الملخص
Objective:To explore the value of magnetic resonance diffusion tensor imaging (DTI) in evaluating cerebrovascular small vessel disease (CSVD) in patients with systemic lupus erythematosus (SLE).Methods:Eighty-two patients with SLE combined with CSVD treated at Yixing People's Hospital from January to December 2022 were selected. They were divided into acute phase infarction group (16 cases), chronic phase infarction group (26 cases), and chronic ischemic lesion group (40 cases) based on routine MRI examination results. All patients underwent DTI examination to obtain the average diffusion coefficient (DCavg) and anisotropy score (FA) of the affected and contralateral normal white matter areas, and the evaluation value of DTI for CSVD in SLE patients was analyzed.Results:The DCavg value on the affected side of 82 patients was significantly higher than that on the healthy side: (11.10 ± 3.48) 10 -3 mm 2/s vs. (8.18 ± 2.42) 10 -3 mm 2/s, and the FA value on the affected side was significantly lower than that on the healthy side: 0.28 ± 0.05 vs. 0.45 ± 0.08, with a statistical significant differences ( P<0.05). The DCavg values of the acute infarction group, chronic infarction group, and chronic ischemic focus group were (11.88 ± 3.50), (9.69 ± 3.24) and (8.52 ± 2.34) 10 -3 mm 2/s, respectively, with statistical significant differences ( P<0.05). The FA values of the acute infarction group, chronic infarction group, and chronic ischemic focus group were 0.28 ± 0.04, 0.33 ± 0.06 and 0.40 ± 0.07, respectively, with statistical significant differences ( P<0.05). The receiver operating characteristic curve was drawn, and the results showed that the area under the curve (AUC) of the acute phase infarction group and the chronic phase infarction group evaluated by DCavg and FA alone and in combination were 0.757, 0.756, and 0.820, respectively. The AUC of the chronic phase infarction group and the chronic ischemic focus group evaluated by DCavg and FA were 0.772, 0.776, and 0.813, respectively. The AUC value of the combined evaluation was relatively large. Conclusions:DTI has good evaluation value for CSVD in SLE patients and can accurately determine the type of CSVD.
الملخص
Achieving HBV DNA negative transformation and HBsAg clearance with effective antiviral therapy can reduce the incidence of HCC, but some patients are still at risk of developing HCC. Therefore, screening high-risk patients for close monitoring is essential to reduce the incidence of HCC. This paper reviews the occurrence of HCC, risk factors and risk prediction models of HBV DNA negative transformation and HBsAg clearance, and provides a basis for screening and follow-up management of high-risk group of HCC with chronic hepatitis B.
الملخص
In the past 40 years,patients with primary biliary cholangitis (PBC)have benefited from the extensive use of ursodeoxycholic acid (UDCA),resulting in increase of response rate and survival rate. The prognosis of PBC patients was significantly improved. However,some patients responded poorly to UDCA and with poor long-term outcome. Therefore,accurate diagnosis,evaluation and risk stratification based on serological and pathological characteristics of the patients are very important for the treatment of PBC. This article summarized the progress in diagnosis and treatment of PBC.
الملخص
Nonalcoholic fatty liver disease (NAFLD) is a chronic disease with complex lesions, and it is difficult to determine the clinical stage. Liver biopsy is still the gold standard for the diagnosis of NAFLD; however, its clinical application is limited by various factors. Therefore, noninvasive methods for the accurate diagnosis of NAFLD are research hotspots at present. Imaging examinations help to achieve qualitative and quantitative evaluations of hepatic steatosis and fibrosis and thus has a promising future in clinical practice. This article summarizes the research advances in the imaging diagnosis of nonalcoholic fatty liver disease in recent years.
الملخص
In recent years,ursodeoxycholic acid is commonly used for the treatment of primary biliary cholangitis (PBC);however,the growing number of PBC patients and the occurrence of suboptimal response and treatment intolerance pose a great challenge to treatment regimens.The approval of the new drug obeticholic acid brings hope to PBC patients,and a combination of fibrates also has a promising future.More studies are in progress.Although new drugs,such as monoclonal antibody,fibroblast growth factor 19,and sodium-dependent bile acid transporter inhibitor,have limited efficacy data,they provide new directions for the treatment of PBC.With the help of individualized follow-up and stratified therapy,the management of PBC patients will enter a new stage.
الملخص
With the progress in detection methods and the update of diagnostic and therapeutic concepts, more and more patients with primary biliary cholangitis (PBC) have been diagnosed and treated. A high proportion of PBC patients, however, progress to liver decompensation, with an increased risk of liver transplantation and death and a significant reduction in long-term survival. These patients need early diagnosis and urgent treatment. This article discusses how to identify the PBC patients with poor prognosis early from the aspects of biochemical response, disease features, and biomarkers, and reviews the progress in related complementary therapies and new drugs including Ocaliva, Fibrates, UDCA-derived drugs, and molecular targeted drugs.