TBA治疗月经过多的长期疗效及其对生活质量的影响

目的采用热球凝切(thermal balloon ablation,TBA)子宫内膜对月经过多的病人进行研究,观察长期疗效及生活质量的改变。方法采用TB型子宫内膜治疗仪对70例月经过多病人进行TBA治疗,术后连续随访24个月,以电话或面见的方式,随访临床症状及生活质量状况,并作相应的统计学处理。结果术后6、 12、18、24个月治疗有效率分别为95．71％、94．28％、87．14％、84．29％。,再次手术有5例,占7．14％。术前与术后 24个月时相比,月经期从(8．8±2．2)d／周期缩减至(4．1±1．3)d／周期,P<0．0001;月经量从(11．4±2．6)片／d减至 (4．8±1．5)片／d,P<0．001。血红蛋白从(82．75±12．40)g／L,上升为(110．30±1．00)g/L,P<0．0001;生活质量 (SRHMS)量表健康评定总分从(166．50±10．11)分上升到(357．33±32．16)分,P<0．0001。结论 TBA治疗月经过多,可改善患者临床症状,同时提升生活质量。     

血清总胆汁酸测定对肝疾病诊断意义

目的 探讨血清总胆汁酸测定对肝脏疾病的诊断价值。方法 空腹静脉血，分离血清，酶法测定。结果 胆汁酸在下列各组肝脏疾病的阳性率依次为：急性肝炎99％，慢性活动性肝炎94％、肝硬化98％、肝癌97％，比同时测定ALT、AST、ALP、r—GT的阳性率要高。结论 胆汁酸测定是诊断肝脏疾病的重要指标。     

肺炎支原体感染患儿血清总胆汁酸水平探讨

目的：分析肺炎支原体感染患儿血清总胆汁酸(TBA)水平变化,探讨血清TBA检测的临床意义。方法选取2015年4~8月我院儿科接收的100例肺炎支原体感染患儿(观察组)及同期进行健康体检的100例非肺炎支原体感染儿童(对照组)作为研究对象,入院当天检测观察组血清TBA水平,并与对照组比较。根据病情轻重将观察组分为轻度组(n=48)、中度组(n=35)、重度组(n=17),比较其血清TBA水平差异。根据血清TBA水将观察组分为两组,≤10μmol/L组(32例)及>10μmol/L组(68例),对两组患者的临床资料进行回顾性分析,采用单因素及logistic回归多因素分析影响肺炎支原体感染患儿血清TBA变化的相关因素。结果观察组患者的血清TBA水平为(17.5±6.04)μmol/L,对照组为(4.41±1.65)μmol/L,观察组高于对照组,差异有统计学意义(P<0.05)。肺炎支原体感染轻度组血清TBA检测结果为(6.52±3.63)μmol/L,中度组为(16.6±4.88)μmol/L,重度组为(29.8±10.7)μmol/L,肺炎支原体感染患儿随着病情的加重,其血清TBA水平呈现进行性升高（P<0.05）;单因素及Logistic多因素分析提示：年龄、体重指数、谷丙转氨酶(ALT)、谷草转氨酶(AST)是肺炎支原体感染患儿血清TBA水平>10μmol/L的危险因素(P<0.05)。结论对肺炎支原体感染患儿血清TBA实施动态监测有助于评估患者的肝损伤及疾病严重程度,对改善预后有重要价值。     

血清腺苷脱氨酶和总胆汁酸测定在肝病诊断中的应用研究

目的探讨肝病患者血清腺苷脱氨酶(ADA)和总胆汁酸(TBA)检测在肝病诊断中的应用价值。方法以速率法测定血清腺苷脱氨酶(ADA),酶循环法测定总胆汁酸(TBA),溴甲酚氯法测定血清白蛋白(ALB),速率法测定丙氨酸氨基转移酶(ALT),用全自动生化分析仪分别测定肝病患者637例和正常对照128例。结果各型肝病患者血清的ADA和TBA都明显高于对照组(P〈0.01〉,并随着肝功能损伤程度的加重ADA、TBA明显升高。ADA、TBA在各型肝病患者中的异常率明显较高,平均异常率分别为93.80%和99.84%,而ALT在慢性肝炎、肝硬化的异常率较低,ALB在重症肝炎、肝硬化的异常率明显高于在急性肝炎和慢性肝炎,ALB、ALT在各型肝病中的平均异常率分别为46.31%和62.95%。结论血清腺苷脱氨酶和总胆汁酸能较早地反应肝脏损伤、合成及代谢功能,是肝功能损害早期灵敏指标,联合检测ADA和TAB对肝病的病情和早期判定具有重要的临床实用价值。     

Assessing routine and serum markers of liver fibrosis in CHB patients using parallel and serial interpretation

OBJECTIVE: The purpose of this study was to determine the cut-offs of serum biomarkers of liver fibrosis in HBsAg-positive patients by receiver operating characteristic (ROC) curves, and to determine the validity of these markers in parallel and serial interpretation. METHODS: This study included 444 HBsAg-positive patients who had liver biopsy performed between January 1, 2003 and March 31, 2006. Some routine and clinical chemistry tests were run, and the stage of liver fibrosis was measured. The cut-offs of those markers were identified by using ROC curves. Sensitivity, specificity, predictive values (both positive and negative), and the Youden's index of these markers were calculated in parallel and serial interpretation. RESULTS: The 444 patients were divided into a training group (322 patients) and a validation group (122 patients). All markers except gender, HB and TP were found to be statistically significant factors associated with significant fibrosis in the training group. The AUROC of GGT, APRI, AGE-PLT and AST in the training group were 0.772, 0.769, 0.748 and 0.700, respectively, and their sensitivities in the validation group were 65.00%, 70.00%, 75.00% and 60.00%, respectively. In parallel interpretation, the highest sensitivity was 85.00% at AGE-PLT union or logical sum AST, and in serial interpretation, the best specificity was 96.34% at GGT intersection AGE-PLT. CONCLUSION: A few routine and serum biomarkers can be used to effectively assess most patients with HBsAg-positive CHB with and without significant liver fibrosis in parallel and serial interpretation.     

血清瘦素、总胆汁酸联合检测对妊娠肝内胆汁淤积症患者的诊断价值

目的 探讨妊娠肝内胆汁淤积症(ICP)患者血清瘦素(leptin)、总胆汁酸(total bile acids,TBA)水平对ICP患者母体并发症及围生儿的关系.方法 检测91例ICP产妇(其中轻度42例、中度38例、重度91例)和34例健康晚期妊娠妇女(对照组)leptin和TBA水平,TBA测定采用TBA试剂盒,第5代循环酶法,leptin测定采用酶联免疫测定法.结果 ICP产妇leptin和TBA水平明显高于对照组,差异有统计学意义(P＜0.01),ICP患者母体并发症及围生儿患病率也明显高于对照组,差异有统计学意义(P＜0.05),重度组患者与中度、轻度组比较差异有统计学意义(P＜0.05).结论 leptin和TBA联合检测对妊娠ICP患者早期诊断和治疗、母体并发症及围生儿病情观察及预后有重要意义.     

血清总胆汁酸测定对慢性肝炎的诊断价值

目的 探讨血清总胆汁酸(TBA)检测对慢性肝炎的诊断价值。方法 针对130例肝穿刺活检病理证实为慢性肝炎的病人及肝穿刺病理证实为炎症的20例病人，应用酶比色法测定血清TBA水平。结果 慢性肝炎组病人血清TBA水平均显著高于无炎症活动的对照组病人，且TBA水平与肝炎病理分级呈正相关。结论 血清TBA水平是慢性肝炎诊断的一个敏感指标，并有助于判定慢性肝炎病情程度。     

Postprandial oxidative stress is increased after a phytonutrient-poor food but not after a kilojoule-matched phytonutrient-rich food

Research indicates that energy-dense foods increase inflammation and oxidative activity, thereby contributing to the development of vascular disease. However, it is not clear whether the high kilojoule load alone, irrespective of the nutritional content of the ingested food, produces the postprandial oxidative and inflammatory activity. This study investigated the hypothesis that ingestion of a high-fat, high-sugar, phytonutrient-reduced food (ice cream) would increase oxidative and inflammatory activity greater than a kilojoule-equivalent meal of a phytonutrient-rich whole food (avocado). The individual contributions of the fat/protein and sugar components of the ice cream meal to postprandial inflammation and oxidative stress were also quantified. Using a randomized, crossover design, 11 healthy participants ingested 4 test meals: ice cream, avocado, the fat/protein component in ice cream, and the sugar equivalent component in ice cream. Plasma glucose, cholesterol, triglycerides, and inflammatory and oxidative stress markers were measured at baseline and 1, 2, and 4 hours (t1, t2, t4) after ingestion. Lipid peroxidation was increased at 2 hours after eating fat/protein (t0-t2, P < .05) and sugar (t1-t2, P < .05; t1-t4, P < .05). Antioxidant capacity was decreased at 4 hours after eating ice cream (t0-t4, P < .01) and sugar (t0-t4, P < .01). Ingestion of a kilojoule-equivalent avocado meal did not produce any changes in either inflammatory or oxidative stress markers. These data indicate that the ingestion of a phytonutrient-poor food and its individual fat/protein or sugar components increase plasma oxidative activity. This is not observed after ingestion of a kilojoule-equivalent phytonutrient-rich food.     

Improvement of brain energy metabolism and cholinergic functions contributes to the beneficial effects of silibinin against streptozotocin induced memory impairment

Recently, silibinin, a clinically used hepatoprotectant, has been reported to prevent amyloid beta induced memory impairment by reducing oxidative stress and inflammation in mice brain. However, the exact mechanism of neuroprotective effect of silibinin has not been properly studied especially in context of brain energy metabolism and cholinergic functions, the essential factors that undergo impairment in Alzheimer's disease. Therefore, the present study investigated the effect of silibinin on impairment in memory, brain energy metabolism and cholinergic function following intracerebral (IC) streptozotocin (STZ) administration in mice. STZ (0.5 mg/kg), administered twice at an interval of 48 h, caused significant memory impairment tested by Morris water maze. Further, STZ significantly decreased ATP and increased synaptosomal calcium level in mice brain. Increased oxidative and nitrosative stress was also observed in IC STZ injected mice brain. STZ IC induced memory impairment is associated with increased activity and mRNA expression of acetylcholinesterase (AChE) and decreased α-7 nicotinic acetylcholine receptor (α-7-nAChR) mRNA expression in mice brain. Pretreatment with silibinin (100 and 200 mg/kg, po) attenuated STZ induced memory impairment by reducing oxidative and nitrosative stress and synaptosomal calcium ion level. Further, silibinin dose dependently restored ATP level indicating improvement in brain energy metabolism. The activity and mRNA expression of AChE was restored by silibinin. Moreover, α-7-nAChR mRNA expression was significantly increased by silibinin in STZ treated mice brain. The present study clearly demonstrates that beneficial effects of silibinin in STZ induced memory impairment in mice is due to improvement in brain energy metabolism and cholinergic function.