慈菇消脂丸对NF-κB介导的非酒精性脂肪肝病大鼠肝细胞凋亡的干预作用

目的通过观察慈菇消脂丸对高脂饮食诱导非酒精性脂肪肝病(NAFLD)大鼠肝细胞凋亡相关调控基因核转录因子κB(NF-κB)、B细胞淋巴瘤-2基因(Bcl-2)、Bcl-2相关X蛋白(Bax)表达的影响,探讨解毒化痰法治疗NAFLD的作用机制。方法 60只SPF级健康雄性Wistar大鼠,随机分为6组:正常对照组,模型组,慈菇消脂丸高、中、低剂量组,盐酸吡格列酮组,每组10只。采用高脂饮食喂饲大鼠建立NAFLD模型后,连续药物治疗6周。给药结束后,处死全部动物,取肝脏和血清。全自动生化分析仪检测各组大鼠肝功、血脂;HE染色观察肝脏的组织形态学特点;透射电子显微镜观察肝细胞的超微结构;Western Blot技术检测肝组织NF-κB、Bcl-2、Bax的表达。结果与正常组比较,模型组大鼠血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白(LDL-C)水平升高(P0.01);肝组织呈中重度脂肪变性并同时伴有肝细胞凋亡;肝组织中NF-κB、Bax蛋白表达增强(P0.01),Bcl-2蛋白表达减低(P0.01),Bcl-2/Bax比值降低(P0.01)。与模型组比较,慈菇消脂丸各剂量组大鼠血清ALT、AST、TG、TC水平降低(P0.01);肝组织NF-κB、Bax蛋白表达减低(P0.01),Bcl-2蛋白和Bcl-2/Bax比值升高(P0.05)。与盐酸吡格列酮组比较,慈菇消脂丸高剂量下调NF-κB蛋白、上调Bcl-2蛋白表达的作用更显著(P0.01)。结论慈菇消脂丸能够明显改善NAFLD大鼠肝功及血脂;上调Bcl-2蛋白表达,降低NF-κB、Bax蛋白表达,使Bcl-2/Bax比值升高,从而抑制肝细胞凋亡,起到防治NAFLD的作用。     

双环醇对实验性非酒精性脂肪肝大鼠的防治作用

目的探讨双环醇对非酒精性脂肪肝大鼠的防治作用。方法采用高脂饲料饲养制备非酒精性脂肪肝大鼠模型,同时给予不同剂量双环醇治疗,通过检测血清肝酶谱丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、碱性磷酸酶（ALP）、转肽酶（GGT）,血脂,肝组织匀浆三酰甘油含量和肝脏组织学变化,观察不同剂量双环醇对非酒精性脂肪肝大鼠的防治作用。结果模型组大鼠肝脏出现明显的脂肪变性,肝酶活性（AST、ALP、GGT）,血脂和肝组织三酰甘油含量升高;双环醇各剂量组肝细胞脂肪变显著减轻,肝酶活性（AST、ALP、GGT）、血脂和肝组织三酰甘油含量较模型组显著下降。结论双环醇对非酒精性脂肪肝具有良好的防治作用。     

脂肪肝肝脂与血脂的相关性研究

目的:探讨非酒精性脂肪肝的发病机制,分析肝脂与血脂的相关性。对几种生化和免疫测定脂质的检验方法进行分析比较,评价和筛选有效的检验方法,使血液检测分析成为脂肪肝诊断的重要指标,并为脂肪肝研究和抗脂肪肝药物开发提供依据。方法:建立大鼠非酒精性脂肪肝模型后,采血后处死大鼠,摘取肝脏。观察肝组织病理的同时检验血脂和肝脏脂肪的多项生化指标。对几种生化和免疫测定脂质的方法进行分析比较。结果:模型组与正常组比较的大鼠肝脏细胞发生脂肪变性。大鼠血脂和肝组织中检测的TG、TC、HDL-C、ALT、AST、GGT有不同程度增高(P<0.01),其中TG含量明显升高(P<0.001),与光镜下观察结果一致。肝脏细胞发生脂肪变性的同时肝脏脂质、血脂和肝功能酶类升高,血脂与肝脂的变化呈正相关,肝功能酶类变化也呈正相关。结论:高脂饮食饲养大鼠血脂和肝脂含量可不同程度地增高,具备人类脂肪肝特征,符合人类脂肪肝的演变过程。肝脂、血脂含量分析是非酒精性脂肪肝研究的关键性指标,对脂肪肝明确诊断有特殊意义。     

甘氨酸对非酒精性脂肪肝小鼠瘦素水平的影响

目的 甘氨酸对非酒精性脂肪肝小鼠瘦素(leptin)水平的影响.方法 健康成年雄性昆明种小鼠40只,随机分4组:对照组、高脂模型组、甘氨酸(Gly)低剂量组、甘氨酸高剂量组,各组分别给予正常饲料和高脂饲料喂养2周,甘氨酸各剂量组隔日腹腔注射不同浓度Gly溶液.实验末,取肝组织观察小鼠非酒精性脂肪肝的形成,酶联接免疫法测定小鼠血清中leptin水平.结果 光镜下高脂模型组肝组织可见弥漫性脂肪变性,甘氨酸各剂量组肝组织脂肪变性少,肝细胞内脂滴小且少,高脂模型组和甘氨酸各剂量组leptin水平明显大于对照组,甘氨酸各剂量组leptin水平显著高于高脂模型组,甘氨酸高、低剂量组之间leptin含量无显著性差异.结论 Gly对非酒精性脂肪肝形成有抑制作用,明显升高血中leptin水平可能是其作用机制之一.     

脂肝泰胶囊对高脂血症性脂肪肝大鼠肝脏形态学改变的影响

目的 观察脂肝泰胶囊对大鼠高脂血症性脂肪肝肝脏形态学改变的影响,为临床治疗高脂血症性脂肪肝提供实验依据。方法 采用高脂饮食喂饲大鼠复制脂肪肝模型,实验分组为模型组、脂肝泰高剂量组、脂肝泰低剂量组、东宝肝泰对照组和正常对照组。以高、低剂量脂肝泰和东宝肝泰进行干预,各组大鼠肝脏取材,常规HE染色,光镜观察。结果 模型组肝细胞索结构不清,多数肝细胞内可见大小不等、数量不一的脂滴空泡,呈现中至重度脂肪变性;脂肝泰胶囊治疗组大鼠肝小叶和肝血窦结构清晰,细胞内无明显脂滴空泡。结论 脂肝泰胶囊能有效地防治高脂血症性脂肪肝。     

清脂软胶囊对实验性高脂模型大鼠脂肪肝变性程度及对血脂水平的影响

目的 观察清脂软胶囊对高脂模型大鼠脂肪肝的病变程度及对血脂水平的影响.方法 SD大鼠灌胃高胆固醇脂肪乳剂以制备大鼠高血脂模型,以清脂软胶囊为治疗组,血脂康为阳性对照组,观察实验动物治疗3周后血清总胆固醇、总甘油三酯、高、低密度脂蛋白水平及动脉粥样硬化指数,同时显微镜下观察肝脏脂肪变性程度,进行统计学分析.结果 与模型对照组比较,清脂软胶囊二个剂量组(150、75 mg/kg)对高脂模型大鼠血清总胆固醇、总甘油三酯水平具有显著的降低作用(P＜0.05);对高密度脂蛋白有一定的升高作用,但无显著性差异(P＞0.05);大剂量组有降低低密度脂蛋白的作用;同时,清脂软胶囊组动脉硬化指数显著低于模型对照组(P＜0.01).肝脏病理结果显示,清脂软胶囊可以减轻高脂模型大鼠肝脏脂肪病变的程度.结论 清脂软胶囊可以调节高脂模型大鼠血脂水平,降低动脉硬化指数,减轻模型大鼠脂肪肝的病变程度.     

白藜芦醇对非酒精性脂肪肝大鼠的作用机制研究

目的:;探讨白藜芦醇对非酒精性脂肪肝大鼠的分子机制。方法:;实验分组:正常对照组;模型组;白藜芦醇低剂量组;白藜芦醇高剂量组。正常SD大鼠高脂饲养8周,复制大鼠非酒精性脂肪肝模型,组织病理学观察,Realtime PCR检测氧化及凋亡相关基因,血清生化检测。结果:; 白藜芦醇治疗组和模型组比较,形态学显示治疗组肝肌细胞变性坏死明显减轻;氧化应激相关指标SOD1活性增高;均有显著性差异(P<0.05)。 结论:;白藜芦醇调控氧化应激相关基因表达,减轻肝细胞的脂质过氧化损伤,改善肝脏功能。      

卡托普利对非酒精性脂肪肝的防治作用及氧化应激的影响

目的 观察卡托普利对大鼠非酒精性脂肪肝的作用及其氧化应激的影响.方法 将78只雄性SD大鼠随机分为6组,正常组给予普通饲料;其余组(包括模型组)给予高脂饲料,造模6周后,将卡托普利高、中、低剂量组和罗格列酮组分别给予等体积高、中、低剂量卡托普利和罗格列酮;给予正常组和模型组等体积蒸馏水,6周后取血做血生化检测及丙二醛(MDA)、谷胱甘肽(GSH)测定;取肝脏称重,计算肝脏指数;取相同部位的肝组织匀浆测总胆固醇(TC)、三酰甘油(TG);另取肝组织同定做病理检查;其余液氮固定测定 CYP2E1 mRNA.结果 模型组谷丙转氨酶(ALT)、谷草转氨酶(AST)、TG、TG、MDA、肝指数、CYP2E1 mRNA表达水平均增高,GSH含量下降;卡托普利高剂量组ALT、AST、TC、 TG、MDA、肝指数、CYP2E1 mRNA表达水平均降低(P＜0. 05),GSH含量升高(P＜0. 05).肝脏病理学检查显示模型组可见肝细胞广泛发生脂肪变性及炎症反应,卡托普利高剂量组肝细胞脂肪变性与炎症程度明显减轻.结论 卡托普利可增强抗氧化应激能力,减轻肝细胞脂肪变性,对非酒精性脂肪肝有一定的防治作用.     

脂易消对NAFLD大鼠肝组织ChREBP m RNA表达的影响

目的:观察脂易消对实验性非酒精性脂肪性肝病 (NAFLD) 大鼠肝组织碳水化合物反应元件结合蛋白 (ChREBP)m RNA 表达的影响。方法:采用高脂饮食制备 NAFLD 大鼠模型,分低、中、高剂量脂易消治疗组、易善复胶囊阳性对照组、模型对照组、正常对照组。显微镜下观察 HE 染色后各组肝细胞脂肪变性及肝组织炎性改变情况 ;使用 RT-PCR 法检测各组大鼠肝组织 ChREBP m RNA 的水平。结果:实验结束时模型组体重指数 (BMI) 明显增高,与正常组比较差异有显著统计学意义 ( P 0.01) ;而与模型组相比,脂易消各剂量组及易善复组肝指数明显降低,差异有统计学意义 ( P 0.05) ;但高、中、低剂量组与易善复组比较差异均无统计学意义 ( P 0.05)。光镜观察显示正常对照组没有发生脂肪变性及炎性浸润;模型组总体肝组织脂肪变性程度与正常组肝组织相比有显著的差异。脂易消组肝组织发生弥漫性肝细胞脂肪变性及轻微的炎性浸润,程度轻于模型组。易善复组肝组织炎性改变程度与脂易消组比较没有明显的差异。结论:脂易消能改善肝细胞脂肪性变及肝组织炎性病变,提高肝组织 ChREBP m RNA 表达水平,对高脂饮食引起的 NAFLD 有治疗作用,具有与易善复相似的疗效。     

脂易消对非酒精性脂肪肝炎大鼠肝组织APNmRNA的调控

[目的]观察脂易消对实验性非酒精性脂肪性肝炎(NASH)大鼠肝组织脂联素(APN)mRNA表达的影响,探讨脂易消治疗NASH的作用机理。[方法]采用高脂饮食制备NASH大鼠模型,分低、中、高剂量脂易消治疗组、易善复胶囊阳性对照组、生理盐水阴性对照组、正常对照组。酶法检测大鼠血清中肝功能ALT、AST水平;肝组织常规HE染色,观察肝细胞脂肪变性、炎症活动程度;采用RT-PCR法检测大鼠肝脏中APN mRNA的表达水平。[结果]脂易消各治疗组大鼠血清ALT、AST水平与模型组比较差异有统计学意义(P0.01,P0.05);肝细胞炎症活动度皆有明显改善(P0.05);肝组织APN mRNA表达明显增强(P0.01,P0.05);但与易善复组相比,各剂量治疗组则无显著性差异(P0.05)。[结论]脂易消通过改善肝细胞炎症活动度,减轻肝组织损伤,同时增强肝组织APN表达水平,对高脂饮食诱发的NASH有治疗作用,其疗效与易善复相似。其治疗非酒精性脂肪性肝炎的途径可能与脂易消提高肝组织APN表达水平有关。     

Liver

Alleviation of ischemia-reperfusion injury in rat liver donors by induction of exogenous hTERT gene;Effects of surgical technique on acute renal failure after orthotopic liver transplantation in patients with end-stage liver disease at high risk： a report of 90 eases;Timing for liver transplantation for chronic severe hepatitis;Analysis of bacterial variance and drug resistance after orthotopic liver transplantation;The influence of splenectomy on orthotopic liver transplantation and its management     

Liver

<正>209461 Intraoperative ligation of recipient’s portasystemic shunt in liver transplantation/Chen Litian(,Organ Transplant Center,Tianjin 1st Centr Hosp Tianjin 300192)…∥Chin J Gen Surg.-2009,25(4).-489～491Objective To investigate the clinical significance of ligating the portasystemic shunt confirmed by preoperative CT evaluation during orthotopic liver transplantation.Methods From January 2007 to August 2008,35 patients in Tianjin First Central Hospital underwent preoperative three-dimensional CT scan,among them 23 patients had spontaneous major portasystemic shunts,the other 12 patients did not have portasystemic shunts.16 out of the 23 cases with significant shunts underwent shunt ligation based on portal blood flow volume measured by intraoperative portal vein flowmetry.The shunt of the other 7 patients were left untreated.Results The portal blood flow in the 12 patients without portasystemic shunt judged by preoperative CT scanning were(1 101±70)ml/min.The shunts in 7 patients with portal blood flow greater than 1 000 ml/min were not ligated,that of the 16 patients with portal blood flow volume lower than 1 000 ml/min were ligated.The portal blood flow volume in those 16 patients before and after ligating the shunt were(657±112)ml/min and(1 136±161)ml/min,respectively(P<0.05).Postoperatively 2 patients suffered from portal vein thrombosis,among them 1 patients suffered from intermittent disturbance of consciousness,2 patients died within 3 months,with one died of respiratory failure from pulmonary aspergillus infection,one died of hepatic failure in 2 months after operation because of graft dysfunction.The other 19 patients with normal blood flow and well-functioning graft were alive.Conclusion The ligation of portasytemic shunt is mandatory in patients when pretransplant CT evaluation showing a major porto-systemic shunts and portal blood flow volume was less than 1 000 ml/min.5 refs,2 figs.     

Liver

<正>209293 Probing into indication of living-related Liver Transplantation for Wilson’s disease/Cheng Feng(Liver Transplant Center,1st Hosp Nanjing Med Univ,Key Lab Living Donor Liver Transplant,Minist Public Health,Nangjing 210029)…∥Chin J Surg.-2009,47(6).-437~440Objective To probe into indication of living-related liver transplantation(LRLT)for Wilson’s Disease.Methods From January 2001 to February 2007,thirty-seven living-related liver transplants were performed.A retrospective analysis was carried on outcome of those patients.The indications for LRLT were acute hepatic failure in 3 patients and chronic advanced liver disease in 32 patients including 13 patients with Wilsonian neurological manifestations.Two patients presented with severe Wilsoian neurological manifestations even though their liver functions were stable.According to the scoring system for evaluation of the neurological impairment in Wilsion disease based on neurological signs and functions(total score was 30),the pre-transplantation score of those patients with neurological manifestations was 15.9±4.3(n=15).Results Thirty-seven patients were followed up for 20-93 months.The survival rates of post-transplant patients and grafts at 1,3,and 5 year were 91.9%,83.8%,75.7%,and 86.5%,78.4%,75.7%,respectivly.Postoperative surgical complications occurred in 2 donors with bile leakage required drainage,in 2 recipients with hepatic thormbosis underwent retransplantation of cadeveric liver and in 1 recipient with hepatic stenosis required balloon dilatation.Neurological function was improved in all recipients and the score of posttransplantation at 6,12,18,24,and 30 months was 17.5±3.7(n=13);21.0±4.3(n=12);23.9±3.9(n=10);26.6±2.2(n=10)and 28.1±1.9(n=7)respectively.Conclusion Patients with acute hepatic failure or patients with severe liver disease unresponsive to chelation tratment should be treated with LRLT.Early transplantation in patients with an unsatisfactory response medical tratment may prevent irreversible neurologica     

Liver

Prevention and treatment of artery complication after liver transplantation by HBO , Clincal feature of cytomegabvirus pneumonia in orthtopic liver-transplantation and treatments, Risk factors of diabetes mellitus following orthotopic liver transplantation , Re-infection of hepatitis B virus after liver transplantation , Diagnosis and treatment of fungal infection after orthotopic liver transplantation , Two successful adult-to-adult living donor liver transplantation using dual grafts     

Liver

<正>209604 The suppressive effect of CD8+ CD28-regulatory T cells from spontaneous tolerance models on the acute rejection responses in rat liver transplantation/Chen Ning(陈宁,Dept Gastroenterol,Peking Univ Peop Hosp,Beijing 100044)…∥Chin J Organ Trans-plant. -2009,30(9). -524 ～526     

Liver

<正>209087 Clinical analysis of outcome of invasive fungal infection after kidney transplantation/Chen Guodong(陈国栋,Dept Transplant Surg,1st Hosp,Sun Yat sen Univ, Guangzhou 510080)…∥Chin J Organ Transplant. -2009, 30(10). -616～619 Objective To explore the outcome of invasive fungal infection in kidney transplantation and the influencing factors.     

探讨脂肪肝供肝在肝脏移植中的价值

目的探讨应用不同脂肪沉着程度供肝对肝移植患者预后的影响。方法选取64例进行肝移植术患者,依据供肝浸润程度,随机分为轻度脂肪肝组、中度脂肪肝组、重度脂肪肝组、无脂肪肝组共四组,每组各16例,比较四组患者肝功能(主要观察ALT、AST指标)、入住ICU的平均时间、1年移植物成活率、移植物原发无功发生率。结果轻度脂肪肝组入住ICU的平均时间、ALT和AST水平、移植物原发无功发生率与无脂肪肝组接近;中度脂肪肝组入住ICU平均时间、ALT和AST水平均较轻度组和无脂肪肝组明显增高,P0.05;重度脂肪肝组入住ICU平均时间、ALT和AST水平、移植物原发无功发生率明显较前三组为高,P0.05。结论轻、中度肝脏脂肪浸入可作为肝移植供肝,重度脂肪肝不能作为供肝的选择目标。     

Microenvironment of Liver Regeneration in Liver Cancer

The occurrence and development of liver cancer are essentially the most serious outcomes of uncontrolled liver regeneration. The progression of liver cancer is inevitably related to the abnormal microenvironment of liver regeneration. The deterioration observed in the microenvironment of liver regeneration is a necessary condition for the occurrence, development and metastasis of cancer. Therefore, the use of a technique to prevent and treat liver cancer via changes in the microenvironment of liver regeneration is a novel strategy. This strategy would be an effective way to delay, prevent or even reverse cancer occurrence, development and metastasis through an improvement in the liver regeneration microenvironment along with the integrated regulation of multiple components, targets, levels, channels and time sequences. In addition, the treatment of "tonifying Shen (Kidney) to regulate liver regeneration and repair by affecting stem cells and their microenvironment" can regulate "the dynamic imbalance between the normal liver regeneration and the abnormal liver regeneration"; this would improve the microenvironment of liver regeneration, which is also a mechanism by which liver cancer may be prevented or treated.     

化肝汤1号治疗酒精性肝纤维化症状及肝功能改变

目的观察活血化瘀、软坚散结药配伍治疗肝纤维化时对患者主、次症状改变及肝功能的影响。方法将确诊为酒精性肝纤维化患者90例,随机分为三组,治疗组采用自制方剂化肝汤1号(醋鳖甲、黄芩、柴胡、赤芍等),对照组1采用凯西莱治疗,对照组2采用化肝汤1号和凯西莱联合治疗,疗程3个月。观察三组患者治疗前后主、次症状改善情况,血清天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、γ谷氨酰转肽酶(γ-GT)变化。结果三组治疗后的临床疗效比较差异无统计学意义(H=2.5897,P>0.05)。三组治疗后肝功能指标均有改善,与治疗前比较,差异有统计学意义(P<0.05)。结论化肝汤1号可有效地降低肝细胞的损害程度,促进受损细胞修复,从而改善肝功能。