绞股蓝总皂苷对四氯化碳诱导大鼠肝纤维化的防治作用

目的:观察绞股蓝总皂苷对四氯化碳( CCl4)诱导的大鼠肝纤维化的防治作用.方法:采用CCl4诱导的大鼠肝纤维化模型,分为正常组(Z,n=6)、模型组(M,n=8)、绞股蓝总皂苷组(J,n=8)、秋水仙碱(Q,n=8).造模6周末开始给药(股蓝总皂苷200mg/kg体重、秋水仙碱0.1mg/kg体重),给药3周.观察:①大鼠体重、肝脾比值的变化;②血清丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)活性、白蛋白( Alb)、总胆红素(TBil)含量、肝组织羟脯氨酸(Hyp)含量;③肝组织超氧化物歧化酶(SOD)活性及丙二醛(MDA)、还原型谷胱甘肽(GSH)、谷胱甘肽过氧化物酶(GSH-Px)含量;④肝组织病理及胶原沉积情况.结果:①M组大鼠血清ALT、AST、GGT、TBil显著升高,Alb显著降低;J和Q组大鼠血清ALT、AST、GGT、TBil显著下降,Alb显著升高;②M组大鼠肝组织Hyp含量显著升高,J组及Q组大鼠肝组织Hyp含量显著下降;③肝组织HE染色显示:M组大鼠肝细胞脂肪变性,大量纤维结缔组织增生,假小叶形成.J组及Q组大鼠肝细胞脂肪变性减轻,纤维增生减少,少见完整假小叶结构.天狼星红染色显示:M组大鼠肝窦周胶原沉积明显,形成较厚汇管区和中央静脉间的纤维间隔,J组和Q组大鼠肝脏汇管区胶原纤维染较M组明显减轻;④M组大鼠肝组织SOD活性及GSH含量明显降低,MDA含量显著升高.J组大鼠肝组织SOD活性显著提高.结论:绞股蓝总皂苷具有显著抗CCl4诱导的大鼠肝纤维化及氧化损伤的作用.     

鸭乙型肝炎肝纤维化模型的初步研究

目的研制乙型肝炎肝纤维化的动物模型.方法采用1d龄樱桃谷鸭,随机分为正常组、鸭乙型肝炎病毒(DHBV)造模组及CCl4造模组,分别于60、100及112d随机抽样观察两造模组鸭肝组织病理变化,于100d检测3组动物肝组织DHBV、DNA、肝功能和肝纤维化指标.结果CCl4造模组脂肪变性明显,肝细胞水样变性伴中等炎性细胞浸润,纤维组织增生明显;DHBV造模组以水样变性为主,可见肝窦消失或肝窦扩张瘀血,脂肪变性以小脂滴为主,肝细胞坏死程度较轻,但炎性细胞浸润明显,且以淋巴细胞多见,纤维增生形成时间略长,60d尚未见纤维增生,80d时汇管区纤维组织中度增生,100d和112d时纤维组织明显增生,有的形成假小叶,其纤维化形成率与CCl4组(90%)接近(100d为60.7%,112d为87.5%).肝组织DHBVDNA检测结果,DHBV造模组水平较高,其肝功能ALT正常,白蛋白明显降低,球蛋白显著升高,肝纤维化指标如HA、PCⅢ和肝组织Hyp均明显上升.结论采用DHBV阳性血清反复攻击樱桃谷鸭112d以上,可复制形成率较高的鸭乙型肝炎肝纤维化模型.     

姜黄素对实验性肝纤维化大鼠肝脏bax和bcl-2表达的影响

[目的]探讨姜黄素(curcumin,CUR)对大鼠肝纤维化的防治作用及对肝组织bax和bcl-2蛋白及基因表达的影响.[方法]建立CCl4致大鼠实验性肝纤维化模型.用免疫组化法比较正常组、模型组以及CUR组的bcl2、bax蛋白的表达,用RT-PCR法比较各组肝组织bcb-2、bax mRNA的表达.[结果]CUR组肝组织炎症和纤维化程度较模型组显著减轻.bax蛋白主要表达在肝细胞质,而纤维间隔及汇管区呈低表达;beb-2主要表达在纤维间隔及汇管区.bax及bcl-2在模型组及CUR组表达均高于正常组(P<0.01),CUR组均较模型组降低(P<0.01).bax及bcI-2 mRNA在模型组及CUR组表达比正常组增高(P<0.01,<0.05),CUR组均较模型组降低(P<0.05).[结论]CUR可能通过降低肝细胞表达bax、减少肝细胞凋亡而减轻肝脏损伤,通过降低bcl-2表达、诱导肝星状细胞凋亡发挥减轻肝纤维化的作用,防治大鼠肝纤维化.     

IL-10对实验性肝纤维化大鼠基质金属蛋白酶-2影响的研究

目的研究IL-10对实验性肝纤维化大鼠基质金属蛋白酶-2(MMP-2)的影响.方法建立大鼠肝纤维化模型并行IL-10干预实验,从正常大鼠(N组)和CCl4诱导肝纤维化大鼠(C组)及IL-10干预肝纤维化大鼠(E组)中取肝脏组织,采用S-P免疫组织化学方法检测分析不同组大鼠肝脏组织中MMP-2的表达状况.结果N组MMP-2阳性染色偶见于窦内皮细胞及肝细胞的胞浆;C组MMP-2阳性染色多见于汇管区新生的胆管细胞及纤维隔内条索状的成纤维细胞,26例标本中阳性13例,强阳性8例.第5周开始MMP-2有阳性表达,第9周阳性表达明显增强;E组MMP-2阳性染色明显减少,多见于汇管区的新生胆管细胞,27例标本中阳性10例,强阳性1例.Redit分析表明3组间MMP-2阳性表达有显著性差异(P＜0.01).结论MMP-2随着大鼠肝纤维化进展阳性表达升高,IL-10对CCl4诱导的大鼠肝纤维化具有保护作用,可明显抑制纤维化的生成和沉积.     

胆管上皮细胞增生在胆管结扎大鼠胆汁性肝纤维化形成中的作用

目的 研究胆管上皮细胞(biliary epithelia cells,BECs)增生在胆管结扎(bile duct ligation,BDL)大鼠胆汁性肝纤维化形成中的作用.方法 BDL的方法制作大鼠胆汁性肝纤维化模型,5周后杀鼠取材,观察内容包括大鼠血清总胆红素(TBlL)、总胆汁酸(TBA),肝组织羟脯氨酸(Hyp)含量,组织病理学,免疫组织化学观测Ⅰ型胶原(Col Ⅰ)、Ⅳ型胶原(Col Ⅳ)、层粘蛋白(LN)、纤连蛋白(FN)和α-平滑肌肌动蛋白(α-SMA);肝组织片激光显微切割(LCM)获取BECs,实时荧光定量PCR检测BECs表达Procollagen α1(Ⅳ)、血小板衍生生长因子B(PDGF-B)、结缔组织生长因子(CTGF)及转化生长因子β1(TGF-β1)mRNA.结果 1、胆管结扎模型大鼠血清TBiL和TBA含量均值分别为假手术组大鼠的22倍和3倍(P＜0.01);模型组大鼠肝组织Hyp含量是假手术组的4倍(P＜0.01);2、模型组大鼠BECs增生非常显著,肝实质细胞比例显著减少;3、模型组大鼠在增生胆管周围的LM表达显著增加;FN不但在肝窦内有阳性染色,还强烈地表达于增生的胆管周围;肝窦壁的Col Ⅰ阳性染色增强,增殖的BECs周围未见明显阳性染色;肝窦壁ColⅣ表达未见明显变化,但强烈表达于增殖的BECs周围的基底膜上;α-SMA阳性染色见于汇管区周围的肌成纤维细胞上,且这些肌成纤维细胞常常围绕在增生的胆管上皮细胞周围.4、模型组大鼠BECs的Procol α1(Ⅳ)、PDGF-B、TGF-β1及CTGF的mRNA表达量均显著增加(与假手术组比较,均为P＜0.001).结论 BECs增生是BDL大鼠胆汁性肝纤维化的启动因素和中心病理环节,抑制胆管上皮细胞的异常增生及其细胞生物学病理变化应是抗胆汁性肝纤维化治疗学研究的主要目标.     

不同浓度CCl4注射联合饮用乙醇诱导大鼠肝硬化模型研究

目的 探索不同浓度CCl4联合饮用乙醇制备大鼠肝硬化模型,寻求最佳的药物和乙醇浓度。方法 取90只SD大鼠, 分为对照组10只和实验组A组、B组、C组和D组,每组20只,给予不同浓度的CCl4油溶液腹腔注射,同时以不同浓度的乙醇溶液为饮用水,制备肝硬化模型。结果 在实验12 w末,A组大鼠死亡10只, B组死亡8只,C组死亡4只,D组死亡5只;实验A组肝细胞走向紊乱,纤维组织增生,纤维间隔形成。有假小叶形成,肝细胞大小不一,呈点灶状坏死,肝细胞凋亡、再生,汇管区内炎细胞浸润;B组与A组变化相似;C组肝细胞走向紊乱,纤维间隔形成,但无假小叶形成,肝细胞脂肪变性,纤维组织增生,肝细胞凋亡,汇管区内炎细胞浸润;D组与C组表现类似。结论 适当浓度的CCl4油溶液结合乙醇溶液为饮用水诱导大鼠肝硬化模型可显著提高造模成功率。     

四氯化碳诱导的肝纤维化大鼠肝窦毛细血管化的形成

目的：观察四氯化碳（CCl4）诱导的大鼠肝纤维化过程中肝窦毛细血管化的形成过程,探讨其与肝纤维化的关系。方法32只清洁级雄性SD大鼠,随机分为正常对照组,肝纤维化模型组,正常对照组大鼠腹腔注射0．9％氯化钠溶液2 mL/kg ,模型组大鼠腹腔注射50％ CCl4-蓖麻油混合液2 mL/kg ,每周2次,共8周;分别于造模第2、4、6、8周处死大鼠,观察肝组织炎症及纤维化程度,放射免疫法检测血清中透明质酸（HA）的含量,透射电镜观察肝窦窦壁结构,S-P 免疫组织化学检测各组大鼠肝组织CD31、层黏连蛋白（LN）、IV型胶原（Col-IV）的表达。结果肝脏组织学证实CCl4诱导的大鼠肝纤维化模型构建成功,6周可见纤维间隔形成;透射电镜显示,CCl4诱导2周时,部分肝窦内皮细胞（liver sinusoidal endothelial cells ,LSEC）窗孔减少,内皮下未见基底膜（Basement membrane,BM）,随着造模的进程,LSEC 窗孔进一步减少,部分甚至消失,第6、8周时局部肝窦内皮下形成连续的BM。同时,随着肝纤维化的进程,HA浓度逐渐升高,肝窦内皮细胞表面标志物CD31及基底膜主要成分Col-IV、LN表达逐渐增强。结论在CCl4诱导大鼠肝纤维化过程中,肝窦毛细血管化是逐渐形成的,LSEC失窗孔早于纤维间隔的形成,而肝窦内皮下基底膜出现在纤维间隔形成以后。     

川芎嗪对肝硬化大鼠瘦素及其受体表达的干预作用

瘦素与肝纤维化关系密切，但其在肝硬化形成过程中的作用机制不明。目前使用的抗肝硬化药物疗效均不满意。目的：观察瘦素及其功能性受体（Ob-Rb）在大鼠肝硬化形成过程中的表达变化，以及川芎嗪对两者表达的干预作用，探讨川芎嗪抗肝纤维化的作用机制。方法：诱导CCl4大鼠肝纤维化模型。川芎嗪预防组和治疗组分别于实验第1d和第31d开始予川芎嗪每天10mg／100g体重干预。于12周内分批处死各组大鼠。以逆转录聚合酶链反应（RT-PCR）检测肝组织瘦素和Ob-RbmRNA表达，以免疫组化方法检测瘦素和Ob-Rb的表达和定位，同时行血清透明质酸（HA）水平检测和肝内胶原定量分析。结果：正常肝组织中有少量瘦素和Ob-RbmRNA表达，随着肝硬化的形成，两者表达逐渐增加，与血清HA水平和肝内胶原含量呈正相关。肝硬化模型组汇管区、纤维间隔、小叶内血管、胆管、肝窦周围瘦素和Ob-Rb表达明显增加，表达强度从第3～12周呈递增趋势。川芎嗪预防组和治疗组瘦素和Ob。Rb及其mRNA表达均低于肝硬化模型组，两组血清HA水平和肝内胶原含量亦显著低于肝硬化模型组。结论：瘦素和Ob-Rb在肝硬化形成过程中发挥重要作用。川芎嗪能下调CCl4肝纤维化大鼠肝组织瘦素和Ob-Rb的表达，这可能是其抗肝纤维化的作用机制之一。     

荔枝核总黄酮对肝纤维化大鼠肿瘤坏死因子相关凋亡诱导配体表达的影响

[目的]研究荔枝核总黄酮(TFL)与胆管阻塞性肝纤维化大鼠肿瘤坏死因子相关凋亡诱导配体(TRAIL)表达的关系以及TFL抗肝纤维的作用。[方法]雄性SD大鼠60只,随机分为3组:假手术组、模型组及TFL给药组,除假手术组外其他大鼠采用胆总管结扎制备肝纤维化大鼠模型。TFL给药组给予TFL200 mg/(kg.d)灌胃,4周后处死所有大鼠,取血清和肝组织进行检测,酶联免疫吸附法检测大鼠血清中TRAIL水平;放射免疫法检测大鼠血清中透明质酸(HA)、层粘蛋白(LN)及Ⅲ型前胶原(PCⅢ)的水平;采用苏木精-伊红染色和Masson胶原染色观察大鼠肝纤维化程度;采用免疫组织化学法检测肝组织TRAIL表达情况。[结果]同模型组相比,TFL给药组肝组织纤维化程度明显改善;TFL给药组和假手术对照组血清TRAIL HA、LN、PCⅢ均显著低于模型组(P0.05),且TFL给药组和假手术对照组之间血清TRAIL水平差异无统计学意义(P0.05);血清TRAIL水平与肝组织中TRAIL表达一致;血清TRAIL水平与血清HA、LN、PCⅢ呈正相关(r=0.97,0.95,0.94,P0.01)。[结论]TRAIL可促进胆管阻塞性大鼠肝纤维化发生发展,TFL可以改善肝纤维化程度,其机制可能与抑制肝内TRAIL的表达有关。     

飞天蜈蚣七对肝纤维化大鼠肝组织转化生长因子β1蛋白表达的影响

目的探讨飞天蜈蚣七防治肝纤维化的作用机制.方法CCl4法复制肝纤维化模型,48只SD大鼠随机分为飞天蜈蚣七组(A组)、秋水仙碱组(B组)、模型组(C组)和正常对照组(D组),每组12只.各组分别在第22、43天时,检测血清透明质酸(HA)、层粘蛋白(LN)、Ⅲ型前胶原(PC-Ⅲ)含量;行肝组织转化生长因子-β1(TGF-β1)免疫组化染色,检测其蛋白表达.结果第22天时,与D组、A组比较,C组血清HA、PC-Ⅲ升高,TGF-β1阳性表达较强(P＜0.05),LN升高(P＞0.05);第43天时,与D组比较,C组血清HA、LN、PC-Ⅲ明显降低,肝组织TGF-β1阳性表达明显减轻(P＜0.05).结论飞天蜈蚣七可以减轻肝纤维化程度、抑制肝组织TGF-β1蛋白的表达,飞天蜈蚣七可作为抗肝纤维化的一种有效药物.     

Mitochondrial dysfunction due to long-chain Acyl-CoA dehydrogenase deficiency causes hepatic steatosis and hepatic insulin resistance

Alterations in mitochondrial function have been implicated in the pathogenesis of insulin resistance and type 2 diabetes. However, it is unclear whether the reduced mitochondrial function is a primary or acquired defect in this process. To determine whether primary defects in mitochondrial beta-oxidation can cause insulin resistance, we studied mice with a deficiency of long-chain acyl-CoA dehydrogenase (LCAD), a key enzyme in mitochondrial fatty acid oxidation. Here, we show that LCAD knockout mice develop hepatic steatosis, which is associated with hepatic insulin resistance, as reflected by reduced insulin suppression of hepatic glucose production during a hyperinsulinemic-euglycemic clamp. The defects in insulin action were associated with an approximately 40% reduction in insulin-stimulated insulin receptor substrate-2-associated phosphatidylinositol 3-kinase activity and an approximately 50% decrease in Akt2 activation. These changes were associated with increased PKCepsilon activity and an aberrant 4-fold increase in diacylglycerol content after insulin stimulation. The increase in diacylglycerol concentration was found to be caused by de novo synthesis of diacylglycerol from medium-chain acyl-CoA after insulin stimulation. These data demonstrate that primary defects in mitochondrial fatty acid oxidation capacity can lead to diacylglycerol accumulation, PKCepsilon activation, and hepatic insulin resistance.     

Relationship between hepatic/visceral fat and hepatic insulin resistance in nondiabetic and type 2 diabetic subjects

BACKGROUND AND AIMS: Abdominal fat accumulation (visceral/hepatic) has been associated with hepatic insulin resistance (IR) in obesity and type 2 diabetes (T2DM). We examined the relationship between visceral/hepatic fat accumulation and hepatic IR/accelerated gluconeogenesis (GNG). METHODS: In 14 normal glucose tolerant (NGT) (body mass index [BMI] = 25 +/- 1 kg/m(2)) and 43 T2DM (24 nonobese, BMI = 26 +/- 1; 19 obese, BMI = 32 +/- 1 kg/m(2)) subjects, we measured endogenous (hepatic) glucose production (3-(3)H-glucose) and GNG ((2)H(2)O) in the basal state and during 240 pmol/m(2)/min euglycemic-hyperinsulinemic clamp, and liver (LF) subcutaneous (SAT)/visceral (VAT) fat content by magnetic resonance spectroscopy/magnetic resonance imaging. RESULTS: LF was increased in lean T2DM compared with lean NGT (18% +/- 3% vs 9% +/- 2%, P < .03), but was similar in lean T2DM and obese T2DM (18% +/- 3% vs 22% +/- 3%; P = NS). Both VAT and SAT increased progressively from lean NGT to lean T2DM to obese T2DM. T2DM had increased basal endogenous glucose production (EGP) (NGT, 15.1 +/- 0.5; lean T2DM, 16.3 +/- 0.4; obese T2DM, 17.2 +/- 0.6 micromol/min/kg(ffm); P = .02) and basal GNG flux (NGT, 8.6 +/- 0.4; lean T2DM, 9.6 +/- 0.4; obese T2DM, 11.1 +/- 0.6 micromol/min/kg(ffm); P = .02). Basal hepatic IR index (EGP x fasting plasma insulin) was increased in T2DM (NGT, 816 +/- 54; lean T2DM, 1252 +/- 164; obese T2DM, 1810 +/- 210; P = .007). In T2DM, after accounting for age, sex, and BMI, both LF and VAT, but not SAT, were correlated significantly (P < .05) with basal hepatic IR and residual EGP during insulin clamp. Basal percentage of GNG and GNG flux were correlated positively with VAT (P < .05), but not with LF. LF, but not VAT, was correlated with fasting insulin, insulin-stimulated glucose disposal, and impaired FFA suppression by insulin (all P < .05). CONCLUSIONS: Abdominal adiposity significantly affects both lipid (FFA) and glucose metabolism. Excess VAT primarily increases GNG flux. Both VAT and LF are associated with hepatic IR.     

Peptic ulcer in hepatic cirrhosis and renal failure

Abstract The prevalence of peptic ulcer in cirrhotic patients is similar to that reported for the general population. Although gastric acid outputs ar normal or lower in cirrhotic subjects compared with non-cirrhotics, the frequency of non-response to histamine H₂-receptor antagonists is higher. Peptic ulcer disease in the cirrhotic seems to pursue a more virulent course compared with that in the non-cirrhotic subject.
Peptic ulcer prevalences in patients dying of uraemia or in uraemic patients on maintenance dialysis treatment are comparable with those in the general population. However, the frequency of peptic ulcer, especially complicated ulcer, is increased following renal transplantation. Ulcer complications in this context are associated with a high mortality rate. Pre-transplant risk factors for subsequent development of peptic ulcer remain to be identified and the value of histamine H₂-receptor antagonists in prophylaxis is as yet unproven.     

Changes in serum and hepatic levels of immunoreactive prolyl hydroxylase in two models of hepatic fibrosis in rats

Changes in serum and hepatic levels of immunoreactive prolyl hydroxylase (IRPH) as well as cellular localization of the enzyme were studied in 2 models of hepatic fibrosis, which was induced in male rats either by subcutaneous administration of CCl4 (Group A) or by intraperitoneal injection of porcine serum (Group B). Hepatic fibrosis appeared at the 8th week in Group A and at the 12th week in Group B, and liver cirrhosis developed at the 16th week in both models. Although tissue contents of hydroxyproline (HP) and IRPH increased in both models, only HP levels correlated with the degree of fibrosis. Serum IRPH levels and serum asparate aminotransferase (AST) activities increased, showing a significant positive correlation, in group A, whereas both remained in a control range in Group B. Moreover, in another model which received a single intraperitoneal injection of CCl4, serum IRPH showed a marked increase and then a rapid decrease in parallel with the change in serum AST. Immunohistochemical analysis also showed a difference between the two fibrosis models: in group A, IRPH was positive mainly in parenchymal cells in the peripheral zone of the pseudolobulus, while in group B the staining was diffuse. These results indicate that the elevation of serum IRPH is, at least in part, due to the parenchymal cell damage, and that IRPH levels should be carefully evaluated when being used as a parameter to estimate the activity of fibrogenesis in the liver.     

Simvastatin enhances hepatic nitric oxide production and decreases the hepatic vascular tone in patients with cirrhosis

BACKGROUND & AIMS: In cirrhosis, an insufficient release of nitric oxide contributes to increased hepatic resistance and portal pressure and enhances the postprandial increase in portal pressure. We hypothesized that simvastatin, which enhances Akt-dependent endothelial nitric oxide synthase phosphorylation, may increase hepatic nitric oxide release and decrease hepatic resistance in patients with cirrhosis and portal hypertension. METHODS: In protocol 1, 13 patients had measurements of the hepatic venous pressure gradient, hepatic blood flow, mean arterial pressure, cardiac output, and nitric oxide products before and 30 and 60 minutes after 40 mg of simvastatin. In protocol 2, 17 patients were randomized to receive placebo or simvastatin (40 mg) 12 hours and 1 hour before the study. After baseline measurements of the hepatic venous pressure gradient, hepatic blood flow, and nitric oxide products, a standard liquid meal was given, and measurements were repeated at 15, 30, and 45 minutes. RESULTS: In protocol 1, acute simvastatin did not modify the hepatic venous pressure gradient but increased the hepatic blood flow (21% +/- 13% at 30 minutes; P = 0.01) and decreased hepatic sinusoidal resistance by 14% +/- 11% (P = 0.04). Nitric oxide product levels significantly increased in hepatic venous blood (from 31.4 +/- 12.3 nmol. mL(-1) to 35.8 +/- 10.7 nmol. mL(-1); P = 0.04), but not in peripheral blood. Systemic hemodynamics were not modified. In protocol 2, simvastatin pretreatment significantly attenuated the postprandial increase in hepatic venous pressure gradient (mean peak increase, 10% +/- 9% vs. 21% +/- 6% in placebo; P = 0.01). Hepatic blood flow increased similarly in the 2 groups. Hepatic nitric oxide products increased in the simvastatin group but not in the placebo group. CONCLUSIONS: Simvastatin administration increases the hepatosplanchnic output of nitric oxide products and decreases hepatic resistance in patients with cirrhosis.     

Cerebral changes in hepatic encephalopathy

Hepatic encephalopathy (HE) accompanied by an impairment of consciousness from orientation disorder (grade II) to coma (grade IV) is considered to be overt HE and is treated as an emergency. However, subclinical hepatic encephalopathy (SHE) can be detected by sensitive and quantitative neuropsychological examinations in cirrhotic patients without overt HE. The introduction of the SHE concept is clinically important for preventing the deterioration of SHE (grades 0 and I) to overt HE (grade II and more severe), prolonging the compensated state of cirrhosis without its deterioration to hepatic failure, and the continuation of patient treatment at home. We developed a new diagnostic method for SHE using a quantitative neuropsychological test, with the computerization of all operations. Evaluations of cerebral function and morphology are useful for the determination of the patho-physiology of HE, and assist the diagnosis of SHE. The latencies of the P3 wave in the visually evoked potential and the P300 wave in the event-related potential are prolonged in cirrhotic patients with SHE and are well expressed in three-dimensional coloured topograms (brain mapping). Automated polysomnographic analysis is useful for continuous-monitoring electroencephalograms (EEG) and for the detection of the sleep disturbance observed in cirrhotic patients with SHE. Brain atrophy in computed tomography (CT), magnetic resonance imaging (MRI) and high signals in the basal ganglia in the MR-T1-weighted images have frequently been observed in patients with SHE. The reduction of regional cerebral blood flow (rCBF) by ^99mtechnetium-1, 1-ethylcysteinate dimer (^99mTc-ECD)-single photon emission computed tomography (SPECT) and the choline/N-acetylaspartic acid ratio by ¹proton-magnetic resonance spectroscopy (¹H-MRS) were observed in the hippocampus in patients with SHE. These approaches (cerebral function tests and imaging diagnoses of the brain) can also be used to evaluate the effectiveness of treatments for HE; for example, branched-chain amino acid (BCAA) was shown by automated continuous polysomnographic analysis to be a psychotropic drug which acts directly on the central nervous system and the clinical significance of choline administration to HE patients is now being evaluated by ¹H-MRS and neuropsychological tests.     

Macrophage and hepatic stellate cell responses during experimental hepatocarcinogenesis

The aim of the study was to assess the monocyte/macrophage and hepatic stellate cell responses during experimental diethylnitrosamine (DEN)-induced hepatocarcinogenesis. Diethylnitrosamine (50mg/L) was administered to 39 rats for 10 weeks; liver tissue was obtained at weeks 10, 16 and 19. In this model, necroinflammatory damage occurs during the period of DEN administration but thereafter subsides; dysplastic nodules and carcinomas subsequently develop. Monocytes/ macrophages were detected immunohistochemically using ED1 and ED2 monoclonal antibodies; hepatic stellate cells (HSC) were detected using antibodies to alpha-smooth muscle actin (alpha-SMA) (activated HSC) and glial fibrillary acidic protein (GFAP). Parenchymal ED1- and ED2-positive monocytes/macrophages and alpha-SMA-positive HSC increased at week 10 when there was ongoing DEN-induced necroinflammatory activity. ED1- and ED2-positive cells were also prominent at weeks 16 and 19, particularly around the periphery of dysplastic and carcinomatous nodules, with occasional macrophages between dysplastic hepatocytes. alpha-SMA-positive HSC were present within sinusoids between dysplastic cells and were more abundant at weeks 16 and 19 than in control or week 10 animals. Activated HSC were prominent in fibrous septa around and within dysplastic and carcinomatous nodules at weeks 16 and 19. In contrast, GFAP-positive HSC did not accumulate in developing septa or within dysplastic and carcinomatous nodules. We have demonstrated changes in the monocyte/ macrophage and HSC populations during the development of hepatocellular dysplasia and carcinoma at time points when there is little necroinflammatory activity; this may therefore represent a host response to hepatocyte dysplasia. The HSC activation may be mediated, in part, by monocyte/ macrophage-derived factors, but we speculate that it may also result from direct stimulation by factors released from dysplastic hepatocytes.     

Anti-proliferative and pro-apoptotic effects of tectorigenin on hepatic stellate cells

AIM: To investigate the effect of tectorigenin on proliferation and apoptosis of hepatic stellate cells (HSC)-T6 cells. METHODS: HSC-T6 cells were incubated with tectorigenin at different concentrations, and their proliferation was assessed by bromodeoxyuridine incorporation assay. Apoptosis was detected by flow cytometry assay with Hoechst 33342 staining. Also, generation of reactive oxygen species (ROS), intracellular [Ca2+]i, potential of mitochondrial membrane, activities of cytochrome c and caspase-9 a...     

Use of radiofrequency hepatic parenchymal transection device in hepatic hemangioma resection: early experience and lessons learned

Background. Control of intraoperative hemorrhage represents a significant challenge in hepatic surgery, particularly during resection of large, hypervascular hepatic hemangiomata (HH). Various devices to minimize blood loss from hepatic parenchymal transection are currently under investigation. Herein, we present our experience with a radiofrequency (RF)-powered multiarray for resection of HH. Patients and methods. From September 2005 to January 2006, we conducted a retrospective review of our hepatobiliary database to identify patients with symptomatic giant cavernous HH undergoing resection with a RF multiarray device. The purpose of this review was to assess the technical aspects of using RF energy to assist in the resection of HH. Results. The extent of operation varied depending on the size and location of the tumor. Two patients underwent two atypical subsectionectomies and two underwent trisectionectomies. The Habib™ sealer provided a safe and effective method for hepatic parenchymal transaction. No patients required blood transfusion, and no injuries to major biliary or vascular strictures were observed at 1 year follow-up. A seroma developed in one patient 6 months postoperatively, but was drained percutaneously. Conclusions.Hepatic parenchymal transection with the Habib sealer device is a feasible approach to resect HH. Further study is needed to objectively compare the efficacy of RF-assisted parenchymal transection with that of traditional parenchymal transection techniques.