水飞蓟宾-磷脂酰胆碱复合物对小鼠急性肝损伤保护作用的量效关系

目的　观察不同剂量水飞蓟宾 -磷脂酰胆碱复合物 (SPC)对四氯化碳 (CCl4)所致小鼠急性肝损伤的影响。方法　雌性小鼠随机分组给药后测定血清中谷丙转氨酶 (ALT)和谷草转氨酶 (AST)活性 ,取肝组织作病理学检查。结果　不同剂量的水飞蓟宾 -磷脂酰胆碱复合物均可明显降低CCl4所致小鼠血清中ALT和AST活性升高 ,并与剂量呈正相关。SPC组肝组织变性、坏死的程度亦明显减轻 (P <0 .0 0 1,P<0 .0 1,P<0 .0 5 )。结论　SPC对CCl4所致小鼠急性肝损伤具有明显的保护作用 ,高、中、低剂量组间降酶作用呈明显的量效关系。     

肝腺瘤的影像学诊断

目的探讨影像学(US、CT、MRI及DSA)诊断肝腺瘤的价值。方法回顾性分析经手术、病理证实的11例肝腺瘤的影像学表现,其中11例行US和CT检查(有1例行CT灌注成像,CTP),5例行MRI扫描,4例行DSA检查,并与手术病理所见对照。结果11例肝腺瘤均为单发肿块,无肝硬化背景,直径2.0～10.0cm。影像学表现:US检查,10例呈稍低或不均匀稍强回声,边界清晰,6例见低回声晕,彩色多普勒显示肿块内有较丰富的血流;CT检查,10例为稍低或等密度,8/10例动脉期全瘤明显强化,门脉期轻度强化,延迟期呈等密度,1例平扫和延迟期呈等密度,动脉期中度强化,门脉期轻度强化,误诊为血管瘤。1/11例CT灌注成像(CTP)检查,肝动脉灌注量(HAP)=1.08ml/(min.ml),门静脉灌注量(PVP)=0.19ml/(min.ml),肝动脉灌注指数(HPI)=0.85,各参数值与肝癌均有明显不同;MRI检查,5例肝腺瘤均能显示完整包膜,T1WI上2例稍高于肝脏信号,1例呈等信号,2例为稍低信号,T2WI上5例均表现为以稍高信号为主的混杂信号,脂肪抑制像(STIR)1例呈略低信号,4例信号与T2WI相似,行增强扫描的4例病灶动脉期显著强化,门脉期强化减退,平衡期呈等信号。DSA检查,3/4例病灶见粗细不均的异常血管影,实质期可见肿瘤染色表现。结论肝腺瘤的US和DSA表现均缺乏特异性,CT、MRI则具有一定的特点。CTP对肝腺瘤可能具有诊断和鉴别诊断价值。     

还原型谷胱甘肽对大鼠肝星状细胞TIMP—1表达的影响

目的 研究还原型谷胱甘肽对大鼠肝星状细胞（hepatic stellate,cells,HSC)中金属蛋白酶1组织抑制因子（TIMP－2）表达的影响。从分子和蛋白水平探讨还原型谷胱甘肽对大鼠肝纤维化的作用和可能机制。方法 采用50％CCl4制备大鼠肝纤维化模型，在造模过程中给予还原型谷胱甘肽进行干预。应用RT－PCR才Western Blot技术，在分子和蛋白水平检测体外分离大鼠HSC中的TIMP－1的表达情况。结果 还原型谷胱甘肽干预组与模型组和正常对照组相比，HSC中TIMP的表达降低（P＜0．05）。结论 还原型谷胱甘肽的干预可下调大鼠HSC中TIMP－1的表达，对实验性肝纤维化起到减轻作用。     

DSA—Control of implanted devices for arterial hepatic perfusion

In contrast to conventional film angiography, the perfusion pattern of hepatic arterial chemotherapy was consistently visualized by DSA in 40 patients with implanted Infusaid pump or Port-A devices. Incomplete perfusion of a liver region by the cytotoxic agent was recognized by DSA as accurately as by nuclide scintigraphy. Furthermore, DSA appeared to be more sensitive in determining aberrantly perfused extrahepatic regions; this was especially true when there was a nonligated right hepatic artery. Specific details of vascular lesions and associated complicating events also could be satisfactorily analyzed by DSA only.     

PREVIOUS INTRAVENOUS CHEMOTHERAPY DOES NOT ALTER RESPONSE RATE OR SURVIVAL TIME OF PATIENTS WITH HEPATIC METASTASES FROM COLORECTAL CANCER TREATED BY HEPATIC ARTERY CHEMOTHERAPY

Background : The present paper addressed the issue of whether pretreatment with intravenous (IV) chemotherapy affects response rate or survival in patients receiving hepatic artery chemotherapy (HAC). Methods : Case note reviews of 164 patients treated in a teaching hospital from June 1990 to July 1996 were carried out. Results : The response rate and carcino-embryonic antigen (CEA) fall in the two groups was almost identical. There was a nonsignificant survival advantage in the non-pretreatment group. Conclusions : Previous administration of IV chemotherapy did not affect the CEA response of patients receiving HAC.     

幼儿园824名3－6岁幼儿肝功能、乙肝表面抗原检测结果分析

为了解幼儿的肝功能和ＨＢｓＡｇ携带情况，我们于１９９１年肝炎发病高峰季节对我县四所幼儿园共８２４名幼儿进行了ＡＬＴ、ＴＴＴ、ＺｎＴＴ、ＨＢｓＡｇ检测。结果ＡＬＴ、ＴＴＴ均升高１例，有体征；ＡＬＴ单项升高６例，无症状；ＨＢｓＡｇ阳性５８例，其中９例ＡＬＴ升高，４例ＴＴＴ升高。幼儿园是幼儿集中的地方、同吃、同住、接触密切，对ＨＢｓＡｇ阴性者接种乙肝疫苗，对ＡＬＴ升高者不能忽视以免发生肝炎流行。     

检测各型乙肝患者血小板功能的临床意义

检测198例各型乙肝患者血小板功能的五个项目：血小板总数、粘附试验、聚集试验、血块退缩、血小板第3因子有效性，发现各期乙肝患者血小板功能的异常有显著性差异（P＜0．01）．并提示乙肝患者除有血小板数量的改变外，还有质量的改变，因此，全面的血小板功能检测可作为估计乙肝患者肝损害程度的辅助指标．     

Kynurenine aminotransferase activity in human liver: identity with human hepatic C-S lyase activity and a physiological role for this enzyme

The C-S lyase enzymes are responsible for the generation of mutagenic and cytotoxic metabolites via aberrant drug-metabolising pathways in mammalian tissues. We have examined human hepatic cytosolic, mitochondrial and microsomal fractions for evidence of C-S lyase activity. The cytosolic enzyme was purified using fast protein liquid chromatography over FFQ Sepharose, Mono P and Superose 12. An homogeneous protein (monitored by SDS-PAGE) was obtained following purification, and an 11-fold increase in C-S lyase specific activity was observed. The molecular weight of the enzyme was found to be 37 kDa in denaturing conditions, 82.3 kDa in non-denaturing conditions, and the C-S lyase activity was shown to co-purify with kynurenine aminotransferase activity when the transaminase activity of the enzyme was examined with kynurenine as the substrate.     

MR imaging of the brain in patients with hepatic form of Wilson''s disease

The aim of this study was to detect the sites and frequency of possible lesions by brain magnetic resonance imaging (MRI; 1,5T) in a group of 16 neurologically asymptomatic patients with hepatic form of Wilson's disease (WD; seven untreated and nine under treatment). Abnormal MR findings of the brain were found in 75% of patients. Lesions in brain parenchyma were detected in all untreated, drug-naive patients and in 44% of treated patients. Abnormal signal in globus pallidus, putamen, and caudate nucleus was revealed in 86, 71 and 71% of treated and in 33, 33 and 22% of untreated patients, respectively. In five of eight patients with putaminal pathology (62.5%) and in four of seven patients with caudate nuclei involvement (57%), only proton density 2-weighted sequence (PDW) exhibited sensitivity for lesion detection, with both T1W and long echo T2W sequences being insensitive. This superiority of PDW sequence was even more pronounced in the group of untreated patients in whom 80% of putaminal pathology was visible exclusively on this sequence. The lower frequency of lesions in the group of treated in comparison with untreated patients indicated that they might be reversible in the course of chronic chelating therapy.     

细菌内快速构建两种用于肝纤维化基因治疗的重组复制缺陷型腺病毒

目的 :在大肠杆菌内快速构建两种分别含有人肝细胞生长因子 (hepatic growth factor,HGF)和非分泌型人尿激酶型纤溶酶原激活剂 (urokinase- type plasm inogen activator,u PA) c DNA片段的重组复制缺陷型腺病毒。方法 :分别将人 HGF和 u PA c DNA片段与穿梭载体 p Track- CMV连接 ,线性化后与骨架载体 Ad Easy- 1在大肠杆菌 BJ5 183内同源重组获得腺病毒载体 p Ad HGF和 p Adu PA,经 2 93细胞包装后得到复制缺陷型重组腺病毒 Ad HGF和 Adu PA;将 Ad HGF和 Adu PA分别体外感染肝细胞株 L0 2 ,以 Northern印迹法和 Western印迹法检测两种病毒在肝细胞中的表达。 结果 :连接、重组后通过酶切和测序法筛选出病毒质粒 p Ad HGF和 p Adu PA;经 2 93细胞包装 ,3d后均观察到绿色荧光蛋白明显表达 ,Cs Cl梯度离心纯化最终分别获得 4× 10 1 0 efu/ m l滴度的重组病毒 Ad HGF和 6× 10 1 0 efu/ ml Adu PA;两种病毒体外感染肝细胞 3d后 ,HGF和u PA表达均明显增加。结论 :细菌内同源重组制备复制缺陷型腺病毒 ,纯化过程简单 ,重组腺病毒在肝细胞中均高效表达 ,为肝细胞移植基因治疗肝纤维化提供了新的手段