愈肝龙胶囊联合恩替卡韦治疗乙型肝炎肝纤维化临床观察

目的:研究愈肝龙胶囊联合恩替卡韦治疗慢性乙型肝炎肝纤维化的临床疗效。方法:将符合纳入标准的116例慢性乙型肝炎肝纤维化患者随机分为观察组64例和对照组52例,两组患者均给予恩替卡韦抗病毒治疗,观察组加用愈肝龙胶囊。观察两组患者治疗前与治疗36个月后肝硬度值(LSM)、超声影像学指标(门静脉内径、脾脏厚度)、血清肝纤维化指标4项(HA、LN、C-Ⅳ、PC-Ⅲ)、肝功能(ALT、AST、PLT、Alb、TBil)、APRI指数的变化。结果:两组患者治疗36个月后,观察组的LSM值、肝纤维化指标(C-Ⅳ)、肝功能(ALT、AST、PLT、Alb、TBil)以及APRI指数优于治疗前(P<0.05),且与对照组比较差异有显著性意义(P<0.05)。结论:复方中成药愈肝龙胶囊联合恩替卡韦改善慢性乙型肝炎肝患者肝纤维化与肝功能的效果优于单用恩替卡韦。     

Fas配体和细胞黏附分子1在肥大扁桃体组织高内皮小静脉中的表达及意义

目的：探讨Fas配体（FasL）和细胞黏附分子1（ICAM-1）在肥大扁桃体组织高内皮小静脉（HEV）中的表达及意义。方法：收集37例扁桃体切除标本,其中20例为慢性肥大性扁桃体炎患者（CHT组）,17例为特异性扁桃体肥大患者（ITH组）。应用苏木精-伊红染色法和免疫组织化学染色（SABC法）研究2组扁桃体组织HEV的T、B淋巴细胞的数目,内皮细胞中FasL及ICAM-1的表达。结果：CHT组HEV中ICAM-1的表达明显高于ITH组（P〈0.05）,而ITH组HEV中FasL的表达明显高于CHT组（P〈0.05）。结论：HEV内皮细胞表达的ICAM-1和FasL均可能在扁桃体肥大的发生、发展过程中起一定的促进作用,前者主要促进CHT发展,后者主要导致ITH。     

Effect of Anluohuaxian Tablet Combined with γ-IFN on Schistosomal Liver Fibrosis

The therapeutic effects of anluohuaxian tablet combined with γ-IFN on schistosomal liver fibrosis and its mechanism were studied in a murine model and clinical cases of schistosomal liver fibrosis, Fifty Kunming mice were randomly divided into 5 groups： normal control group, infection control group, anluohuaxian tablet-treated group, γ-IFN-treated group and combined treatment （anluohuaian tablet＋γ-IFN） group. Pathologic changes in liver, including hepatic pigmentation and the size of schistosomal egg granuloma, were observed by HE staining after treatment for 8 weeks. The expression of the type Ⅰ and Ⅲ collagen, and TIMP-1 was detected by immunohistochemistry. TGF-β1 mRNA expression was examined by real-time fluorescent quantitative PCR. Sixty patients with schistosomal liver fibrosis were divided into treatment group and control group. The patients in treatment group were treated with anluohuaxian tablet in combination with γ-IFN for 6 months. Before and after treatment, the changes of symptoms and signs, liver function, serum liver fibrosis indexes and imaging indexes were observed. The results showed that as compared with infection control group, all forms of treatments relieved the hepatic pathological injury with apparently diminished size of schistosomal egg nodules and decreased percentage of pigmentation （P〈0.05）. Furthermore, the expression of collagen Ⅰ and Ⅲ, TIMP-1, and TGF-β1 mRNA in combined treatment group was significantly decreased as compared with anluohuaxian tablet-treated and γ-IFN-treated groups （P〈0.05）. In the clinical observation, the serum liver fibrosis indexes, the portal vein width as well as the spleen thickness was significantly reduced in treatment group as compared with control group （P〈0.05）. It was concluded that the combined use of anluohuaxian tablet with γ-IFN in schistosomal liver fibrosis could protect liver function, alleviate liver fibrosis, and could be used as a choice in treating patients with schiatosomal liver fibrosis.     

抗肝衰复方治疗MHV-3感染肝衰竭小鼠的作用观察

目的:观察抗肝衰复方治疗Balb/cJ小鼠感染MHV-3所致肝衰竭的疗效及初步探讨其作用机制.方法:将75只Balb/cJ小鼠随机分为3组:生理盐水对照组、茵陈复方组1、茵陈复方组2(抗肝衰复方组).采用MHV-3感染Balb/cJ小鼠,建立急性肝衰竭模型.描绘各茵陈复方组的生存曲线,观察血清生化及肝脏病理组织学改变,免疫组化检测小鼠肝组织纤维介素(mfgl2)的表达状况.结果:与生理盐水对照组及茵陈复方组1比较,抗肝衰复方组的生存情况最佳,血清ALT、STB明显降低(P＜0.01或P＜0.05);肝细胞损害明显减轻(P＜0.05);与生理盐水对照组及茵陈复方组1比较,抗肝衰复方组中肝组织mfgl2表达明显减少(P＜0.01或P＜0.05).结论:抗肝衰复方可减轻MHV-3感染的Balb/cJ小鼠肝衰竭时的肝功能损伤及肝细胞mfgl2的表达水平.     

IL-17在小鼠自身免疫性肝炎中的表达及其意义

目的 探讨IL-17在小鼠自身免疫性肝炎中的表达及其意义.方法 建立实验性自身免疫性肝炎小鼠模型,检测肝脏病理组织学改变以及血清中谷丙转氨酶(ALT)水平;免疫组化方法检测肝脏组织中IL-17的表达;ELISA方法检测小鼠血清中IL-17水平.结果 成功地建立实验性自身免疫性肝炎小鼠模型,其血清ALT水平在建模后21 d达到高峰.模型组小鼠的肝脏组织中IL-17高表达,而对照组肝脏组织中没有IL-17表达;建模后小鼠血清中IL-17水平较对照组明显升高(P＜0.05),并于21 d达峰值.IL-17与血清ALT水平以及肝脏损伤趋势一致.肝组织中IL-17阳性细胞数和浸润中性粒细胞数呈正相关.结论 IL-17可能在自身免疫性肝炎的发病中起重要作用.     

抗肝衰复方联合西药治疗重型肝炎临床疗效观察

目的：评价抗肝衰复方对急性、亚急性、慢性重型肝炎患者的临床治疗效果。方法：随机选择120例重型肝炎患者将其分为两组，对照组60例采用《病毒性肝炎防治方案》确定的常规西药治疗，治疗组60例在常规西医治疗基础上加用抗肝衰复方（药物口服和／或灌肠）治疗，100ml／次，1剂／d，14天为1个疗程，连用3—4个疗程。观察临床症状、体征变化，比较肝功能、乙肝病毒血清标志物及常规生化指标改善情况，研究抗肝衰复方对重型肝炎患者主要并发症的干预效果，统计治疗的有效率及存活率。结果：治疗组有效率71．7％。显效率为48．3％，对照组有效率为51．7％，显效率为20.2％，差异均有显著性意义（P〈0.05或P〈0．01）；治疗3个疗程后患者乏力、上腹不适、恶心、纳差、腹胀等临床症状及体征迅速缓解，血清总胆红素（TBil）、天门冬氨酸转氨酶（AST）、凝血酶原活动度（PTA）也明显改善，差异均有显著性意义（P〈0．05或P〈0．01）。而丙氨酸转氨酶（ALT）与对照组比较也有下降，但差异无显著性意义（P〉0．05）。并发症在治疗3个疗程后均少于对照组，肝性脑病、肝肾综合征等并发症减少较对照组差异有显著性意义（P〈0.05）；治疗3个疗程后HBVDNA、HBeAg定量滴度与对照组比较均有加速下降趋势，但差异无显著性意义（P〉0．05）。结论：抗肝衰复方有助于改善急性、亚急性、慢性重型肝炎患者的预后，是提高整体治疗重型肝炎疗效的有效措施之一。     

Differential Gene Expression Profiles in Acute Hepatic Failure Model in Mice Infected with MHV-3 Virus Intervened by Anti-hepatic Failure Compound

Differential gene expression profiles in Balb/cJ mouse model of acute hepatic failure infected with MHV-3 virus intervened by anti-hepatic failure compound(AHFC) and the changes of cytokines regulated by genes were investigated.The Balb/cj mice were divided into AHFC-intervened group and control group randomly.Acute hepatic failure model of Balb/cJ mice infected with MHV-3 virus was established.The survival rate in the two groups was observed.It was found that the survival rate in the AHFC-intervened group and control group was 90% and 50% respectively 48 h after intraperitoneal injection of MHV-3(P<0.05).Before and after the experiment,the cytokines in peripheral blood of the survival mice were determined,and RNA was extracted from survival mouse liver tissue for the analysis of the differential gene expression by a 36 kb mouse oligonuleotide DNA array.In all the genes of microarray there were 332 genes expressed differently in the two groups,in which 234 genes were up-regulated and 78 genes down-regulated.Through clustering analysis,the differential expression of immune related genes,including TNF receptor superfamily,Kctd9,Bcl-2,Fgl2,IL-8,IL-6,IFN-γ,TNF-α etc.might be related with the curative effectiveness of AHFC.It was suggested that AHFC can balance the immune state of mouse model of acute hepatic failure infected with MHV-3 virus mainly through regulating the expression of immune related genes,decrease the immune damage and inhibit liver cell apoptosis of mouse acute hepatic failure model obviously so as to increase the survival rate of mouse models of acute hepatic failure.     

应用人类全基因组寡核苷酸芯片筛查自身免疫性肝炎相关基因

为研究自身免疫性肝炎发病过程中基因表达改变与免疫反应的关系,我们采用人类全基因寡核菅酸芯片筛查自身免疫性肝炎差异表达基因,并对结果进行聚类分析,筛选出与疾病关系最密切的基因功能群,为进一步阐明发病机制,寻找致病基因提供参考。     

可溶性纤维介素蛋白在实验性自身免疫性肝炎组织中的表达

自身免疫性肝炎(AIH)是一种病因不明的慢性肝细胞炎症.纤维介素蛋白(fgl2)可分为跨模型和可溶性.