Type 2 alveolar epithelial cell(AT2)senescence plays a crucial role in the onset andprogression of pulmonary fibrosis.Recent studies have revealed a close relationship betweenAT2 senescence and pulmonary fibrosis,sugg...Type 2 alveolar epithelial cell(AT2)senescence plays a crucial role in the onset andprogression of pulmonary fibrosis.Recent studies have revealed a close relationship betweenAT2 senescence and pulmonary fibrosis,suggesting that senescent cells have a dual role inthe injury repair process of lung tissue.On the one hand,senescent AT2 loses its repairfunction,and on the other hand,senescent cells exacerbate the inflammatory and fibroticprocesses by secreting senescence-associated secretory phenotype.In this paper,we willreview the biological mechanisms and pathological features of AT2 senescence and itsrelationship with the development of pulmonary fibrosis,and discuss current therapeuticintervention strategies,including the potential of small molecule drugs,cellular therapies,gene editing techniques,and traditional Chinese medicine.Finally,the paper summarizesthe challenges of current research and suggests future research directions.展开更多
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
<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
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
Liver cirrhosis is a common and growing public health problem globally.The diagnosis of cirrhosis portends an increased risk of morbidity and mortality.Liver biopsy is considered the gold standard for diagnosis of cir...Liver cirrhosis is a common and growing public health problem globally.The diagnosis of cirrhosis portends an increased risk of morbidity and mortality.Liver biopsy is considered the gold standard for diagnosis of cirrhosis and staging of fibrosis.However,despite its universal use,liver biopsy is an invasive and inaccurate gold standard with numerous drawbacks.In order to overcome the limitations of liver biopsy,a number of non-invasive techniques have been investigated for the assessment of cirrhosis.This review will focus on currently available non-invasive markers of cirrhosis.The evidence behind the use of these markers will be highlighted,along with an assessment of diagnostic accuracy and performance characteristics of each test.Non-invasive markers of cirrhosis can be radiologic or serum-based.Radiologic techniques based on ultrasound,magnetic resonance imaging and elastography have been used to assess liver fibrosis.Serum-based biomarkers of cirrhosis have also been developed.These are broadly classified into indirect and direct markers.Indirect biomarkers reflect liver function,which may decline with the onset of cirrhosis.Direct biomarkers,reflect extracellular matrix turnover,and include molecules involved in hepatic fibrogenesis.On the whole,radiologic and serum markers of fibrosis correlate well with biopsy scores,especially when excluding cirrhosis or excluding fibrosis.This feature is certainly clinically useful,and avoids liver biopsy in many cases.展开更多
The error equation of a rotating inertial navigation system was introduced. The effect of the system's main error source (constant drift of gyro and zero bias of accelerometer) under rotating conditions for the sy...The error equation of a rotating inertial navigation system was introduced. The effect of the system's main error source (constant drift of gyro and zero bias of accelerometer) under rotating conditions for the system was analyzed. Validity of theoretical analysis was shown via simulation, and that provides a theoretical foundation for a rotating strap-down inertial navigation system during actual experimentation and application.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
目的早期诊断对提高原发性肝癌患者生存率尤为关键,本研究旨在探讨肝脏瞬时弹性硬度检查(Fibroscan)诊断早期乙型肝炎(简称乙肝)相关肝癌的临床价值。方法选取156例慢性乙肝患者,分为肝癌组(51例)和非肝癌组(105例),收集所有研究对象的...目的早期诊断对提高原发性肝癌患者生存率尤为关键,本研究旨在探讨肝脏瞬时弹性硬度检查(Fibroscan)诊断早期乙型肝炎(简称乙肝)相关肝癌的临床价值。方法选取156例慢性乙肝患者,分为肝癌组(51例)和非肝癌组(105例),收集所有研究对象的临床资料及相关实验室检查结果,并采用Fibroscan测定肝硬度值(LS),分析肝癌的高危因素、LS评价肝纤维化的临床价值。结果肝癌家族史、HBV-DNA水平(log10>5 IU/ml)、AFP水平(>400 mg/L)、高LS值(>13 k Pa)是肝癌发生的危险因素(均P<0.05)。当LS诊断界值为13 k Pa时,Fibroscan诊断肝癌的灵敏度和特异度分别为82.35%、78.09%;当LS诊断界值为18 k Pa,Fibroscan诊断肝癌的灵敏度下降(62.75%),特异度升高(88.57%)。结论 LS和慢性乙肝患者发生肝癌的风险密切相关,Fibroscan作为一种无创预测肝癌的方式,在肝癌早期诊断中有积极意义。展开更多
基金supported by the Tianjin Wuqing District Health and Health Research Project(WQWJ202403).
文摘Type 2 alveolar epithelial cell(AT2)senescence plays a crucial role in the onset andprogression of pulmonary fibrosis.Recent studies have revealed a close relationship betweenAT2 senescence and pulmonary fibrosis,suggesting that senescent cells have a dual role inthe injury repair process of lung tissue.On the one hand,senescent AT2 loses its repairfunction,and on the other hand,senescent cells exacerbate the inflammatory and fibroticprocesses by secreting senescence-associated secretory phenotype.In this paper,we willreview the biological mechanisms and pathological features of AT2 senescence and itsrelationship with the development of pulmonary fibrosis,and discuss current therapeuticintervention strategies,including the potential of small molecule drugs,cellular therapies,gene editing techniques,and traditional Chinese medicine.Finally,the paper summarizesthe challenges of current research and suggests future research directions.
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<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Liver cirrhosis is a common and growing public health problem globally.The diagnosis of cirrhosis portends an increased risk of morbidity and mortality.Liver biopsy is considered the gold standard for diagnosis of cirrhosis and staging of fibrosis.However,despite its universal use,liver biopsy is an invasive and inaccurate gold standard with numerous drawbacks.In order to overcome the limitations of liver biopsy,a number of non-invasive techniques have been investigated for the assessment of cirrhosis.This review will focus on currently available non-invasive markers of cirrhosis.The evidence behind the use of these markers will be highlighted,along with an assessment of diagnostic accuracy and performance characteristics of each test.Non-invasive markers of cirrhosis can be radiologic or serum-based.Radiologic techniques based on ultrasound,magnetic resonance imaging and elastography have been used to assess liver fibrosis.Serum-based biomarkers of cirrhosis have also been developed.These are broadly classified into indirect and direct markers.Indirect biomarkers reflect liver function,which may decline with the onset of cirrhosis.Direct biomarkers,reflect extracellular matrix turnover,and include molecules involved in hepatic fibrogenesis.On the whole,radiologic and serum markers of fibrosis correlate well with biopsy scores,especially when excluding cirrhosis or excluding fibrosis.This feature is certainly clinically useful,and avoids liver biopsy in many cases.
基金the Nature Science Foundation of China under Grant No.60604019 and No.6075001
文摘The error equation of a rotating inertial navigation system was introduced. The effect of the system's main error source (constant drift of gyro and zero bias of accelerometer) under rotating conditions for the system was analyzed. Validity of theoretical analysis was shown via simulation, and that provides a theoretical foundation for a rotating strap-down inertial navigation system during actual experimentation and application.
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.
文摘目的早期诊断对提高原发性肝癌患者生存率尤为关键,本研究旨在探讨肝脏瞬时弹性硬度检查(Fibroscan)诊断早期乙型肝炎(简称乙肝)相关肝癌的临床价值。方法选取156例慢性乙肝患者,分为肝癌组(51例)和非肝癌组(105例),收集所有研究对象的临床资料及相关实验室检查结果,并采用Fibroscan测定肝硬度值(LS),分析肝癌的高危因素、LS评价肝纤维化的临床价值。结果肝癌家族史、HBV-DNA水平(log10>5 IU/ml)、AFP水平(>400 mg/L)、高LS值(>13 k Pa)是肝癌发生的危险因素(均P<0.05)。当LS诊断界值为13 k Pa时,Fibroscan诊断肝癌的灵敏度和特异度分别为82.35%、78.09%;当LS诊断界值为18 k Pa,Fibroscan诊断肝癌的灵敏度下降(62.75%),特异度升高(88.57%)。结论 LS和慢性乙肝患者发生肝癌的风险密切相关,Fibroscan作为一种无创预测肝癌的方式,在肝癌早期诊断中有积极意义。
