Sarcoidosis and primary biliary cirrhosis

Summary An unusual case of a woman with primary biliary cirrhosis and cutaneous sarcoidosis is described. The factors that allow a specific diagnosis of each condition are presented and the literature pertaining to such complex and unusual cases is presented.This work was supported in part by a grant from the Gastroenterology Medical Research Foundation of Southwestern Pennsylvania.     

ERK信号传导通路调控乙醛刺激的肝星状细胞Na+/Ca2+泵mRNA表达的研究

目的 :探讨Erk信号传导通路调控乙醛刺激的肝星状细胞 (HSC)Na /Ca2 泵mRNA表达的影响。方法 :用链霉蛋白酶和胶原酶原位灌流 ,Metrizamide密度梯度离心分离大鼠肝星状细胞 ,采用RT PCR测定PD980 5 9阻断乙醛激活的肝星状细胞Erk活性后Na /Ca2 泵mRNA表达。结果 :乙醛刺激后 ,HSC后明显促进Na /Ca2 泵mRNA表达 (P<0 0 1) ,不同剂量PD980 5 9对肝星状细胞Na /Ca2 泵mRNA表达的影响无统计学意义。结论 :Erk信号传导通路可能对乙醛刺激的肝星状细胞激活状态的启动无明显影响     

枳鳖胶囊抗大鼠肝纤维化形态学及肝组织Ⅲ型胶原mRNA表达的实验研究

目的:观察枳鳖胶囊抗肝纤维化形态学和Ⅲ型胶原mRNA表达的变化。方法:选择66只健康清洁级SD大鼠,雌雄各半,随机分为:正常对照组,模型组,秋水仙碱组,枳鳖胶囊大、中、小剂量组。以40%四氯化碳花生油皮下注射结合高脂饲料、酒水饮料复合因素诱导大鼠肝纤维化模型。造模结束后,除正常组不予处理外,其他组分别以蒸馏水,秋水仙碱混悬液,高、中、低浓度枳鳖胶囊溶液灌胃,疗程36d。疗程结束后,观察大鼠新鲜肝脏的表面情况、色泽、质地等大体形态,测定肝组织Ⅲ型胶原mRNA的表达,光镜观察肝组织HE染色和网状纤维染色的病理形态学改变。结果:模型组大鼠肝细胞损害、肝脏脂肪变性和胶原纤维增生的程度最显著,Ⅲ型胶原mRNA的表达最强。枳鳖胶囊组上述改变明显减轻,且可抑制Ⅲ型胶原mRNA的表达,疗效优于秋水仙碱组。结论:枳鳖胶囊可较好地保护肝细胞,并能阻止肝纤维化进程甚或逆转肝纤维化病理改变,抑制胶原基因表达,抑制胶原基因表达可能是其抗肝纤维化的作用机理之一。     

软肝丸治疗慢性血吸虫肝纤维化200例临床观察

目的 观察软肝丸对慢性血吸虫肝纤维化的疗效。方法 用软肝丸治疗慢性血吸虫肝纤维化病人200例，观察治疗前后肝脏的B超影像学改变。结果 治疗24周后，软肝丸组肝脏影像学有明显改善或恢复正常，与对照组比较，差异具有显著性（P〈0．05）。结论 软肝丸可明显改善慢性血吸虫肝纤维化。     

Liver pathology associated with the use of anabolic-androgenic steroids

Abstract: This review examines the liver-damaging side effects of anabolic-androgenic steroids (AAS). It seems that AAS can cause development of peliosis hepatis, subcellular changes of hepatocytes, hepatocellular hyperplasia and hepatocellular adenomas. On the other hand, it has not been convincingly proved that AAS can cause development of hepatocellular carcinomas when used in the usual therapeutic doses. Tumours reported as hepatocellular carcinomas caused by AAS seem to be hyperplastic lesions of a benign nature able to regress with withdrawal of the putative agent. The effects of untraditional combinations and high-dose AAS are not yet known, leaving the possibility of a carcinogenic effect in those cases.     

顺铂白蛋白微球肝动脉栓塞后在体内的分布

用生物降解材料牛血清白蛋白制得顺铂微球，采用肝动脉插管术对新西兰兔实施肝动脉栓塞，以常规注射剂为照，研究药物体内分布。结果：肝组织顺铂量在不同时间均显著高于注射剂对照组（Ｐ＜０．０１），栓塞１４ｄ肝中顺铂量仍为对照组的３．５倍；肾脏、脾、肺、心、脑等组织的药物量均低于对照组。提示顺铂微球肝动脉栓塞能显著提高靶区的药物浓度，同时减少在其他组织中的分布，并可降低药物的肾毒性及神经毒性反应。     

全植入式药泵行肝血管灌注治疗晚期肝癌

对２４例不能切除的晚期肝癌采用完全植入式药泵行肝动脉和门静脉双灌注化疗。结果：部分缓解（ＰＲ）１５例（６２．５％），稳定（Ｓ）８例（３３．３％），进展（Ｐ）１例。平均生存期为９．１７月，半年生存率为６６．７％，１年为２５％。在ＡＦＰ＞４００μｇ／Ｌ的１０例中，５例下降。     

Axial tissue diffusion can account for the disparity between current models of hepatic elimination for lipophilic drugs

An assumption of previous models of hepatic elimination is that there is negligible axial diffusion in the liver. We show, by construction of a stochastic model and analysis of published data, that compounds which are readily diffusible and partitioned into hepatocytes may undergo axial tissue diffusion. The compounds most likely to be affected by axial tissue diffusion are the lipophilic drugs for which the cell membranes provide little resistance and which are highly extracted, thereby creating steep concentration gradients along the sinusoid at steady state. This phenomenon greatly modifies the availability of the compound under conditions of altered hepatic blood flow and protein binding. For moderately diffusible compounds, these relationships are similar to those predicted by the simplistic venous-equilibrium model. Hence, the paradoxical ability of the venous-equilibrium model to describe the steady-state kinetics of lipophilic drugs such as lidocaine, meperidine, and propranolol may be finally resolved. The effects of axial tissue diffusion and vascular dispersion on hepatic availability of drugs are compared. Vascular dispersion is of major importance to the availability of poorly diffusible compounds, whereas axial tissue diffusion becomes increasingly dominant for highly diffusive and partitioned substances.This study was supported by the National Health and Medical Research Council of Australia.     

男性肝硬化患者血清睾丸酮、雌二醇水平

本文观察了80例男性肝炎后肝硬化患者。检测了血清睾丸酮（T），雌二醇（E2）水平及E2／T比值的变化。与正常对照组及脑血管意外对照组进行了统计比较，发现E2及E2／T比值升高，T值降低2与对照组间比较均有显著差异，但肝硬化各组间无明显差异。文中分析了检测结果并探讨了与性功能变化的关系。认为性功能降低可能是由于血清睾丸酮水平降低所致。     

Report of a Case of Pericardial Mesothelioma with Liver Metastases Responding Well to Pemetrexed and Platinum-Based Chemotherapy

Pericardial mesothelioma remains a disease with a bleak prognosis. We report the case of a patient with metastases to liver and good response to pemetrexed and carboplatin-based combination chemotherapy and consequent prolonged progression-free survival.