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41.
《中国现代医生》2020,58(2):135-138+封三
目的探讨实时剪切波弹性成像在评估拉米夫定治疗乙肝纤维化临床疗效中的作用。方法选取2017年1月~2018年1月我院收治的80例乙肝纤维化患者,根据随机数字法分为对照组和观察组,每组40例。对照组采用常规治疗,观察组在对照组的基础上给予拉米夫定进行治疗,治疗6个月。比较两组治疗前后肝功能、肝纤维化指标,利用实时剪切波弹性成像评估两组治疗前后肝脏弹性模量值及肝穿刺活检情况,并进行比较。结果两组治疗后AST、ALT、TBIL水平均明显低于治疗前,差异有统计学意义(P0.05);观察组治疗后AST、ALT、TBIL水平均明显低于对照组,差异有统计学意义(P0.05);两组治疗后HA、LN、PⅢPN-P、CL-Ⅳ水平及杨氏弹性模量值均显著低于治疗前,差异有统计学意义(P0.05);观察组治疗后HA、LN、PⅢPN-P、CL-Ⅳ水平及杨氏弹性模量值均显著低于对照组,差异有统计学意义(P0.05);与治疗前相比,两组治疗后肝穿刺活检结果均有好转,尤其是汇管区、肝小叶内炎症及肝纤维化改善明显。结论实时剪切波弹性成像作为肝脏硬度定量检测的无创性技术,可用于拉米夫定治疗乙肝纤维化临床疗效评估的重要方法。 相似文献
42.
43.
K.-C. Sung D.-C. Seo S.-J. Lee M.-Y. Lee S.H. Wild C.D. Byrne 《Nutrition, metabolism, and cardiovascular diseases : NMCD》2019,29(5):489-495
Background and aims
It is not known whether non alcoholic fatty liver disease (NAFLD) is a risk factor for diabetes in non obese, non centrally-obese subjects. Our aim was to investigate relationships between fatty liver, insulin resistance and a biomarker score for liver fibrosis with incident diabetes at follow up, in subjects who were neither obese nor centrally-obese.Methods and results
As many as 70,303 subjects with a body mass index (BMI) < 25 kg/m2 and without diabetes were followed up for a maximum of 7.9 years. At baseline, fatty liver was identified by liver ultrasound, insulin resistance (IR) by homeostatic model assessment of insulin resistance (HOMA-IR) ≥2.0, and central obesity by waist circumference (waist circumference ≥90 cm (men) and ≥85 cm (women). The Fibrosis-4 (FIB-4 score) was used to estimate extent of liver fibrosis. Cox proportional hazards models adjusted for confounders were used to estimate hazard ratios (aHRs) for incident diabetes. As many as 852 incident cases of diabetes occurred during follow up (median [IQR] 3.71 [2.03] years). Mean ± SD BMI was 22.8 ± 1.8 and 21.7 ± 2.0 kg/m2 in subjects with and without diabetes at follow up. In subjects without central obesity and with fatty liver, aHRs (95% CI) for incident diabetes at follow up were 2.17 (1.56, 3.03) for men, and 2.86 (1.50,5.46) for women. Similar aHRs for incident diabetes occurred with fatty liver, IR and the highest quartile of FIB-4 combined, in men; and there was a non significant trend toward increased risk in women.Conclusions
In normal weight, non-centrally obese subjects NAFLD is an independent risk factor for incident diabetes. 相似文献44.
桑根酮C对博莱霉素诱导小鼠肺纤维化改善作用及机制研究 总被引:1,自引:0,他引:1
目的观察桑根酮C对博莱霉素诱导的小鼠肺纤维化的影响,并探讨其可能的作用机制。方法 C57BL/6小鼠随机分为4组,即假手术组、模型组和桑根酮C(100、50 mg/kg)组,每组20只。假手术组小鼠气管内注射生理盐水,模型组小鼠气管内注射博莱霉素诱导肺纤维化模型。术后第4天开始给药,连续给药28d后检测小鼠呼吸功能;检测肺内羟脯氨酸含量;HE染色观察肺内炎症表现;Masson染色观察肺内胶原活性;免疫组化法检测肺内转化生长因子-β1(TGF-β1)蛋白表达量;免疫蛋白印迹法检测肺内α平滑肌肌动蛋白(α-SMA)、核转录因子-κB p65(NF-κB p65)、磷酸化的核转录因子-κB p65(p-NF-κB p65)、Ⅰ型胶原和Ⅲ型胶原表达量。结果与模型组比较,桑根酮C能够改善经博莱霉素诱导形成肺纤维化后小鼠的呼吸功能,能够明显降低肺内羟脯氨酸含量,明显减轻肺内炎症和胶原沉积,肺内TGF-β1、α-SMA、NF-κBp65、p-NF-κBp65、Ⅰ型胶原和Ⅲ型胶原蛋白表达量明显降低。结论桑根酮C能够明显改善博莱霉素诱导小鼠肺纤维化,改善呼吸功能,其机制可能与抑制TGF-β1过表达和降低炎症转录因子NF-κB及磷酸化表达有关。 相似文献
45.
目的对比研究腹腔镜下外生性肾血管平滑肌脂肪瘤"蘑菇状"剜除与标准肾部分切除术的安全性及有效性,为肾血管平滑肌脂肪瘤腹腔镜下"蘑菇状"剜除术术式的建立提供临床依据。
方法选取海南医学院第二附属医院与解放军总医院2018年1月至2019年5月期间,接受腹腔镜手术的肾血管平滑肌脂肪瘤患者53例,其中25例沿肿瘤假包膜行"蘑菇状"剜除术(A组)、28例行肾部分切除术(B组)。比较两组手术患者的肾动脉阻断时间、手术时间、术中出血量、术后24 h血红蛋白、术后eGFR(estimated glomerular filtration rate,估计肾小球率过滤)的变化、术后住院时间和术后肿瘤复发率。
结果53例手术无术中转开放,无死亡病例。肾动脉阻断时间:A组(11.9±2.2)min、B组(21.5±6.5) min(P<0.001)。手术时间:A组(87.9±24.8)min、B组(114.3±38.9) min(P<0.001)。术中出血量:A组20 ml(20~40)ml、B组50 ml(50~100)ml(P<0.001)。术后24 h血红蛋白变化:A组(7.4±4.3) g/L、B组(12.4±8.8) g/L(P=0.013)。术后24 h eGFR变化:A组(6.2±7.2 )ml(min·1.73 m2),B组(12.7±12.8)ml(min·1.73 m2)(P=0.027)。术后6个月eGFR变化:A组(1.5±3.7)ml(min·1.73 m2)、B组(6.5±5.6)ml(min·1.73 m2)(P<0.001)。术后住院时间:A组4.0 d(3~4)d、B组4.5 d(3~6)d(P=0.023)。术后随访两组术后肿瘤均无复发。
结论采用腹腔镜"蘑菇状"剜除术治疗外生性肾血管平滑肌脂肪瘤在肾动脉阻断时间、术中出血量、术后24 h血红蛋白、术后eGFR变化、术后住院时间等方面均优于传统肾部分切除术,两组术后肿瘤均无复发;该方法安全、有效,适于临床推广。 相似文献
46.
目的:探讨枳术丸水煎液及其拆方对大鼠结肠Cajal间质细胞(ICC)增殖和凋亡的影响及其分子机制,并从细胞分子层面分析中医攻补兼施法治疗慢传输型便秘可能的机制。方法:将40只大鼠随机分成白术组、枳实组、枳术丸组、空白血清组,每组10只。白术组灌以17.7 g·kg-1·d-1白术水煎液,枳实组灌以8.9 g·kg-1·d-1枳实水煎液,枳术丸组灌以26.4 g·kg-1·d-1枳术丸水煎液,空白血清组灌以无菌蒸馏水3 mL,每日1次,连续7 d,取血制备含药血清和空白血清。将4组含药血清分别配成5%,10%,15%,20%4个体积分数,干预24 h,观察ICC的数量、形态,用细胞增殖毒性检测试剂盒(CCK-8)检测各组细胞增殖情况,测定各组最佳干预体积分数。将大鼠结肠ICC细胞分为正常组、空白血清组、白术组、枳实组、枳术丸组,5-乙炔基-2'脱氧尿嘧啶核苷(EdU)检测各组ICC的增殖情况,流式细胞仪检测各组ICC的凋亡情况;蛋白免疫印迹法(Western blot)检测各组ICC中X连锁凋亡抑制蛋白(XIAP),增殖细胞核抗原(PCNA)蛋白表达情况。结果:与正常组比较,空白血清组、白术组、枳实组最佳干预体积分数均为10%,枳术丸组最佳干预体积分数为5%。与正常组比较,所有实验中空白血清组对ICC增殖和凋亡的影响没有明显差异;与正常组及空白血清组比较,白术组、枳实组、枳术丸组ICC增殖率有显著差异(P0.05,P0.01),与白术组和枳实组比较,枳术丸组对ICC增殖率明显增加(P0.05,P0.01);与枳实组比较,白术组对ICC增殖率变化不明显。与正常组及空白血清组比较,白术组、枳实组、枳术丸组ICC的凋亡率无明显差异;与正常组及空白血清组比较,白术组、枳实组、枳术丸组内的XIAP,PCNA蛋白水平均明显上调(P0.05,P0.01),三组间比较差异不明显。结论:枳术丸、枳实、白术在一定浓度下均能通过增加XIAP,PCNA蛋白表达促进ICC的增殖,且对ICC的凋亡无明显影响;以攻补兼施法立法的方剂枳术丸能促进ICC的增殖,并且其增殖效果优于攻伐单药枳实和补益单药白术。 相似文献
47.
Jinlan He Jianxiong He Li Min Yan He Hui Guan Jingjing Wang Xingchen Peng 《International journal of cancer. Journal international du cancer》2020,146(4):1052-1063
Sorafenib provides survival benefits in patients with advanced renal cell carcinoma (RCC), but its use is hampered by acquired drug resistance. It is important to fully clarify the molecular mechanisms of sorafenib resistance, which can help to avoid, delay or reverse drug resistance. Extracellular vesicles (EVs) can mediate intercellular communication by delivering effector molecules between cells. Here, we studied whether EVs are involved in sorafenib resistance of RCC and its possible molecular mechanisms. Using differential centrifugation, EVs were isolated from established sorafenib-resistant RCC cells (786-0 and ACHN), and EVs derived from sorafenib-resistant cells were uptaken by sensitive parental RCC cells and thus promoted drug resistance. Elevated exogenous miR-31-5p within EVs effectively downregulated MutL homolog 1 (MLH1) expression and thus promoted sorafenib resistance in vitro. Mice experiments also confirmed that miR-31-5p could mediate drug sensitivity in vivo. In addition, low expression of MLH1 was observed in sorafenib-resistant RCC cells and upregulation of MLH1 expression restored the sensitivity of resistant cell lines to sorafenib. Finally, miR-31-5p level in circulating EVs of RCC patients with progressive disease (PD) during sorafenib therapy was higher when compared to that in the pretherapy status. In conclusion, EVs shuttled miR-31-5p can transfer resistance information from sorafenib-resistant cells to sensitive cells by directly targeting MLH1, and thus magnify the drug resistance information to the whole tumor. Furthermore, miR-31-5p and MLH1 could be promising predictive biomarkers and therapeutic targets to prevent sorafenib resistance. 相似文献
48.
Béla Nagy Zsolt Bene Zsolt Fejes Sonya L. Heltshe David Reid Nicola J. Ronan Yvonne McCarthy Daniel Smith Attila Nagy Elizabeth Joseloff György Balla János Kappelmayer Milan Macek Scott C. Bell Barry J. Plant Margarida D. Amaral István Balogh 《Journal of cystic fibrosis》2019,18(2):271-277
Background
We have recently shown that human epididymis protein 4 (HE4) levels correlate with the severity of cystic fibrosis (CF) lung disease. However, there are no data on how HE4 levels alter in patients receiving CFTR modulating therapy.Methods
In this retrospective clinical study, 3 independent CF patient cohorts (US-American: 29, Australian: 12 and Irish: 19 cases) were enrolled carrying at least one Class III CFTR CF-causing mutation (p.Gly551Asp) and being treated with CFTR potentiator ivacaftor. Plasma HE4 was measured by immunoassay before treatment (baseline) and 1–6?months after commencement of ivacaftor, and were correlated with FEV1 (% predicted), sweat chloride, C-reactive protein (CRP) and body mass index (BMI).Results
After 1?month of therapy, HE4 levels were significantly lower than at baseline and remained decreased up to 6?months. A significant inverse correlation between absolute and delta values of HE4 and FEV1 (r?=??0.5376; P?<?.001 and r?=??0.3285; P?<?.001), was retrospectively observed in pooled groups, including an independent association of HE4 with FEV1 by multiple regression analysis (β?=??0.57, P?=?.019). Substantial area under the receiver operating characteristic curve (ROC-AUC) value was determined for HE4 when 7% mean change of FEV1 (0.722 [95% CI 0.581–0.863]; P?=?.029) were used as classifier, especially in the first 2?months of treatment (0.806 [95% CI 0.665–0.947]; P?<?.001).Conclusions
This study shows that plasma HE4 levels inversely correlate with lung function improvement in CF patients receiving ivacaftor. Overall, this potential biomarker may be of value for routine clinical and laboratory follow-up of CFTR modulating therapy. 相似文献49.
50.
目的:观察糖尿病肾病不同分期内热证与肾功能及炎症指标的相关性。方法:收集202例糖尿病肾病患者的临床资料,采用酶联免疫吸附法检测微炎症指标,包括超敏C反应蛋白(high-sensitivity C-reactive protein,HS-CRP)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α),进行统计分析。结果:与非内热证组比较,中期、晚期内热证组24小时尿蛋白定量明显升高;晚期内热证组的血清肌酐明显升高,肾小球滤过率(glomerular filtration rate,GFR)明显降低;炎症因子CRP、IL-6、TNF-α随疾病进展均呈上升趋势;晚期内热证组与非内热证组比较,IL-6、TNF-α升高;中期HS-CRP与内热积分呈正相关,晚期TNF-α与内热积分呈正相关。结论:内热病机贯穿于糖尿病肾病的始终,与糖尿病肾病肾功能以及疾病进展密切相关;同时,内热积分与炎症因子HS-CRP、TNF-α的表达存在一定的相关性,这种相关性在疾病中期、晚期表现更加明显。 相似文献