ABSTRACT
Liver fibrogenesis is a common pathway of pathological progression of chronic liver injuries. The diagnosis of liver fibrosis provides an important basis for treatment decision-making and prognostic evaluation of chronic liver diseases. With the rapid development of therapeutics, many new clinical issues have emerged, which requires new techniques for the diagnosis of liver fibrosis. At present, histological assessment remains the most reliable method for a definite diagnosis of liver fibrosis and cirrhosis. With reference to related clinical articles and data, this article analyzes the clinical value and research directions of histological assessment in chronic liver disease management and diagnosis of liver fibrosis/cirrhosis and its reversal.
ABSTRACT
Objective: To investigate effectiveness of anteromedial thigh perforator flap in repair of soft tissue defects of lower limbs. Methods: Between January 2015 and October 2018, 7 patients with soft tissue defects of the lower limbs were repaired with the anteromedial thigh perforator flaps. The patients were males, aged 8-30 years (median, 23 years). There were 5 cases of traffic accident injuries (the time from injury to admission was 1-4 hours, with an average of 1.5 hours), 1 case of scar formation after traffic accident, and 1 case of scar deformity after burn. The defect located in calf in 5 cases, foot in 1 case, and thigh in 1 case. The area of soft tissue defects ranged from 12 cm×4 cm to 21 cm×7 cm; and the area of flaps ranged from 14 cm×5 cm to 24 cm×8 cm. The donor sites were sutured directly. Results: The flaps survived completely after operation in 6 cases, and the wounds healed by the first intention; the partial necrosis of flap occurred and healed after skin graft repair in 1 case. One incision partially ruptured in the donor site and healed after dressing change; the other incisions healed by the first intetion. All patients were followed up 6 months to 2 years with an average of 9 months. Except 1 case complained of edema of the flap, the other patients had good shape, good color, and no swelling. Conclusion: For patients with soft tissue defects of lower limbs that cannot be repaired with anterolateral thigh perforator flap, the anteromedial thigh perforator flap can be used for good results.
ABSTRACT
Ductular reaction is a kind of repair response to biliary and hepatocellular injury, and the pathological changes include lobular bile duct hyperplasia, matrix change and inflammatory cell infiltrations. In human liver, a ductular reaction originates from the activation and proliferation of hepatic progenitor cells. The activated hepatic progenitor cells, the intermediate hepatocytes and the reactive small bile duct cells together form the cell complex of ductular reaction, which has the dual characteristics of hepatobiliary system and co-expresses the hepatocyte and cholangiocyte antigen. Ductular reaction appears in all kinds of acute and chronic hepatobiliary injury, and plays an important role in liver regeneration and repair, fibrogenesis, cirrhosis formation, and hepatobiliary cancer occurrence and development. Understanding the pathological features and pathophysiological mechanisms of ductular reaction in various clinical hepatobiliary diseases and their role in liver regeneration can provide important suggestion for further exploring new-targeted treatment approach.