儿童非酒精性脂肪性肝病

非酒精性脂肪性肝病(NAFLD)是一种病变主体在肝小叶,以肝细胞弥漫性脂肪变性和脂肪蓄积为病理特征,无过量饮酒史的临床综合征。它包括单纯性脂肪肝(NAFL)及其演变的脂肪性肝炎(NASH)和脂肪性肝硬化3种类型。NAFLD的发病与肥胖有关。近20年来,肥胖症在儿童中发病迅速增加,NAFLD作为儿童慢性肝病的常见病逐渐引起人们的重视。     

非酒精性脂肪性肝病的防治

非酒精性脂肪性肝病（NAFLD）是指除外酒精和其他明确的损肝因素所致的、以弥漫性肝细胞大泡性脂肪变性为主要特征的临床病理综合征，临床分为单纯性脂肪肝（SFL）和非酒精性脂肪性肝炎（NASH）两种，严重的NASH病例可发生肝纤维化与肝硬化，甚至引起肝癌，因此对NASH应引起广泛重视。     

非酒精性脂肪性肝病与原发性肝癌

非酒精性脂肪性肝病（NAFLD）的概念80年代由Schaffner首次提出,是指肝组织病理学改变与酒精性肝病相类似,但无过量饮酒史的临床病理综合征,包括单纯性脂肪肝、脂肪性肝炎（NASH）和NASH相关性肝硬化3种病理类型。     

非酒精性脂肪性肝病病理学研究进展

非酒精性脂肪性肝病(NAFLD)是包括单纯性脂肪肝、非酒精性脂肪性肝炎(NASH)、非酒精性脂肪性肝纤维化/肝硬化三个病变过程的临床病理综合征.美国的流行病学调查结果表明NAFLD发病率接近20%[1,2],远远超过丙型肝炎或酒精性肝病的发病率[3],NAFLD现已成为欧美等国慢性肝病中的第一大病种.我国目前尚无确切的NAFLD发病率数据,已有的流行病学研究结果显示,我国NAFLD的发病率约为5%～12%[4],随着我国肥胖人群的不断增加,NAFLD的发病率有可能更高.病理组织学检查被认为是NAFLD诊断的"金标准",自1980年Ludwig等[5]首次命名NASH以来,随着研究的广泛深入,NAFLD病理学研究也取得了很大进展.     

非酒精性脂肪性肝病的临床特征和自然史

非酒精性脂肪性肝病(NAFLD)是一种肝组织病理学改变,与酒精性肝病相类似,但无过量饮酒史的临床病理综合征,包括单纯性脂肪肝、脂肪性肝炎、脂肪性肝纤维化和肝硬化在内的一组临床病理状态。上世纪80年代后期,人们逐渐认识到NAFLD发病率逐年增多,其在西方国家已成为最常见的肝病     

非酒精性脂肪性肝病的相关基因研究

非酒精性脂肪性肝病（NAFLD）是一种无过量饮酒史,以肝实质细胞脂肪变性和脂肪贮积为特征的临床病理综合征。其疾病谱随病理进展而表现不一,包括单纯性脂肪肝、非酒精性脂肪性肝炎（NASH）、肝纤维化和肝硬化。肥胖、2型糖尿病、高脂血症被认为是NAFLD的重要危险因素。NAFLD的发病机制尚不完全清楚,主要有胰岛素抵抗、脂肪变性、脂质过氧化、氧化应激和细胞因子作用等。本文对已报道的,与NAFLD发病相关的基因作一小结,并对这些基因在NAFLD的发生发展中所起的独特作用作一阐述。     

非酒精性脂肪性肝病的治疗新进展

非酒精性脂肪性肝病（NAFLD）是一种常见的临床病理综合征，具有广泛的疾病谱，其病理组织学特点与酒精性肝损伤相似，但患者无明显饮酒史。NAFLD组织学特点多样化，可从单纯的肝脂肪变性，即非酒精性脂肪肝（NAFL）发展为脂肪性肝炎，即非酒精性脂肪性肝炎（NASH），再进展为肝纤维化和肝硬化，继而发展为肝衰竭，且病死率较高。因此NAFLD越来越被视为是导致肝相关性患病率和病死率升高的主要原因之一，已引起人们的广泛关注。     

非酒精性脂肪性肝病及其伴随疾病动物模型的建立

非酒精性脂肪性肝病（NAFLD）是一种包括从单纯性脂肪肝到非酒精性脂肪性肝炎（NASH）的临床病理疾病谱。自然史研究显示,NASH 患者具有更高的肝脏病变进展风险。而且,NAFLD 与代谢综合征（MS）、动脉粥样硬化的关联,使其越来越多受到关注。因此,近年来针对 NAFLD／NASH 的转化研究也日益增多［1］。     

非酒精性脂肪性肝病的中医药研究进展

非酒精性脂肪性肝病(non-alcoholic fatty liver disease,以下简称NAFLD)是指除外酒精和其他明确的损肝因素所致的,病变主体在肝小叶的,以弥漫性肝细胞大泡性脂肪变性和脂肪贮积为病理特征的临床病理综合征,包括单纯性脂肪肝、脂肪性肝炎(NASH)、脂肪性肝硬化三种主要类型.随着人们生活习惯及饮食结构的改变,NAFLD发病率不断上升,NAFLD的中医药研究也逐渐兴起,尤其是近几年来,中医对NAFLD的研究进一步深化,取得了新进展.由于不同医家的经验、体会、认识的不同,其辨证思路及用药习惯也存在差异.现对NAFLD的中医药治疗状况作一评述.     

中医药防治非酒精性脂肪性肝病的研究

非酒精性脂肪性肝病（NAFLD）是指除外酒精和其他损肝因素所致的，以弥漫性肝细胞大泡性脂肪变为主要特征的临床病理综合征．包括非酒精性单纯性脂肪肝（NAFL）、非酒精性脂肪性肝炎（NASH）、非酒精性脂肪性肝硬化三种主要类型。NAFLD在西方普通人群中的发病率接近20％～30％。其中约10％的病人会发展成NASH．后者近30％的病人可进展为肝硬化．甚至发生终末期的肝功能衰竭。我国脂肪肝在一般人群中的患病率为10％～16％，在肥胖患者中，脂肪肝的检出率高达38％。     

过氧化物酶增殖体激活受体γ2基因Pro12Ala多态性与非酒精性脂肪性肝病关系的研究

本研究采用限制性片段长度多态性分析(RFLP)的方法检测过氧化物酶增殖体激活受体(PPAR)γ2基因Pro12Ala多态性,以期从基因学角度进一步阐明NAFLD的发病机制。一、资料与方法1.研究对象:2005年1-6月间天津医科大学总医院汉族体检人员296例,经B超证实有脂肪肝者155例为病例组,无脂肪肝者141例为对照组。脂肪肝诊断标准符合B超检查     

熊去氧胆酸对肝细胞凋亡作用的分子机制

熊去氧胆酸是人胆汁的生理成分,占正常人总胆汁酸的1％～3％。它是一亲水性强,去垢性差,几乎无毒性的胆汁酸,具有利胆、细胞保护和拮抗疏水性胆汁酸的细胞毒性等作用,已广泛在临床上用于治疗原发性硬化性胆管炎、原发性胆汁性肝硬变和妊娠肝内胆汁淤积症等。近年来发现UDCA具有抗肝细胞凋亡作用,并对其作用机制有了一定了解。     

Current malaria situation in Azerbaijan

The malaria epidemiological situation has substantially improved in Azerbaijan. In 1999, the incidence of malaria has been 2.2 times less than in 1998 (2,315 versus 5,175 cases). This reduction has been seen in all endemic areas of the country: the incidence of malaria reduced by a factor of 1.5 to 10, including its border regions where it is by 4 times less (633 versus 2,534 cases). There was a 1.8-fold decrease in the number of new foci in 1999 as compared to 1998 (165 versus 92). All malaria cases had local features. Of the imported cases in 1999, there were 3 cases of tropical malaria from Sudan and one case of P. vivax malaria from Georgia. Priority measures to implement the National Malaria Control Programme are as follows: Early detection, diagnosis, and radical treatment of malaria patients. Strengthening of laboratory service. Chemoprophylaxis for high-risk groups. Vector control. Improvement of knowledge among health workers. Increase in social mobilization.     

Current malaria situation in Turkey

Geographically, Turkey is situated in an area where malaria is very risky. The climatic conditions in the region are suitable for the malaria vector to proliferate. Due to agricultural infrastructural changes, GAP and other similar projects, insufficient environmental conditions, urbanization, national and international population moves, are a key to manage malaria control activities. It is estimated that malaria will be a potential danger for Turkey in the forthcoming years. The disease is located largely in south-eastern Anatolia. The Diyarbakir, Batman, Sanliurfa, Siirt, and Mardin districts are the most affected areas. In western districts, like Aydin and Manisa, an increase in the number of indigenous cases can be observed from time to time. This is due to workers moving from malaria districts to western parts to final work. Since these workers cannot be controlled, the population living in these regions get infected from indigenous cases. There were 84,345 malaria cases in 1994 and 82,096 in 1995, they decreased to 60,884 in 1996 and numbered 35,456 in 1997. They accounted for 36,842 and 20,963 in 1998 and 1999, respectively. In Turkey there are almost all cases of P. vivax malaria. There are also P. vivax and P. falciparum malaria cases coming from other countries: There were 321 P. vivax cases, including 2 P. falciparum ones, arriving to Turkey from Iraq in 1995. The P. vivax malaria cases accounted for 229 in 1996, and 67, cases P. vivax including 12 P. falciparum cases, in 1997, and 4 P. vivax cases in 1998 that came from that country. One P. vivax case entered Turkey from Georgia in 1998. The cause of higher incidence of P. vivax cases in 1995, it decreasing in 1999, is the lack of border controls over workers coming to Turkey. The other internationally imported cases are from Syria, Sudan, Pakistan, Afghanistan, Nigeria, India, Azerbaijan, Malaysia, Ghana, Indonesia, Yemen. Our examinations have shown that none of these internationally imported cases are important in transmitting the diseases. The districts where malaria cases occur are the places where population moves are rapid, agriculture is the main occupation, the increase in the population is high and the education/cultural level is low. Within years, the districts with high malaria cases also differ. Before 1990 Cucurova and Amikova were the places that showed the highest incidence of malaria. Since 1990, the number of cases from south-eastern Anatolia has started to rise. The main reasons for this change are a comprehensive malaria prevention programme, regional development, developed agricultural systems, and lower population movements. The 1999 statistical data indicate that 83 and 17% of all malaria cases are observed in the GAP and other districts, respectively. The distribution of malaria cases in Turkey differs by months and climatic conditions. The incidence of malaria starts to rise in March, reaching its peak in July, August and September, begins to fall in October. In other words, the number of malaria cases is lowest in winter and reaches its peak in summer and autumn. This is not due to the parasite itself, but a climatic change is a main reason. In the past years the comprehensive malaria prevention programme has started bearing its fruits. Within the WHO Roll Back Malaria strategies, Turkey has started to implement its national malaria control projects, the meeting held on March 22, 2000, coordinated the country's international cooperation for this purpose. The meeting considered the aim of the project to be introduced into other organizations. In this regards, the target for 2002 is to halve the incidence of malaria as compared to 1999. The middle--and long-term incidence of malaria will be lowered to even smaller figures. The objectives of this project are as follows: to integrate malaria services with primary health care services to prove more effective studies; to develop early diagnosis and treatment systems, to provide better diagnostic services, and to develop mobile diagnostic ones; to make radical treatment and monitoring patients; to conduct regular active case surveillance studies; to conduct regular vector control studies; to monitor the sensitivity of vectors to insecticides and to provide their alternatives; to design malaria control studies for the specialists of districts; to implement educational programmes among the population and attract it in controlling malaria.     

Current malaria situation in Turkmenistan

Malaria is one of the main health problems facing most developing countries having a hot climate. It is a problem in Turkmenistan. The country is situated in Central Asia, north of the Kopetdag mountains, between the Caspian Sea to the west and the Amu-Darya river to the east. Turkmenistan stretches for a distance of 1,100 km from west to east and 650 km from north to south. It borders Kazakhstan in the north, Uzbekistan in the east and north-east, Iran in the south, and Afghanistan in the south-east. Seven malaria vector species are found in Turkmenistan, the main ones being Anopheles superpictus, An. pulcherrimus, and An. martinius. The potentially endemic area consists of the floodplains of the Tejen and Murgab rivers, with a long chain of reservoirs built along them. In 1980 most cases of imported malaria were recorded in military personnel who had returned from service in Afghanistan. In the past years, only tertian (Plasmodium vivax) malaria has been recorded and there have been no death from malaria over that period. In the Serkhetabad (Gushgi) district there are currently 5 active foci of malaria infection, with a population of 22,000 people. In 1999, forty nine cases of P. vivax malaria were recorded in Turkmenistan. Of them, 36 cases, including 4 children under 14 years were diagnosed for the first time while 13 were relapses. There were 88 fewer cases than those in the previous year (by a factor of 2.8). There were 17 more cases of imported malaria than those in 1998 (by a factor of 1.7), most of which occurred in the foci of malaria infection (Serkhetabad, Tagtabazar, and Kerki districts), in the city of Ashkhabat and in Lebap, Dashkhovuz and Akhal Regions. The emergence of indigenous malaria in the border areas was due to the importation of the disease at intervals by infected mosquitoes flying in from neighbouring countries (e.g. Afghanistan), the lack of drugs to treat the first cases and the lack of alternative insecticides. Most patients suffer from tertian malaria, which is the most dangerous from the epidemiological point of view since the main vectors in Turkmenistan, are highly susceptible to P. vivax infection. The particular dangerous phenomenon is the higher incidence of imported tertian malaria in rural areas where sick people and those who carry the parasite come into close contact with highly susceptible vectors. Thus, the risk that new malaria outbreaks will occur and the disease will become reestablished in the country is very high. It is also influenced by major changes in water use in the country, which have aggravated the mosquito situation. In the area around the Karakum canal and river basins, 17 large reservoirs have been constructed, with very extensive filtration ponds around them, which have become breeding ground's for malaria mosquitoes. There are 1219 water areas without any economic significance in the country, covering a total area of 1054 ha, which require regular treatment with insecticides. With assistance from the WHO European Regional Office, Dr. Guido Sabatinelli in particular, Turkmenistan has developed a plan for preventive malaria control measures for 1999-2001, which has been approved in a decree issued by the Ministry of Health and Medical Industry. The material support received has made it possible to provide large-scale prophylaxis for people who suffered from malaria in 1997-1999, seasonal treatment for people living near the active foci of the disease and interseasonal prophylaxis for people visiting these areas. Seasonal treatment with Dellaguil was made in 4,590 people living in the active foci of malaria infection, and 2,281 fixed-term military personnel belonging to the units stationed in the active foci of malaria infection. In all foci of infection, every person with malaria or carrying the parasite underwent epidemiological investigation and all cases were entered in health clinic records. In 1999, four seminars were held to train 75 specialists from all administrative areas in ways of improving senior staff's skills in the laboratory diagnosis of malaria. The laboratory equipment which the country has received makes it possible to train high-level specialists and to equip its main malaria diagnosis centers with microscopes and reagents. The received insecticides and sprayers enable mosquitoes to be eliminated in an area of 960,000 sq. km (240 foci of infection): for this, our sincere thanks and gratitude are due to Dr. Guido Sabatinelli. Specialists teams have been created in each region by a decree of the Ministry of Health and Medical Industry to conduct mosquito elimination activities, with personal responsibility for their progress. Three-day vector control seminars have been held for disinfectors in all regions. We should stress that 5 extra posts have been created in the parasitology department of the Central Laboratory of Hygiene and Epidemiology, State Epidemiological Surveillance Service in order to strengthen preventive malaria control activities in Turkmenistan (organizational and methodological support for health facilities, staff training, etc.). To prevent the emergence of new breeding grounds for malaria vectors, the state system of health surveillance over the hygiene and technical status of water facilities and the rules governing their work have been reinforced. Local executive authorities do every effort to eliminate small, economically unprofitable water areas by draining, filling in or cleaning them. All existing and potential mosquito breeding grounds within a three-kilometer radius of any community were identified. These water areas were certified and their previous certifications analyzed, taking into account any changes and additional information which has become available about the area. Seasonal variations in the number of larvae and imagoes were monitored in the specimen areas of water and daytime resting sites. The existing vector species were identified and a list of the main species in all areas was prepared. Water areas were treated in accordance with epidemiological instructions. These activities yielded positive results: only 10 cases of locally transmitted malaria were recorded throughout the country in 1999. To interrupt the endemic process of malaria in Turkmenistan, the following plan for 1999-2001 has been adopted. To improve the equipment and material base of a sanitary and epidemiological surveillance service and malaria diagnosis laboratories (vehicles, sprayers, microscopes, chemical reagents, etc.). To continue effort to recruit staff to fill vacancies for parasitologists, entomologists, and parasitology laboratory physicians in the sanitary and epidemiological surveillance service at regional, subregional, and district level. In April 2000, two six-day seminars were held for epidemiologists, parasitologists, and entomologists, organized jointly with WHO representatives at the Central Laboratory for Hygiene and Epidemiology. Two seminars on the laboratory diagnosis of malaria for laboratory physicians were also intended to be held in April 2000. To continue to treat malaria patients and parasite carriers throughout the year to prevent relapses. To continue activities to eliminate mosquitoes, to monitor seasonal variations in the number of vector larvae and imagoes in the specimen areas of water and daytime resting sites mosquito habitats, to identify the existing vector species, and to prepare a list of main species in all areas. To strengthen preventive health monitoring. To provide effective support of health care service by the state border guard service of Turkmenistan by supplying drugs for curative and preventive treatment of its staff. To provide the quantities of insecticides required for mosquito elimination and support staff training. To improve malaria control activities by reporting all cases of malaria promptly, conducting a high-quality epidemiological investigation of every case and a prompt laboratory diagnosis, and providing the parasitology departments of sanitary and epidemiological surveillance service at all levels with all-terrain vehicles, microscopes, and effective communication systems which they require. We are very happy to be cooperating with WHO and grateful for the help it has provided.     

肺癌患者白介素1受体拮抗剂基因多态性的研究

目的 对肺癌患者和健康人的白介素1受体拮抗剂基因(interleukin-1 receptor antagonist gene,IL-1RN)多态性进行研究,探讨IL-1RN与肺癌易感性的关系.方法 采用聚合酶链式反应技术对148例肺癌患者和150名健康对照者的IL-1RN基因多态性进行分析.结果 Ⅱ类等位基因(IL-...     

原发性胆汁性肝硬化研究现状

原发性胆汁性肝硬化 (ｐｒｉｍａｒｙｂｉｌｉａｒｙｃｉｒｒｈｏｓｉｓ ,ＰＢＣ)是一种原因不明的 ,由免疫损害介导的慢性进展性肝脏疾病 ,主要表现为肝内小胆管进行性破坏伴门脉炎症性改变 ,最终导致肝纤维化及肝硬化 ;临床表现为慢性梗阻性黄疸与肝脾肿大 ,晚期可出现肝功能     

海南省疟疾现状

疟疾是海南省最主要的传染病之一 ,虽然 1 999年疟疾疫情报告发病人数较 1 998年有明显下降 ,但仍与 1 997年发病人数相接近 ,且 1 999年疟疾发病人数占全省传染病总数的 2 2 .1 3% ,在传染病中排列第二。“上山感染”成为海南疟疾感染的主要来源 ,特别是抗药性恶性疟的比例有所上升 ,更增加了海南疟防工作难度 ,再加上疟防经费短缺、基层疟防人员减少、媒介防制困难等因素 ,海南的疟疾防治仍面临巨大的困难和挑战。1　疟疾发病情况1 .1　疟疾疫情据 1 999年传染病疫情报告 ,全省疟疾发病 34 55例 ,年发病率为 4 5.69/ 1 0万 ,无患疟死亡病…     

ACE基因多态性与心血管疾病相关性的研究进展

近年来,随着心血管疾病分子和细胞生物学研究取得较大进展,对器官和组织中肾素-血管紧张素系统（reninangiotensin system,RAS）作用的研究正成为热点,而血管紧张素转换酶（angiotensin-converting enzyme,ACE）是肾素-血管紧张素系统的关键酶,可使血管紧张素Ⅰ转变成血管紧张素Ⅱ,还可以使缓激肽灭活.