缬草提取物对类脂质代谢的影响与对胆囊结石治疗作用的关系

目的：研究缬草提取物对胆囊结石的治疗作用对血浆载脂蛋白、血清及胆汁类脂水平影响的关系。方法：大耳白种 家兔，手术植入人胆固醇为主的混合结石 。实验组灌喂缬草提取物，对照组灌喂等容、等渗盐水，8周后取出胆囊结石称重，取胆总管胆汁测胆固醇、磷脂、总胆汁酸浓度；取血清查载脂蛋白A1、B及胆固醇、磷脂、总胆汁酸水平。结果：实验组胆囊结石平均重量较对照组明显减轻（P＜0．01），结石消失率达75％；实验组血清胆固醇及总胆汁酸水平低于对照组（P＜0．05，P＜0．01），载脂蛋白A1高于对照组（P＜0．01），载脂蛋白B低于对照组（P＜0．01），胆总管胆汁酸实验组高于对照组（P＜0．05）。结论：缬草提取物对胆囊结石有明显治疗作用，其治疗作用与其对血清载脂蛋白及对血、胆汁内的类脂质水平改变有关。     

急性脑梗塞溶栓治疗的IL—1β、IL—6、TNF—α

采用溶栓疗法治疗32例急性脑梗塞患者,并与用常规方法治疗者进行对照,观察两组疗法对白细胞介素1β（IL-1β）、白细胞介素6（IL-6）及肿瘤坏死因子（TNF-α）的影响,并对其疗效进行分析。结果显示,溶栓组IL-1β、IL-6、TNF-α在溶栓后2小时及6小时明显下降,与其疗效及预后显著相关;与对照组比较,其欧洲卒中评分（ESS）和对3个月后的每日生活活动（Bathal）指数明显改善。提示溶栓组的近、远期效果均明显优于对照组。     

慢性乙型肝炎血清TNF—α,IL—1B,IL—4和IL—6测定及意义

一般认为乙型病毒性肝炎的肝脏损害是由于免疫引起免疫损伤和免疫紊乱所致.为探讨一些重要细胞因子在慢性乙型肝炎(CHB)中的作用,本文对69例不同临床类型CHB患者血清联合进行TNF-α、IL-Lb、IL-2、IL-4和IL-6测定.现报告如下.     

IL－lβ、IL－6和TNF－α在乙型病毒性肝炎患者肝组织中的检测及意十

了解细胞因子在病毒性肝炎发病过程中的作用。方法运用ＡＢＣ免疫组织化学法对５９例各型乙型病毒性肝炎肝组织中ＩＬ－１β、ＩＬ－６和ＴＮＦ－α进行检测。结果中度慢性肝炎、急性肝炎、肝炎肝硬化和重症肝炎患者的肝组织中ＩＬ－１β、ＩＬ－６和ＴＮＰ－α表达阳性细胞数高于非肝病组（Ｐ值＜０．００１）；肝癌时，癌旁肝组织中ＩＬ－６和ＴＮＦ－α表达阳性细胞数明显高于非肝病组（Ｐ值＜０．０１），而且高于其它各型肝病组（Ｐ值＜０．０５），ＩＬ－１β与非肝病组无差异（Ｐ值＞０．５）。这些细胞因子的表达阳性细胞数依轻度慢性肝炎、中度慢性肝炎、急性肝炎、肝炎肝硬化，重症黄疸肝炎和肝癌癌旁肝组织逐次增多。结论ＩＬ－１β、ＩＬ－６和ＴＮＦ－α可能直接参与和加重病毒性肝炎肝组织的病变过程。关键词     

乙肝后肝硬化患者血清IL—1β,TNF—α变化对骨代谢影响的临？…

为探讨细胞因子对乙肝后肝硬化骨代谢的影响,采用ＲＩＡ及ＥＬＩＳＡ分别测定３６例乙肝后肝硬化患者血清ＩＬ－１β、ＴＮＦ－α水平及骨密度测量,并与１５例健康者对照。结果表明,肝硬化患者血清ＩＬ－１β、ＴＮＦ－α水平较对照组显著升高（Ｐ〈０．００１,Ｐ〈０．００１）,其中骨质疏松（ＯＰ）组较非骨质疏松（ＮＯＰ）组均升高明显（Ｐ〈０．００１,Ｐ〈０．０１）,且两组间Ｃｈｉｌｄ－ＰｕｇｈＡ、Ｃ级同级分别比较     

蛋白酷氨酸激酶在IL—1β和TNF—α诱导类风湿关节炎成纤？…

目的 比较类风湿关节炎（ｒｈｅｕｍａｔｏｉｄ ａｒｔｈｒｉｔｉｓ,ＲＡ）与骨关节炎（ｏｓｔｅｏａｒｔｈｒｉｔｉｓ,ＯＡ）成纤维样滑膜细胞（ｆｉｂｒｏｂｌａｓｔ－ｌｉｋｅ ｓｙｎｏｖｉｏｃｙｔｅｓ,ＦＬＳ）蛋白酪氨酸磷酸化状态的差异;探讨ＲＡＦＬＳ中,蛋白酪氨酸激酶（ｐｒｏｔｅｉｎ ｔｙｒｏｓｉｎｅ ｋｉｎａｓｅ,ＰＴＫ）在ＩＬ－１β和ＴＮＦ－α作用下有丝分裂原活化蛋白激酶（ｍｉｔｏ－ｇｅｎ ａｃｔ     

口服红霉素对正常人及胆结石病人的胆囊动力作用研究

21例健康人和“无症状”胆囊结石病人口服红霉素0.5g,B超分别测定服药前后空腹胆囊容量(FV)及餐后剩余容量(RV).结果示:健康组服药前后FV(ml)分别为11.20±3.36和9.36±2.79,RV(ml)为4.60±2.54和3.16±1.61;胆结石组服药前后FV(ml)分别为20.88±7.14和19.41±7.92,RV(ml)为11.68±5.37和8.08±3.93.服药前后比较差异有显著性(P<0.05～0.01).服药前后胆囊最大排空率(%)健康组分别为59.60±11.93和67.63±18.96(P>0.05);胆结石组分别为44.08±17.91和59.98±13.91(P<0.01).结论认为红霉素可促进正常人和胆囊结石患者的胆囊排空功能,并逆转部分病人的胆囊动力缺陷.     

Gallbladder motility and lithogenicity of bile in patients with choledocholithiasis after endoscopic sphincterotomy

Background/Aims: Ablation of the sphincter of Oddi has been shown to inhibit gallstone formation in the prairie dog model, probably by allevaiting gallbladder bile stasis. The effect of endoscopic sphincterotomy (ES) on gallbladder emptying and lithogenicity of bile has not been studied adequately in humans. We, therefore, studied the changes in gallbladder emptying and lithogenicity of bile following ES in patients with choledocholithiasis and gallbladder in situ.Methods: Thirteen patients with choledocholithiasis with intact gallbladder underwent ES and common bile duct clearance. Eight patients had concomitant gallstones. Gallbladder emptying was studied by real time ultrasonography after stimulation by ceruletid infusion. Fasting gallbladder bile was collected during endoscopic retrograde cholangiography by placing a 7F or 8F catheter in the common bile duct and after ceruletid stimulation of gallbladder for bile microscopy and cholesterol nucleation time determination. Gallbladder emptying, nucleation time and bile microscopy were performed before ES and again between 4 and 8 weeks after ES after cholangiographic confirmation of clearance of common bile duct stones.Results: Fasting and residual gallbladder volumes decreased and ejection fraction increased significantly following ES, suggesting decreased stasis and improved emptying of gallbladder. Nucleation time was prolonged and cholesterol crystal index in bile decreased after ES, suggesting decreased lithogenicity. The decrease in gallbladder volumes and increase in ejection fraction after ES were observed in both groups of patients, with or without concomitant gallstones.Conclusions: ES decreases the stasis of gallbladder bile, improves gallbladder emptying and decreases the lithogenicity of bile in patients with gallstone disease as reflected by prolongation in nucleation time. ES may find a role as an adjunct to oral bile acid therapy and extracorporeal shock wave lithotripsy in addition to a prophylactic role of preventing gallstone formation in high risk groups.     

胆囊癌组织中nm23H1和PTEN基因蛋白表达及其临床意义

目的:探讨nm23H1和PTEN基因蛋白在胆囊癌中表达的意义.方法:应用免疫组化方法,检测52例胆囊腺癌、20例胆囊腺瘤和10例慢性胆囊炎组织中nm23H1和PTEN表达水平.结果:在胆囊癌中nm23H1和PTEN表达阳性率分别为51.9%和42.3%,其表达阳性率均明显低于胆囊腺瘤和慢性胆囊炎(P＜0.05).nm23H1和PTEN表达与胆囊癌的分化程度、浆膜浸润和转移密切相关(P＜0.05).nm23H1和PTEN蛋白表达呈正相关(γ=0.56,P＜0.05).结论:检测nm23H1和PTEN基因蛋白表达可作为评价胆囊癌生物学行为的参考指标.     

Effects of Ursodeoxycholic Acid Therapy on In Vitro Gallbladder Contractility in Patients with Cholesterol Gallstones

During treatment with ursodeoxycholic acid(UDCA), the fasting gallbladder volume increases by ayet unknown mechanism. The present study tests whetherin vitro human gallbladder contractility in response to acetylcholine and cholecystokinin isaffected by UDCA therapy. Gallbladder tissue wasobtained from 15 patients treated with UDCA (10mg/kg/day) during three weeks prior to surgery, and from15 comparable patients not treated. Data were correlated within vivo contractility, bile composition, and gallbladderwall inflammation. The inflammation score was lower inthe treated patient group. UDCA treatment enhanced gallbladder contractility in vitro:Dose-response curves for acetylcholine andcholecystokinin were both shifted to the left, and themaximal contractile stress generated in response tocholecystokinin was higher in the treated group, whereas themaximal acetylcholine-induced stress was not increased.Maximal cholecystokinin-induced stress correlatedpositively with fasting gallbladder volume andnegatively with the biliary cholesterol saturation index,but not with bile salt hydrophobicity or gallbladderwall inflammation score. In conclusion, UDCA treatmentimproves in vitro gallbladder contractility, possibly related to a reduced biliary cholesterolsaturation. Increased fasting gallbladder volumes duringUDCA treatment thus do not appear to result fromdecreased gallbladder muscle contractilestrength.     

香烟烟雾提取物对人内皮细胞细胞间黏附分子-1和白介素-8表达以及与多形核中性粒细胞黏附的影响

目的探讨香烟烟雾提取物（CSE）诱导作用对人内皮细胞细胞间黏附分子-1（ICAM—1）和白介素-8（IL-8）表达以及与多形核中性粒细胞（PMN）黏附的影响。方法培养人脐静脉内皮细胞株（ECV-304）；制备香烟烟雾提取物（CSE）；用不同浓度（0、2．5％、5．0％、10．0％）CSE刺激内皮细胞，酶联免疫吸附测定（ELISA）法检测不同时间点（1h、3h、6h、9h、12h、24h、48h）收集的细胞培养上清液IL-8的浓度，细胞免疫化学染色（SABC）检测ICAM-1在不同时间点（3h、6h、9h、12h）内皮细胞上的表达，细胞记数法测定（1h、3h、6h、9h、12h）后PMN与内皮细胞的黏附率（PMN—EC）。结果（1）各CSE浓度组干预12h后，ICAM-1在EC上的表达量随着干预浓度的增加而增高，除了2．5％CSE干预组和5．0％CSE干预组之间无差异外，各组间差异均有非常显著性意义（P〈0．01）；10．0％CSE干预不同时间点后，随着干预时间的延长，ICAM-1在内皮细胞上的表达量增加。各时间组之间差异均有非常显著性意义（P〈0．01）。（2）随着CSE干预浓度的增加和干预时间的延长，内皮细胞表达IL-8的浓度增高，各组间差异均有非常显著性意义（P〈0．01）。（3）各CSE浓度组干预12h后，PMN—EC黏附率随着干预浓度的增加而增加，各组间差异均有非常显著性意义（P〈0.01）。10.0％CSE干预不同时间点后，随着干预时间的延长，PMN—EC黏附率增加，各时间组差异均有非常显著性意义（P〈0．01）。结论香烟烟雾提取物可以刺激激活血管内皮细胞ICAM-1和IL-8表达，增强PMN与内皮细胞的黏附。     

肝硬化患者胆囊和胃排空功能的研究

例肝硬化患者和10例健康对照者,禁食12小时后口服液体脂餐400ml,采用实时超声方法测定空腹及餐后90分钟内每15分钟胆囊及胃排空功能.结果显示:肝硬化患者胆囊最大排空率较对照组明显降低,胃半排空时间比对照组明显延长,提示肝硬化患者胆囊排空不足,胃排空延迟.肝硬化患者胃及胆囊排空曲线示胃排空延迟,胆囊再充盈迟缓.胆囊和胃排空曲线交点与对照组相似.提示肝硬化患者胆囊排空和胃排空可能有一定联系.结论:肝硬化患者存在胆囊和胃排空运动障碍,胆囊和胃排空之间可能存在一定联系.     

The Influence of Gallbladder Function on the Symptomatology in Gallstone Patients,and the Outcome after Cholecystectomy or Expectancy

The purpose of this study was to examine whether gallbladder function as assessed by a hepatobiliary scintigraphy was related to the symptomatology in gallstone patients and to the outcome 1 year after either cholecystectomy or watchful waiting. The study included 100 patients with uncomplicated gallstone disease. Fifty-six patients had a functioning gallbladder and 44 had a nonfunctioning gallbladder. Patients with a nonfunctioning gallbladder had significantly more vomiting and received more pain-killing injections during pain attacks. Otherwise, there were no differences in pain patterns or characteristics of dyspeptic symptoms in relation to gallbladder function. In patients with a functioning gallbladder, there were no significant differences between the group of patients with impaired and normal gallbladder function. Cholecystectomy was performed in 69 patients and at the 1-year follow-up; 22% continued to have pain attacks, but this was not related to the gallbladder function preoperatively. In 31 patients without cholecystectomy, 14 patients became asymptomatic within a 1-year follow-up. However, this was not related to gallbladder function. In conclusion, gallbladder function evaluated by a hepatobiliary scintigraphy was not related to the symptoms in gallstone patients, and was not related to the occurrence of symptoms after cholecystectomy or watchful waiting.     

胆囊胆固醇性息肉的发病机制和诊治进展

胆固醇性息肉(CPs)是胆囊息肉最常见的类型,其发病机制尚未阐明。目前主要有3种学说:胆囊壁局部合成的胆固醇增加;从胆汁和(或)血液中摄取的胆固醇增加;胆囊黏膜细胞移出过量胆固醇的能力受损。本病临床表现无特异性,B超广泛应用于CPs的诊断,但不能作为确诊依据。CPs的治疗仍存在分歧,多数学者支持保守治疗。本文就CPs的发病机制、临床表现、诊断和治疗现状及其研究进展作一综述。