ABSTRACT
Chronic liver injury caused by any etiology will lead to liver fibrosis, and it was believed in the past that liver fibrosis is a static and irreversible pathophysiological process. In recent years, with the rapid development of molecular biology and the in-depth research on the microscopic aspect of the liver, more and more evidence has shown that liver fibrosis is a dynamic and reversible process. This article reviews the reports of different methods for evaluating the reversal of liver fibrosis caused by various etiologies, summarizes the pathogenesis and reversal mechanism of liver fibrosis, reviews the therapeutic drugs for reversal, and summarizes the current evaluation methods for liver fibrosis, and finally, it is believed that timely clearance or control of potential etiology may help to achieve the reversal of liver fibrosis to a certain degree.
ABSTRACT
PurposeTo investigate the independent risk factors of refractory hypertension for effective screening and treatment.Materials and Methods 142 patients with refractory hypertension underwent renal angiography, morbidity of renal artery stenosis (RAS) and angiography results were analyzed using univariate and multivariate Logistic regression.Results Thirty-eight cases of RAS were identiifed with incidence of 26.8%. Univariate analysis indicated that diabetes, peripheral artery disease and coronary heart disease were the predictor for RAS (P<0.05 orP<0.01). Multivariate regression analysis demonstrated that peripheral artery disease (OR 5.011, 95%CI 2.17-8.93,P<0.001) was independent risk factors for RAS. Diabetes and coronary heart disease were not independent risk factors.Conclusion Peripheral artery disease is independent risk factor for RAS among patients with refractory hypertension, which can serve as a screening index of renal angiography or renal angioplasty and stenting for RAS.
ABSTRACT
Objective To evaluate the clinical efficacy of transcatheter super-selective hepatic artery embolization (TAE) in treating symptomatic polycystic liver disease (PLD). Methods A total of 8 patients with PLD, who were admitted to authors’ hospital during the period from 2009 to 2013 to receive TAE, were enrolled in this study. The patients included 6 females and 2 males with a mean age of 59.5 years (54-65 years). The used embolic agents were polyvinyl alcohol (PVA) microspheres and micro spring coils. Both plain and contrast-enhanced CT scans of the upper abdomen were performed before TAE as well as at 12 months after TAE; the total volume of the hepatic cysts was measured and the changes of the cystic volume were determined. Statistical analysis was conducted using paired t test. Results The technical success rate was 100%. After TAE, the patients developed fever and different degrees of discomfort at liver area, which were disappeared after active symptomatic medication, and no serious complications occurred. The patients were followed up for 12 months , the mean total volume of the intrahepatic cysts decreased from preoperative (5 794±2 066) cm3 (range 3 120-8 935 cm3) to postoperative (3 832±1 525) cm3 (range 2 019-5 925 cm3), the difference was statistically significant (t=6.971, P<0.001). The reduction ratio of total volume of intrahepatic cysts was 34.6%±11.3%(24.3%-60.4%). Conclusion For symptomatic polycystic liver disease, transcatheter super-selective hepatic arterial embolization is a newly-developed treatment. This technique is safe and effective with reliable response and fewer complications. Therefore, it should be recommended in clinical practice.