Gastrointestinal Hemorrhage ; drug therapy ; etiology ; prevention & control ; Humans ; Hypertension, Portal ; complications

Primary myelofibrosis (PMF) is easily confused with cirrhosis, due to its main clinical manifestations of splenomegaly and the blood cytopenia. This review focuses on clinical studies to identify primary myelofibrosis and cirrhosis related portal hypertension, to analyze the differences between the two diseases, in order to distinguish PMF and cirrhosis from the pathogenesis, clinical manifestations, laboratory examinations and treatment principles, and simultaneously improve clinicians' understanding of PMF, which is a reference for exploring the early screening or diagnostic indicators of PMF, also provides a clinical basis for the application of new targeted drugs such as ruxolitinib.
Humans ; Primary Myelofibrosis/drug therapy* ; Hypertension, Portal/complications* ; Liver Cirrhosis/pathology* ; Splenomegaly/pathology* ; Anemia

Endoscopy, Digestive System ; Esophageal and Gastric Varices ; complications ; drug therapy ; surgery ; therapy ; Fibrosis ; complications ; Gastrointestinal Hemorrhage ; drug therapy ; etiology ; surgery ; therapy ; Humans ; Hypertension, Portal ; drug therapy ; etiology ; surgery ; therapy

This article presented an overview of the therapeutic effects of Chinese medicine (CM) preparations for promoting blood circulation and removing blood stasis for patients with portal vein thrombosis (PVT) after splenectomy. Based on published clinical researches of CM preparations for PVT after splenectomy in patients with cirrhotic portal hypertension (CPH), this paper evaluated the incidence of PVT, and explored potential active components and mechanisms of CM preparations. Safflower Yellow Injection, Danshen Injection () Danhong Injection (), and Compound Danshen Dropping Pill () achieved good curative effect alone or combined with anticoagulant therapy. In addition, Compound Biejia Ruangan Tablet () and Anluo Huaxian Pill () can also significantly improve the hemodynamic disorders of portal vein system in patients with cirrhosis. Considering the role of CM preparations in ameliorating the incidence of PVT after splenectomy in patients with CPH, we suggested that future research should provide more attention to CM alone or CM combined with anticoagulant for cirrhosis with PVT.
Anticoagulants/therapeutic use* ; Humans ; Hypertension, Portal/drug therapy* ; Liver Cirrhosis/surgery* ; Medicine, Chinese Traditional/adverse effects* ; Portal Vein ; Risk Factors ; Splenectomy/adverse effects* ; Venous Thrombosis/etiology*

Pseudocirrhosis refers to a condition that shows changes in hepatic contour that mimic cirrhosis radiographically in the absence of the typical histopathological findings of cirrhosis. This condition has been observed in patients with cancer metastatic to the liver, both in those who have undergone prior systemic chemotherapy and those who have not. Pseudocirrhosis may cause difficulty in interpretation of the response to chemotherapy and hepatic decompression and complication of portal hypertension have a negative effect on the prognosis. We report on a case of breast cancer with liver metastases that showed cirrhotic changes during disease progression. Progression of liver metastases was confirmed by F18 fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT). We also performed ultrasound-guided liver biopsy and confirmed tumor infiltration with severe desmoplastic fibrosis. This case suggests the pathogenesis of pseudocirrhosis through histopathological findings and the role of PET-CT in evaluation of the response to chemotherapy in patients with pseudocirrhosis.
Biopsy ; Breast Neoplasms* ; Breast* ; Decompression ; Disease Progression ; Drug Therapy* ; Electrons ; Fibrosis ; Humans ; Hypertension, Portal ; Liver* ; Neoplasm Metastasis* ; Prognosis

Pseudocirrhosis refers to a condition that shows changes in hepatic contour that mimic cirrhosis radiographically in the absence of the typical histopathological findings of cirrhosis. This condition has been observed in patients with cancer metastatic to the liver, both in those who have undergone prior systemic chemotherapy and those who have not. Pseudocirrhosis may cause difficulty in interpretation of the response to chemotherapy and hepatic decompression and complication of portal hypertension have a negative effect on the prognosis. We report on a case of breast cancer with liver metastases that showed cirrhotic changes during disease progression. Progression of liver metastases was confirmed by F18 fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT). We also performed ultrasound-guided liver biopsy and confirmed tumor infiltration with severe desmoplastic fibrosis. This case suggests the pathogenesis of pseudocirrhosis through histopathological findings and the role of PET-CT in evaluation of the response to chemotherapy in patients with pseudocirrhosis.
Biopsy ; Breast Neoplasms* ; Breast* ; Decompression ; Disease Progression ; Drug Therapy* ; Electrons ; Fibrosis ; Humans ; Hypertension, Portal ; Liver* ; Neoplasm Metastasis* ; Prognosis

Portal hypertension, as one of the major complications of liver cirrhosis, is a common clinical syndrome characterized by an increased portal pressure and the formation of portal-systemic collaterals. Currently no ideal therapeutic agent has been available for portal hypertension. Sorafenib is an oral tyrosine kinase inhibitor that has been shown to significantly improve blood flow dynamics, inhibit angiogenesis, reduce liver fibrosis and decrease portal pressure in the treatment of portal hypertension. The authors review the progress in the research of sorafenib in the treatment of portal hypertension and the mechanisms of its actions.
Animals ; Humans ; Hypertension, Portal ; drug therapy ; Niacinamide ; analogs & derivatives ; pharmacology ; therapeutic use ; Phenylurea Compounds ; pharmacology ; therapeutic use

OBJECTIVETo observe the effect of sodium ferulate on the hemodynamics of hepatic cirrhosis patients.

METHODSEighty-two hepatic cirrhosis patients were randomly assigned to two groups, the 27 patients in the control group were treated by conventional liver protecting therapy, and the 55 patients in the treated group were treated with sodium ferulate besides the conventional therapy. The therapeutic course for both groups was two weeks. The following indexes were measured before treatment and two weeks after treatment respectively: inner diameter of portal vein (PV), inner diameter of splenic vein (SPV), maximum portal vein flow rate (PVX), maximum splenic vein flow rate (SPVX), portal vein blood flow (QPV) and endothelin-1 (ET-1) concentration. The adverse effect was observed meanwhile.

RESULTSIn the treated group after treatment, levels of PV, SPV and ET-1 decreased (P < 0.01), PVX and SPVX increased significantly (P < 0.01), but QPV was unchanged; while no significant change of all the indexes was found in the control group (P > 0.05). Further analysis showed that in the treated group, PV, SPV and ET-1 decreased significantly in patients of Child grade A and B (P <0. 01), but QPV changed insignificantly (P > 0.05, and all indexes were unchanged in patients of Child grade C (P > 0.05).

CONCLUSIONSodium ferulate can effectively lower the pressure of portal vein in hepatic cirrhosis patients without any influence on the blood flow of portal vein, the effect is more significant on patients of Child grade A and B.

Adult ; Aged ; Coumaric Acids ; therapeutic use ; Female ; Hemodynamics ; drug effects ; Humans ; Hypertension, Portal ; drug therapy ; physiopathology ; Liver Cirrhosis ; drug therapy ; physiopathology ; Male ; Middle Aged ; Treatment Outcome

Female ; Humans ; Hypertension, Portal ; drug therapy ; etiology ; Liver Cirrhosis ; complications ; drug therapy ; Male ; Tetrazoles ; therapeutic use ; Valine ; analogs & derivatives ; therapeutic use ; Valsartan

We describe a case of systemic sclerosis (SSc) complicated with portal hypertensive ascites which did not improve with diuretics and ascitic drainage. When corticosteroid added, her ascites diminished dramatically. Though portal hypertension can be imputed to other causes, such as polycystic liver in this case, it can occur in limited SSc with positive anti-centromere antibody and respond to corticosteroid treatment.
Adrenal Cortex Hormones ; therapeutic use ; Aged ; Female ; Humans ; Hypertension, Portal ; diagnostic imaging ; drug therapy ; Radiography ; Scleroderma, Systemic ; diagnostic imaging ; drug therapy