue component can help in making correct diagnosis.
基金Supported by the Grants-in-Aid from the Society for the Promotion of Science, Sapporo Medical University for T. Mizuguchi, and Grants-in-Aid from the Ministry of Education, Culture, Sports Science and Technology, Japan. No. 18591519 for T. Mizuguchi, No. 17591420 for T. Katsuramaki, and No. 15390403 for K. Hirata
文摘Epidemiological and clinical data point to a close association between chronic hepatitis B virus infection or chronic hepatitis C virus infection and development of hepatocellular carcinoma(HCC).HCC develops over several decades and is associated with fibrosis.This sequence suggests that persistent viral infection and chronic inflammation can synergistically induce liver fibrosis and hepatocarcinogenesis.The transforming growth factor-β(TGF-β) signaling pathway plays a pivotal role in diverse cellular processes and contributes to hepatic fibro-carcinogenesis under inflammatory microenvironments during chronic liver diseases.The biological activities of TGF-β are initiated by the binding of the ligand to TGF-β receptors,which phosphorylate Smad proteins.TGF-β typeⅠreceptor activates Smad3 to create COOH-terminally phosphorylated Smad3(pSmad3C),while pro-inflammatory cytokine-activated kinases phosphorylates Smad3 to create the linker phosphorylated Smad3(pSmad3L).During chronic liver disease progression,virus components,together with pro-inflammatory cytokines and somatic mutations,convert the Smad3 signal from tumor-suppressive pS-mad3C to fibro-carcinogenic pSmad3 L pathways,accelerating liver fibrosis and increasing the risk of HCC.The understanding of Smad3 phosphorylation profiles may provide new opportunities for effective chemoprevention and personalized therapy for patients with hepatitis virus-related HCC in the future.
基金Supported by National Natural Science Foundation of China and National Key Technologies R and D Program of the 11th five-year plan,No.2009ZX09501-015
文摘AIM:To evaluate the hepatoprotective roles of (Z)5-(4-methoxybenzylidene)thiazolidine-2,4-dione (SKLB010) against carbon tetrachloride (CCl 4)-induced acute and chronic liver injury and its underlying mechanisms of action.METHODS:In the first experiment,rats were weighed and randomly divided into 5 groups (five rats in each group) to assess the protective effect of SKLB010 on acute liver injury.For induction of acute injury,rats were administered a single intraperitoneal injection of 2 mL/kg of 50% (v/v) CCl 4 dissolved in olive oil (1:1).Group 1 was untreated and served as the control group;group 2 received CCl 4 for induction of liver injury and served as the model group.In groups 3,4 and 5,rats receiving CCl 4 were also treated with SKLB010 at doses of 25,50 and 100 mg/kg,respectively.Blood samples were collected at 6,12 and 24 h after CCl 4 intoxication to determine the serum activity of alanine amino transferase.Tumour necrosis factor-α (TNF-α),interleukin-1β (IL-1β) were determined using enzyme-linked immunosorbent assay.At 24 h after CCl 4 injection,liver fibrogenesis was evaluated by hematoxylin-eosin (HE) staining and immunohistochemical analyses.Cytokine transcript levels of TNF-α,IL-1β and inducible nitric oxide synthase in the liver tissues of rats were measured using a reverse transcriptase reverse transcription-polymerase chain reaction technique.In the second experiment,rats were randomly divided into 2 groups (15 rats in each group),and liver injury in the CCl 4-administered groups was induced by a single intraperitoneal injection of 2 mL/kg of 50% (v/v) CCl 4 dissolved in olive oil (1:1).The SKLB010-treated groups received oral 100 mg/kg SKLB010 before CCl 4 administration.Five rats in each group were sacrificed at 2 h,6 h,12 h after CCl 4 intoxication and small fortions of livers were rapidly frozen for extraction of total RNA,hepatic proteins and glutathione (GSH) assays.In the hepatic fibrosis model group,rats were randomly divided into 2 groups (5 rats each group).Rats were injected intraperitoneally with a mixture of CCl 4 (1 mL/kg body weight) and olive oil [1:1 (v/v)] twice a week for 4 wk.In the SKLB010-treated groups,SKLB010 (100 mg/kg) was given once daily by oral gavage for 4 wk after CCl 4 administration.The rats were sacrificed one week after the last injection and the livers from each group were harvested and fixed in 10% formalin for HE and immunohistochemical staining.RESULTS:In this rat acute liver injury model,oral administration of SKLB010 blocked liver tissue injury by down-regulating the serum levels of alanine aminotransferase,suppressing inflammatory infiltration to liver tissue,and improving the histological architecture of liver.SKLB010 inhibited the activation of NF-κB by suppressing the degradation of IκB,and prevented the secretion of pro-inflammatory mediators such as tumor necrosis factor-α,interleukin-1β,and the reactive free radical,nitric oxide,at the transcriptional and translational levels.In this chronic liver fibrosis model,treatment with 100 mg/kg per day SKLB010 attenuated the degree of hepatic fibrosis and area of collagen,and blocked the accumulation of smooth-muscle actinexpressed cells.CONCLUSION:These results suggest that SKLB010 is a potent therapeutic agent for the treatment of CCl 4 induced hepatic injury.
文摘Fibro-muscular dysplasia(FMD)is a rare but well documented disease with multiple arterial aneurysms. The patients,usually women,present with various clinical manifestations according to the specific arteries that are affected.Typical findings are aneurysmatic dilatations of medium-sized arteries.The renal and the internal carotid arteries are most frequently affected, but other anatomical sites might be affected too.The typical angiographic picture is that of a"string of beads". Common histological features are additionally described. Here we present a case of a 47-year-old woman,who was hospitalized due to intractable abdominal pain.A routine work-up revealed a liver mass near the portal vein.Before a definite diagnosis was reached,the patient developed massive upper gastrointestinal bleeding.In order to control the hemorrhage,celiac angiography was performed revealing features of FMD in several arteries, including large aneurysms of the hepatic artery.Active bleeding from one of these aneurysms into the biliary tree indicated selective embolization of the hepatic artery.The immediate results were satisfactory,and the 5 years follow-up revealed absence of any clinical symptoms.
