An overview of animal models for investigating the pathogenesis and therapeutic strategies in acute hepatic failure

Acute hepatic failure （AHF） is a severe liver injury accompanied by hepatic encephalopathy which causes multiorgan failure with an extremely high mortality rate, even if intensive care is provided. Management of severe AHF continues to be one of the most challenging problems in clinical medicine. Liver transplantation has been shown to be the most effective therapy, but the procedure is limited by shortage of donor organs. Although a number of clinical trials testing different liver assist devices are under way, these systems alone have no significant effect on patient survival and are only regarded as a useful approach to bridge patients with AHF to liver transplantation. As a result, reproducible experimental animal models resembling the clinical conditions are still needed. The three main approaches used to create an animal model for AHF are： surgical procedures, toxic liver injury and infective procedures. Most common models are based on surgical techniques （total/partial hepatectomy, complete/transient devascularization） or the use of hepatotoxic drugs （acetaminophen, galactosamine, thioacetamide, and others）, and very few satisfactory viral models are available. We have recently developed a viral model of AHF by means of the inoculation of rabbits with the virus of rabbit hemorrhagic disease. This model displays biochemical and histological characteristics, and clinical features that resemble those in human AHF. In the present article an overview is given of the most widely used animal models of AHF, and their main advantages and disadvantages are reviewed.     

肝内Glisson系统内部结构的观察

肝内Glisson系统由肝内门静脉、肝内肝动脉和肝内肝管组成。观察和测量了其第一级分支,在显微镜下观察了其第二级分支和第三级分支,研究结果为临床应用提供解剖学资料。     

肝尾状叶损伤15例诊治分析

目的：初步探讨了肝尾状叶的解剖及尾状叶损伤的机制，诊断，治疗措施等问题。方法：对15例肝尾状叶损伤病例进行分析。结果：13例治愈，2例死亡。结论：肝尾状叶部位深在，解剖复杂，其损伤多合并其他脏器损伤，伤情重，多需手术治疗。填塞止血，缝合修补及不规则尾状叶切除是常用术式，B超或CT检查及不定时复查对尾状叶损伤的诊断，治疗措施的选择有重要意义。     

Uptake of Colchicine,a Microtubular System Disrupting Agent,by Isolated Rat Hepatocytes

The possible mechanism of hepatic uptake of colchicine (CLC), a microtubule system disrupting agent, was examined using isolated rat hepatocytes. The existence of a carrier-mediated active transport system for CLC was demonstrated. This transport system is saturable, is affected by metabolic inhibitors (dinitrophenol, KCN) and a SH-group blocker (p-hydroxymercuribenzoic acid but not N-ethylmaleimide), and is sensitive to temperature. Ouabain, an inhibitor of Na⁺, K⁺-ATPase, does not affect the transport system of CLC.     

栀子黄色素对四氯化碳肝损伤小鼠的影响

目的 :　研究栀子黄色素 (GY)对 CCl4 肝损伤小鼠的保护作用。方法 :　取健康的雄性昆明种小鼠 (2 0± 2 ) g 5 0只 ,按体重随机分成 5组 ,每组 1 0只 ,即正常组 ,(饲喂正常饲料 ) ,CCl4 肝损伤组 (正常饲料 +CCl4 ) ,低剂量组 (正常饲料 +CCl4 +0 .1 ml GY溶液 /只 ) ,中剂量组 (正常饲料 +CCl4 +0 .2 ml GY溶液 /只 ) ,高剂量组 (正常饲料 +CCl4 +0 .4ml GY溶液 /只 )。GY溶液提前 5 d每天灌胃 ,对照组与肝损伤组灌胃 0 .4ml生理盐水 ,末次灌胃后 2 h给 0 .1 0 % CCl4 0 .4ml致伤。1 8h后摘除眼球取血 ,测定血清谷丙转氨酶 (SGPT)、谷草转氨酶 (SGOT)、乳酸脱氢酶 (LDH)活性 ,破腹取肝脏 ,测定肝脏丙二醛 (MDA)、谷胱甘肽 (GSH)含量及肝脏指数 ,并对肝细胞的组织形态学进行观察。结果 :　预先灌 GY溶液 ,具有显著地抑制 CCl4 引起的小鼠血清 SGPT、SGOT、LDH及肝脏 MDA含量、肝脏指数的升高以及肝脏 GSH含量的降低 ,并能显著地减轻 CCl4 引起的肝小叶内的灶性坏死。结论 :　栀子黄色素对 CCl4 致小鼠肝损伤具有保护作用     

Therapeutic hepatic vein angioplasty for Budd-Chiari syndrome

The authors report a case of Budd-Chiari syndrome treated by percutaneous transluminal angioplasty (PTA). In this case, the occlusion of three major hepatic veins with a big collateral to the inferior vena cava via the right inferior hepatic vein (RIHV) and stenosis of the ostium of RIHV were seen. We performed successful PTA of this stenosis.     

经皮肝穿刺射频消融术治疗肝癌

目的探讨经皮肝穿刺射频消融术(PRFA)治疗肝癌的疗效、适应证与并发症。方法在B超引导下,对54例肝癌患者行65例次PRFA治疗,对治疗后肝功能、甲胎蛋白(AFP)、肿瘤血供的变化、并发症及预后进行观察。结果28例PRFA治疗前AFP升高者有86%(24/28)的患者AFP有不同程度的下降;术后1~48个月MRI或CT复查提示83%(46/54)的患者肿瘤血供明显减少或消失,肿瘤≤3 cm者完全凝固性坏死率81%(26/32);术中术后并发症发生率17%(9/54);患者1 a生存率为91%,2 a生存率为76%。结论PRFA治疗肝癌具有微创、安全、有效等优点,特别适用于不能耐受手术切除且直径≤3 cm的肿瘤。     

The Mechanisms and Importance of Tricuspid Regurgitation and Hepatic Pulsations in Dilated Cardiomyopathy: A Review

Secondary tricuspid regurgitation is a common finding in dilated cardiomyopathy, being present in up to 90% of patients studied with Doppler echocardiography. It appears to be primarily due to annular dilatation and loss of the sphincter-like action of the tricuspid annulus during systole. Apical displacement of the papillary muscle and increased chordal tension may also contribute to mal-coaptation of the tricuspid leaflets in systole. Hepatic pulsations generally occur late in dilated cardiomyopathy, indicating hepatic congestion due to progressive biventricular failure. These are thought to result from secondary tricuspid regurgitation and transmission of the regurgitant v wave to the liver. Careful pulsed-Doppler studies of the timing of hepatic pulsations in dilated cardiomyopathy often show them to be presystolic, rather than systolic, suggesting that a mechanism other than tricuspid regurgitation may be responsible. (ECHOCARDIOGRAPHY, Volume 8, March 1991)     

Hepatic artery aneurysm in corticosteroidtreated,adult Kawasaki's disease

We describe a single case of Kawasaki's disease (mucocutaneous lymph node syndrome) with the rare complication of a hepatic artery aneurysm which was surgically repaired. Unusual features include arterial aneurysmal formation in the hepatic arteries rather than in coronary arteries, the unusual morphology of the hepatic artery aneurysm, and the expansion of the aneurysm after corticosteroid therapy.     

种植性兔VX2肝肿瘤血供的研究

目的探讨种植性兔VX2肝肿瘤生长的自然血供特点。方法VX2瘤株接种于新西兰兔肝左叶,制成模型瘤兔15只,将其按瘤体直径分为3组:A组直径<2.0cm、B组直径2.0～3.0cm、C组直径>3.0cm,分别应用彩色多普勒超声仪检测各组VX2瘤兔的门静脉和肝动脉的血流动力学指标,以及肝动脉血管造影显示瘤体供血情况,分析不同直径大小的瘤体血流分布及构成。结果A组的VX2兔肝肿瘤供血不丰富,肝动脉部分参与供血;B组的VX2兔肝肿瘤瘤内血流丰富,供血以肝动脉为主;C组的VX2兔肝肿瘤中心部出现坏死,瘤周血流丰富,供血以肝动脉为主。C组的VX2兔肿瘤肝动脉最大血流速度(Vmax)(60.3±10.9cm/s)与A组(50.4±12.2cm/s)相比有差异(P<0.01),阻力指数(RI)(0.9±0.12)与A组(0.5±0.02)相比有差异(P<0.01);门静脉平均血流速度(V)及门静脉内径(D)各组差异不大(P>0.05)。结论种植性VX2肝肿瘤主要供血血管为肝动脉,肝动脉最大血流速度和阻力指数随肿块增大明显增加,多普勒流速曲线呈高速高阻型;门静脉平均血流速度及门静脉内径随肿块增大变化不明显。