Esophageal variceal bleeding is a common complication of liver cirrhosis. Non-selective beta blockers (NSBB) have been established in numerous studies as one of the medical treatment for cirrhosis, especially in the primary and secondary prevention of variceal bleeding. The dose of NSBB is adjusted for a reduction in the resting heart rate by 25%, to 55 beat/min, or until the occurrence of adverse effect. The mean adjusted dose of propranolol in Korean study is 160 mg/day. Nevertheless, low dose propranolol is frequently used in real clinical field. A study by Kwon et al. showed that effect of propranolol in the prevention for esophageal rebleeding was superior in maximally-tolerable dose group of propranolol than low dose group. In this editorial, we have reviewed the studies of prevention for variceal rebleeding focusing on the dose of propranolol.
Esophageal and Gastric Varices ; Fibrosis ; Heart Rate ; Liver Cirrhosis ; Propranolol* ; Secondary Prevention

Calcium ; metabolism ; Growth Substances ; metabolism ; Humans ; Pulmonary Fibrosis ; drug therapy ; metabolism ; prevention & control ; Taurine ; therapeutic use

Animals ; Diabetes Mellitus, Experimental/drug therapy* ; Fibrosis/prevention & control* ; Hyperglycemia/prevention & control* ; Hypoglycemic Agents/pharmacology* ; Inflammation/prevention & control* ; Male ; Rats ; Rats, Sprague-Dawley ; Stilbenes/pharmacology*

Myocardial fibrosis is an inevitable process of many heart diseases, such as coronary heart disease, myocardial infarction, hypertension, cardiomyopathy, etc. in development from earlier period to terminal stage. To prevent or reverse the process of fibrosis is one of the most important approaches to retard the occurrence of heart failure and reduce the accidence of arrhythmia. In traditional Chinese medicine myocardial fibrosis belongs to the category of "Xinbi". Studies on the occurrence and regulation of myocardial fibrosis, and its treatment by using integrative Chinese and Western medicine or by Chinese drugs singly and their components were reviewed in this paper.
Cardiomyopathies ; drug therapy ; prevention & control ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Fibrosis ; drug therapy ; prevention & control ; Humans ; Medicine, Chinese Traditional ; Myocardium ; pathology ; Phytotherapy

OBJECTIVETo investigate diagnosis and treatment of abdominal cocoon.

METHODSClinical data of patients received treatment for abdominal cocoon from January 2000 to January 2011 was retrospectively analyzed.

RESULTSA total of 67 patients underwent treatment in our hospital were analyzed, the preoperatively diagnosis rate was only 47.8% (32/67). Patients who received preoperatively nutrition support have a lower postoperative complication (8/27 vs.13/20, χ(2) = 5.815, P < 0.05) and patients with less extent of intestine involved had a lower early postoperative inflammatory ileus (EPII) rate (9/25 vs. 1/22, χ(2) = 6.912, P < 0.05) when compared with large extent.

CONCLUSIONSAppropriate perioperative management play an important role in the prognosis of abdominal cocoon. The main treatment is surgery while preoperatively nutrition support can reduce postoperative complications.

Adolescent ; Adult ; Aged ; Female ; Humans ; Ileus ; prevention & control ; Male ; Middle Aged ; Peritoneal Fibrosis ; surgery ; Postoperative Complications ; prevention & control ; Retrospective Studies ; Young Adult

Globally, viral hepatitis due to hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection is the major cause of advanced liver diseases such as liver cirrhosis and hepatocellular carcinoma (HCC). Chronic inflammation resulting from persistent viral hepatitis is also associated with an increased risk of HCC recurrence. Replication of HBV and/or HCV can reactivate during anti-cancer treatments of HCC and lead to hepatic dysfunction, adversely affecting patient outcomes. The most effective way to prevent chronic viral hepatitis, cirrhosis, or HCC would be the implementation of a vaccine. Unfortunately, a vaccine for HCV is currently not available. For chronically infected patients, antiviral therapy may be the only option that can prevent or retard disease progression. Emerging evidence continues to support direct or indirect benefits from antiviral therapy for preventing liver disease progression to cirrhosis, HCC development, and recurrence after curative treatments in patients with chronic HBV or HCV infection. This paper reviews the literature on the management of viral hepatitis in patients with HCC, focusing on primary and tertiary prevention of HCC.
Carcinoma, Hepatocellular* ; Disease Progression ; Fibrosis ; Hepacivirus ; Hepatitis B virus ; Hepatitis* ; Humans ; Inflammation ; Liver Cirrhosis ; Liver Diseases ; Recurrence ; Tertiary Prevention

OBJECTIVETo investigate the prevention of esophageal varices recurrence by laser inducing esophageal mucosal fibrosis.

METHODSOur study included 42 patients after esophageal varices eradicated by endoscopic varices ligation, and they were divided into 2 groups randomly, each group included 21 patients. One group was assigned to received laser treatment, and indocyanine green solution (1 mg/ml) was injected submucosally, a diode laser (power 10 watts) was applied to the surface from the esophagogastric junction to 5 cm above it. Another group was controlling without any treatments. All patient were followed up by endoscopy every 3 months until 12 months.

RESULTSLaser irradiation was performed safely without any major complications. And lower esophageal mucosa produced fibrosis widely after laser irradiated 1 month. After 12 months follow up, the cumulative recurrence rate was significantly lower than the control group, 14% (3/21) vs 43% (9/21) (chi(2) = 4.20, P < 0.05).

CONCLUSIONSOur study indicates that laser inducing mucous fibrosis is safely and can prevent recurrence of esophageal varices.

Adult ; Esophageal and Gastric Varices ; pathology ; surgery ; Esophagoscopy ; Esophagus ; pathology ; Female ; Fibrosis ; Follow-Up Studies ; Humans ; Laser Coagulation ; methods ; Ligation ; Male ; Middle Aged ; Mucous Membrane ; pathology ; Secondary Prevention

To investigate the effects of mycophenolate mofetil (MMF) on the process of renal interstitial fibrosis, unilateral ureteral obstruction (UUO) model was established in rats. Twenty Sprague-Dawley rats underwent UUO and received vehicle (n = 10) or MMF (20 mg.kg-1.d-1, by daily gastric gavage, n = 10) during a period of 5 days following surgery, and the additional 10 rats were served as sham-operated group. The rats were killed 5 days after surgery. Immunohistochemistry was performed on renal tissue for proliferating cell nuclear antigen (PCNA), alpha-smooth muscle actin (alpha-SMA) and type I and III collagen (col I, col III). Histological studies were also done by MASSON staining. Five days after surgery, proliferating cells in tubules, interstitium as well as interstitial myofibroblast (MyoF) infiltration and interstitial col I, col III deposition were all significantly reduced by MMF treatment. MMF also alleviated the histological changes of UUO rats. These results suggested that the reduction of interstitial MyoF infiltration may be an important event by which MMF prevents renal injury caused by UUO and MMF could be used to limit the progression of renal fibrosis.
Animals ; Female ; Fibrosis ; Kidney ; pathology ; Kidney Diseases ; etiology ; pathology ; prevention & control ; Mycophenolic Acid ; analogs & derivatives ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Ureteral Obstruction ; complications

Humans ; Leukoplakia, Oral ; diagnosis ; therapy ; Lichen Planus, Oral ; diagnosis ; therapy ; Mouth Neoplasms ; prevention & control ; Oral Submucous Fibrosis ; diagnosis ; therapy ; Precancerous Conditions ; diagnosis ; therapy

Relaxin is known to inhibit cardiac fibrosis. However, it is unclear whether relaxin could regulate the effects of Phorbol 12-myristate 13-acetate (PMA, PKC activator) on cardiac fibrosis. So the influence of relaxin on the cell proliferation and collagen expression induced by PMA in cultured cardiac fibroblasts was studied. It showed that PMA significantly increased cardiac fibroblasts proliferation, Type I pro-collagen protein expression, Type I pro-collagen mRNA expression, and rhRLX absolutely significantly decreased PMA induced effects on cardiac fibroblasts proliferation and Type I pro-collagen expressions, indicating that relaxin could inhibit cardiac fibrosis induced by PMA.
Animals ; Animals, Newborn ; Cells, Cultured ; Fibroblasts ; pathology ; Fibrosis ; Heart Diseases ; chemically induced ; pathology ; prevention & control ; Rats ; Rats, Sprague-Dawley ; Relaxin ; therapeutic use ; Tetradecanoylphorbol Acetate ; analogs & derivatives