Multiparametric ultrasound as a new concept of assessment of liver tissue damage

Liver disease accounts for approximately 2 million deaths per year worldwide.All chronic liver diseases(CLDs),whether of toxic,genetic,autoimmune,or infectious origin,undergo typical histological changes in the structure of the tissue.These changes may include the accumulation of extracellular matrix material,fats,triglycerides,or tissue scarring.Noninvasive methods for diagnosing CLD,such as conventional B-mode ultrasound(US),play a significant role in diagnosis.Doppler US,when coupled with B-mode US,can be helpful in evaluating the hemodynamics of hepatic vessels and detecting US findings associated with hepatic decompensation.US elastography can assess liver stiffness,serving as a surrogate marker for liver fibrosis.It is important to note that interpreting these values should not rely solely on a histological classification.Contrast-enhanced US(CEUS)provides valuable information on tissue perfusion and enables excellent differentiation between benign and malignant focal liver lesions.Clinical evaluation,the etiology of liver disease,and the patient current comorbidities all influence the interpretation of liver stiffness measurements.These measurements are most clinically relevant when interpreted as a probability of compensated advanced CLD.B-mode US offers a subjective estimation of fatty infiltration and has limited sensitivity for mild steatosis.The controlled attenuation parameter requires a dedicated device,and cutoff values are not clearly defined.Quan-titative US parameters for liver fat estimation include the attenuation coefficient,backscatter coefficient,and speed of sound.These parameters offer the advantage of providing fat quantification alongside B-mode evaluation and other US parameters.Multiparametric US(MPUS)of the liver introduces a new concept for complete noninvasive diagnosis.It encourages examiners to utilize the latest features of an US machine,including conventional B-mode,liver stiffness evaluation,fat quantification,dispersion imaging,Doppler US,and CEUS for focal liver lesion characterization.This comprehensive approach allows for diagnosis in a single examination,providing clinicians worldwide with a broader perspective and becoming a cornerstone in their diagnostic arsenal.MPUS,in the hands of skilled clinicians,becomes an invaluable predictive tool for diagnosing,staging,and monitoring CLD.

Avoiding hepatic metastasis naturally: Lessons from the cotton top tamarin(Saguinus oedipus )

Much has been written about hepatic metastasis and animal models abound. In terms of the human experience, progress in treating this final common pathway, a terminal event of many human malignancies has been relatively slow. The current thinking is that primary prevention is best served by early detection of cancer and eradication of early stage cancers by screening. Some cancers spread early in their course and the role of screening may be limited. Until relatively recently there has not been a pathfinder model that makes the evasion of this unfortunate event a reality. This review discusses such an animal model and attempts to relate it to human disease in terms of intervention. Concrete proposals are also offered on how scientists may be able to intervene to prevent this deadly progression of the cancer process.

Effect of Yishen Huayu Fang on kidney tissue E-cadherin expression in unilateral ureter ligation in rats

OBJECTIVE:To observe E-calcium sticky protein(E-cadherin) expression in kidney tissues in a rat model of unilateral ureter ligation and the effect of Yishen Huayu Fang(formula of tonifying the kidney and dissolving accumulated blood stasis) on the expression.METHODS:A total of 150 clean grade male rats were randomly divided into a control group,model group,low-dose Yishen Huayu Fang group(low-dose group),high-dose Yishen Huayu Fang group(high-dose group),and Lotensin group.A renal fibrosis model was established with unilateral ureteral obstruction(UUO).Pathological changes of rat renal tissue were observed with light microscopy on days 3,7,14,21,and 28 after UUO.Changes in kidney tissue E-cadherin expression were observed with immunohistochemistry.RESULTS:Three days after modeling,kidney edema appeared followed by gradual inflammatory cell infiltration,and part of the small tubules disappeared while the renal cortex thinned.Meanwhile,the E-cadherin expression level dropped,which was negatively correlated with the obstruction time.After intervention,E-cadherin expression was increased in all treatment groups(P<0.01 or P<0.05),while there were no significant differences between the high-dose and Lotensin groups.CONCLUSION:Yishen Huayu Fang delays the renal fibrosis process by promoting E-cadherin expression in renal tissues and reducing extracellular matrix deposition.