薄层色谱法鉴定蓝狐胆汁及其牛磺熊去氧胆酸对四氯化碳肝损伤的保护作用

 目的 确定蓝狐胆汁的药理作用。方法 取30只昆明种小鼠,分为5组,每组6只。分别为:(1)空白组,非肝损伤处理,投喂蒸馏水,注射无伤害性的豆油;(2)模型组,肝损伤处理,不投喂任何药物,完全为四氯化碳(CCL₄)急性肝损伤个体;(3)阳性组,肝损伤处理,投喂护肝片,0.4 g/kg;(4)高剂量组,肝损伤处理,投喂高剂量蓝狐胆汁粉,10 g/kg;(5)低剂量组,肝损伤处理,投喂低剂量的蓝狐胆汁粉,5 g/kg。首先用TLC法研究蓝狐胆汁成分中是否含有熊胆特有成分——牛磺熊去氧胆酸(UDCA),其次研究其胆汁对小鼠CCL₄肝损伤是否有保护作用。结果 对比蓝狐胆汁与熊胆汁,两者的相似度约50%, 两者共四类物质中,有两类相同,蓝狐胆汁中含有UDCA成分。实验动物的肝脏被CCL₄损伤之后,血清中的AST、ALT浓度明显增高,模型组与空白组对比,差异有统计学意义(P<0.05)。通过药理结果及病理切片,可以看到具有抑制CCL₄,造成急性肝损伤小鼠AST、ALT浓度降低的作用。结论 蓝狐胆汁对损伤的肝细胞有修复意义,对肝脏有明显的保护作用。     

Liver fibrosis evaluation by ARFI and APRI in chronic hepatitis C

AIM: To explore the value of liver fibrosis assessment by acoustic radiation force impulse (ARFI) and the AST/PLT ratio index (APRI) in chronic hepatitis C patients.METHODS: One hundred and twenty eight patients with chronic hepatitis C were examined using ARFI elastometry and APRI, calculated according to known formulae. The gold standard of liver biopsy was referred; ROC curve analysis was used to assess all ARFI and APRI values. The corresponding cut-off values, sensitivities, and specificities were calculated and compared. In addition, the correlation of liver fibrosis stages in chronic hepatitis C patients with ARFI measurements and APRI were also tested to evaluate significant data.RESULTS: The values of ARFI in S1-S4 were 1.23 ± 0.34 m/s, 1.48 ± 0.43 m/s, 2.06 ± 0.45 m/s, and 2.30 ± 0.87 m/s. The values of APRI in S1-S4 were 0.31 ± 0.45 m/s, 0.28 ± 0.38 m/s, 0.58 ± 0.59 m/s and 0.65 ± 0.34 m/s. ARFI (r = 0.649, P < 0.05) showed a better correlation with liver fibrosis stages in chronic hepatitis C than APRI (r = 0.478, P < 0.05). The areas under the ROC curves for ARFI and APRI were 0.775 and 0.721 for stages ≥ S2, 0.901 and 0.787 for stages ≥ S3, and 0.792 and 0.780 for S = 4, respectively.CONCLUSION: Both ARFI and APRI could evaluate liver fibrosis stages in chronic hepatitis C. ARFI is more accurate than the APRI index.     

肝脏移植再灌注损伤早期NF-κB活性的影响及意义

目的观察肝脏移植后再灌注早期血液核转录因子-κB（NF-κB）活性、TNF-α、肝酶学指标的关系,探讨再灌注早期再灌注损伤的机制。方法对20例肝硬化晚期病人（实验组）接受肝移植术前1h,供肝恢复血供后1、2、4及6h抽取患者外周血进行肝酶学检查,用Westernblot技术检测外周血中NF-κBP65表达,用双抗体夹心酶联免疫吸附法测定外周血中TNF-α表达水平,同时与10例健康成人（对照组）外周血肝酶学指标、NF-кBP65和TNF-α水平对比。结果肝移植术后早期外周血肝酶学指标在4h达到高峰,4h后呈现下降趋势,NF-κBP65和TNF-α的表达水平在2h达到峰值,且均高于移植术前和对照组,差异均有统计学意义（P〈0.05）。结论NF-кBP65及TNF-α在肝移植术后早期高表达,同时伴有肝脏损伤酶学指标反应性上调,表示肝移植术后肝脏炎症通路活跃,可能和缺血后再灌注有关。     

Cervical non-squamous carcinoma: an effective combination chemotherapy of taxane, anthracycline and platinum for advanced or recurrent cases

Objective

An effective salvage chemotherapy for advanced and recurrent non-squamous carcinoma of the uterine cervix has not yet been established. The aim of the present study was to analyze the safety and efficacy of a combination chemotherapy for this disease using taxane, anthracycline, and platinum.

Study design

This was a retrospective analysis of advanced and recurrent non-squamous cervical cancers treated at the Osaka University Hospital and the Osaka Medical Center for Cancer and Cardiovascular Diseases during a 10 year study period from 2000 to 2009. Single agent chemotherapies and combination chemotherapies for advanced and recurrent cervical cancer cases of non-squamous histology which were reported in the English literature were also reviewed.

Results

Salvage chemotherapy, using taxane, anthracycline and platinum, was performed for 5 advanced and 14 recurrent cases. Prior to the salvage chemotherapy, 15 (79%) of the 19 patients had already received either radiation or chemotherapy. A complete or partial tumor response was achieved in 8 (42%) of the 19 cases. The response rate for recurrent disease in a previously irradiated field was 40%. The median progression-free survival (PFS) and overall survival (OS) were 8 months (1–108) and 13 months (5–108), respectively. Grade 4 and febrile grade 3 neutropenia was observed in 6 cases (32%), but there was no case in which salvage chemotherapy had to be cancelled due to toxicity. According to previous reports, the cumulative response rate of combination chemotherapy (35%) was significantly higher than that of single agent chemotherapy (17%) (p < 0.001). OS tended to be longer in the combination chemotherapy cases (8.7 months to 18 months) than that of single agent chemotherapy cases (7.3+ months to 9.1+ months).

Conclusion

Combination chemotherapy of taxane, anthracycline, and platinum was found to have a survival benefit for advanced and recurrent cervical cancer patients of non-squamous carcinoma histology, with a tolerable toxicity.     

空心莲子草醇提物对化学性肝损伤的影响

目的观察空心莲子草（APG）对化学性肝损伤小鼠的影响。方法分别采用CCl4和D-半乳糖胺作为化学毒物制成化学性肝损伤模型。测定各组动物血清丙氨酸氨基转移酶（ALT）和血清天门冬氨酸氨基转移酶（ASY）的活性。光镜下观察其肝脏病理变化,并测定肝匀浆MDA含量和SOD活力。结果CCl4肝损伤模型组和D-半乳糖胺肝损伤模型组小鼠的血清ALT和AST均明显高于正常对照组（P〈0．01）,SOD活力较正常对照组低（P〈0．01）,MDA含量高于正常对照组（P〈0．01）,表明CCl4和D-半乳糖胺均造模成功。空心莲子草高、中剂量组较模型组血清ALT和AST活性明显降低（P〈0．01）,MDA含量明显降低和SOD活力明显提高（P〈0．01）。病理组织学观察,空心莲子草组肝损较模型组明显减轻。结论空心莲子草对化学性肝损伤有保护作用。      

乳酸脱氢酶同工酶1（LD1）在诊断儿童心肌细胞损伤中的应用

目的探讨LD1在辅助诊断儿童心肌细胞损伤中的应用价值。方法用日立7180全自动化分析仪对594例门诊的儿科患者（年龄〈=14岁）同时检测心肌酶谱：磷酸肌酸激酶（CK）、磷酸肌酸激酶biB同工酶（CK-MB）、乳酸脱氢酶（LD）、乳酸脱氢酶同工酶1（LD1）、天门冬氨酸转移梅（AST）、α-羟丁酸脱氢酶（α-HBD）,比较各项检测指标对心肌细胞损伤的诊断价值。结果对594例患者心肌酶谱检测中,伴有CK升高的占2．5％,CK-MB升高的占39．9％,LD升高的占66．2％,廿皿D升高的占63．0％,AST升高的占9．4％,LD1升高的占1．0％,心肌细胞损伤诊断4例,占0．6％。结论将LD1组合到心肌酶谱的检测中,可有效排除非心肌细胞损伤引起的传统心肌酶谱中检测结果的非特异性增高,对心肌细胞损伤的筛查有较好的应用价值。     

五味子对四氯化碳所致小鼠急性肝损伤的作用研究

目的:观察五味子对四氯化碳(CCl4)所致小鼠急性肝损伤的保护作用。方法:采用CCl4造成小鼠急性肝损伤模型,终点比色法测定小鼠血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转换酶(AST)、白蛋白(ALB)含量,观察病理组织学改变。结果:五味子明显降低CCl4引起的ALT、AST增高;病理组织学检查发现五味子明显减轻肝细胞的损伤。结论:五味子对CCl4所致小白鼠急性肝损伤具有明显的保护作用。