慢性肝炎及肝硬化患者血清中MMP-13 、TNF-α及IL-6的表达

目的研究基质金属蛋白酶（MMP-13）在慢性乙型肝炎及乙型肝炎后肝硬化患者血清中的表达水平，同时检测患者血清中的肿瘤坏死因子α（TNF-α）、白细胞介素-6（IL-6）以了解其与MMP-13之间的关系。方法采用双抗体“夹芯”酶联免疫吸附测定（ELISA）方法对13例慢性乙型肝炎患者及28例乙型肝炎后肝硬化肝功能失代偿患者进行血清MMP-13、TNF—α及IL-6检测，并分别对健康对照组进行检测。结果乙型肝炎后肝硬化患者的MMP-13与对照组及慢性乙型肝炎组相比较，有显著增高（P〈0．05）。慢性乙型肝炎及乙型肝炎后肝硬化患者的血清中TNF—α及IL-6水平与对照组相比较，均有显著增高（P〉0．05）。慢性乙型肝炎及乙型肝炎后肝硬化患者血清中TNF-α及IL-6水平与MMP-13水平无明显相关性（P〉0．05）。结论MMP-13在肝纤维化形成过程中具有重要作用。TNF—α及IL-6对慢性乙型肝炎与乙型肝炎后肝硬化患者血清中MMP-13表达的影响甚小。     

血清TNF-α、MMP-9、IL-6水平检测在老年慢性心力衰竭患者病情评估中的应用价值

目的分析血清肿瘤坏死因子(TNF-α)、基质金属蛋白酶-9(MMP-9)、白介素-6(IL-6)水平检测在老年慢性心力衰竭(CHF)患者病情评估中的应用价值。方法选取老年CHF患者96例为观察组,同期健康体检者32例为对照组,采用酶联免疫法测定两组血清TNF-α及IL-6水平,采用双抗体夹心法测定两组血清MMP-9水平。对比两组血清TNF-α、MMP-9及IL-6水平及观察组不同心功能等级血清TNF-α、MMP-9及IL-6水平。结果观察组血清TNF-α、MMP-9、IL-6水平均高于对照组(P<0.05);不同心功能等级血清TNF-α、MMP-9、IL-6水平比较采用单因素方差分析,差异有统计学意义(P<0.05);心功能Ⅱ级患者血清TNF-α、MMP-9及IL-6水平均低于心功能Ⅲ级、Ⅳ级患者,心功能Ⅲ级患者低于心功能Ⅳ级患者(P<0.05)。结论血清TNF-α、MMP-9及IL-6水平与老年CHF患者病情严重程度呈正相关,在老年CHF患者病情评估具有较高的检测价值。     

抗 HMGB1抗体对小鼠肝纤维化的保护作用

目的：：探讨 HMGB1在 CCL4导致的肝纤维化发生发展中的作用及作用机制。方法：昆明种雄性小鼠30只,随机分为3组：正常组、CCL4肝纤维化组、抗 HMGB1抗体组,建模8周后取肝组织及血清。用 ELISA 法检测血清中 HA、Col-Ⅰ、PⅢP 和 IL-6、TNF-α的含量;用 HE 染色和天狼猩红染色观察肝组织病理改变和胶原纤维形成情况;用 Real time RT-PCR 法检测小鼠肝组织中 TGF-β、α-SMA 和MMP-9 mRNA 的表达。结果：CCL4肝纤维化组小鼠血清 HA、Col-Ⅰ、PⅢP、IL-6、TNF-α含量和肝组织 TGF-β、α-SMA 和 MMP-9 mRNA 表达均明显高于正常组小鼠(P <0.05);而且抗 HMGB1抗体组小鼠血清 HA、Col-Ⅰ、PⅢP、IL-6、TNF-α含量和肝组织 TGF-β1、α-SMA 和 MMP-9 mRNA 表达均明显低于 CCL4肝纤维化组小鼠(P <0.05)。结论：抗 HMGB1抗体可减轻小鼠肝纤维化,减少小鼠炎症因子和纤维化因子的表达;HMGB1可能通过启动炎症反应而促进肝纤维化发生发展。     

老年慢性心力衰竭患者血清TNF-α和MMP-9等的检测水平及对预后判断的意义

目的观察老年慢性心力衰竭（CHF）患者血清标志物TNF-α、MMP-9、脂联素（APN）、脑钠肽（BNP）、胱抑素C（Cys-C）、同型半胱氨酸（Hcy）、C反应蛋白（CRP）表达及对预后判断的意义。方法将本院收治的97例老年慢性心力衰竭患者作为观察组,选择同期体检的30例健康者作为对照组,观察两组TNF-α、MMP-9及IL-6等血清表达水平,同时观察心衰严重程度及患者预后情况,并分析其相关性。结果观察组TNF-α、MMP-9及IL-6等血清表达水平显著高于对照组,两组间差异有统计学意义（P〈0.05）;血清TNF-α和MMP-9表达水平与LVEF呈正相关（P〈0.01）;心功能等级越差患者,其再次住院率、病死率越高,各组间比较差异有统计学意义（P〈0.05）。结论慢性心力衰竭（CHF）血清标志物TNF-α和MMP-9等的表达水平与心功能等级及预后有关,对于判断病情及预后有重要的临床意义。     

中药结肠灌洗联合血浆置换对慢性重型乙型肝炎患者血清肿瘤坏死因子-α、白介素-18及内毒素水平的影响

目的观察中药结肠灌洗联合血浆置换对慢性重型乙型肝炎患者肝功能、血清TNF-α、IL-18及内毒素水平的影响,并探讨其机理。方法选择慢性重型乙型肝炎患者112例,分为中药结肠灌洗联合血浆置换组(治疗组)、血浆置换组(对照组),分别检测治疗前后肝功能、血清TNF-α、IL-18及内毒素水平的变化。结果治疗组治疗后血清TNF-α、IL-18及内毒素水平较治疗前显著下降(P0.05);同对照组比较血清总胆红素、血氨、血清TNF-α、IL-18及内毒素水平有显著性差异(P0.05)。结论中药结肠灌洗联合血浆置换治疗慢性重型乙型肝炎可更有效降低肝功能、血清TNF-α、IL-18及内毒素的水平,提高重型肝炎患者的存活率。     

IL-6、TNF-α、MMP-9表达水平与股动脉支架植入后再狭窄的相关性分析

目的:探索IL-6、TNF-α、MMP-9表达水平与股动脉支架植入术后再狭窄的相关作用。方法:选择2016年1月-2017年12月于本院血管外科就诊,经彩超或CTA或MRA证实存在股动脉狭窄或闭塞患者60例,于股动脉支架植入术前24 h,术后24 h、72 h、1个月、3个月及6个月检测患者血液标本中IL-6、TNF-α、MMP-9表达水平,并分析其与股动脉支架植入术后再狭窄严重程度的相关关系。结果:随访期间发生股动脉再狭窄(ISR组)19例,非狭窄(非ISR组)41例,再狭窄发生率为31.67%。在血清IL-6、TNF-α、MMP-9表达水平方面,两组术后24 h均明显高于术前24 h,差异均有统计学意义(P0.05),术后72 h与术后24 h比较,ISR组差异无统计学意义(P0.05),非ISR组差异有统计学意义(P0.05)。在血清IL-6、TNF-α、MMP-9表达水平方面,ISR组术后1、3、6个月均明显高于术前,非ISR组术后1、3、6个月均明显低于ISR组,差异均有统计学意义(P0.05)。非ISR组术后1、3、6个月与术前比较,差异均无统计学意义(P0.05)。术后6个月血清IL-6、TNF-α、MMP-9表达水平均与支架内再狭窄程度呈正相关(P0.05)。结论:股动脉再狭窄患者术后IL-6、TNF-α及MMP-9表达水平在股动脉支架植入术后会出现明显升高,并高于非狭窄患者,血清IL-6、TNF-α及MMP-9表达水平均与支架内再狭窄程度呈正相关,可作为股动脉支架植入术后治疗效果监测指标。     

安络化纤丸和恩替卡韦联合治疗对乙型肝炎肝硬化代偿期患者肝纤维化和炎性因子的影响

目的探讨安络化纤丸和恩替卡韦联合治疗对乙型肝炎肝硬化代偿期患者肝纤维化和炎性因子的影响。方法选择2016年1月至2017年12月新乡医学院第三附属医院收治的124例乙型肝炎肝硬化代偿期患者为研究对象,根据治疗方法将患者分为观察组64例和对照组60例,所有患者给予常规保肝治疗,在常规治疗基础上,对照组患者给予恩替卡韦治疗,观察组患者给予安络化纤丸联合恩替卡韦治疗,疗程均为24周。2组患者分别于治疗前、后采用酶联免疫吸附试验法检测血清透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原肽(PⅢP)、Ⅳ型胶原蛋白(Ⅳ-C)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)水平,采用胶乳免疫比浊法检测血清超敏C反应蛋白(hs-CRP)水平,应用Fibro Scan~?502型无创肝纤维化诊断仪测定肝脏硬度(LS)。结果治疗前2组患者血清HA、PⅢP、LN、Ⅳ-C、TNF-α、IL-6及hs-CRP水平比较差异均无统计学意义(P>0.05),2组患者治疗后血清HA、PⅢP、LN、Ⅳ-C、TNF-α、IL-6及hs-CRP水平显著低于治疗前(P<0.05);治疗后,观察组患者血清HA、PⅢP、LN、Ⅳ-C、TNF-α、IL-6及hs-CRP水平显著低于对照组(P<0.05)。治疗前2组患者LS比较差异无统计学意义(P>0.05),2组患者治疗后LS显著低于治疗前(P<0.05);治疗后,观察组患者LS显著低于对照组(P<0.05)。结论安络化纤丸联合恩替卡韦治疗乙型肝炎肝硬化代偿期患者可有效减轻炎症反应和肝纤维化。     

氧化苦参碱在治疗慢性乙型肝炎中抗肝纤维化的作用机制

目的 探讨氧化苦参碱在治疗慢性乙型肝炎(CHB)病情发展中抗纤维化的作用机制.方法 将80例CHB患者分为两组:在常规护肝及支持治疗基础上,治疗组40例,用氧化苦参碱注射液150mg静脉滴注:对照组40例,以古拉定1.2g静脉滴注,疗程8周,治疗前后检测患者肝功能、肝纤维化指标及血清淋巴细胞因子血清转化生长因子(TGF-β1)、肿瘤坏死因子(TNF-α)、白介素-10(IL-10).结果 治疗后两组肝功能均明显改善,两组比较无统计学差异(P＞0.05);治疗组治疗后肝纤维化指标透明质酸、层黏蛋白、Ⅲ型前胶原、Ⅳ型胶原(CⅣ)明显低于对照组(P＜0.01);治疗组治疗后血清TGF-β1、TNF-α水平显著降低,IL-10水平显著增高,与对照组治疗后比较有显著差异(P＜0.05).结论 氧化苦参碱治疗后慢性乙型肝炎患者血清细胞因子TGF-β1、TNF-α水平降低,IL-10水平升高,发挥抗肝纤维化作用.     

恩替卡韦联合复方鳖甲软肝片对乙型肝炎患者血清IL-6、IL-8、TNF-α水平影响及肝损伤保护作用研究

目的:探讨恩替卡韦联合复方鳖甲软肝片对乙型肝炎患者血清IL-6、IL-8、TNF-α水平影响及对肝损伤保护作用。方法:选取我院收治的乙型肝炎患者124例,根据治疗方法不同分为两组,每组各62例,其中对照组62例,予常规的保肝治疗,实验组在对照组的基础上实施恩替卡韦联合复方鳖甲软肝片治疗。治疗后观察并比较两组患者的临床疗效,血清IL-6、IL-8、TNF-α水平,肝功能情况以及肝纤维化情况。结果:与对照组相比较,实验组的临床疗效显著改善(P0.05),血清IL-6、IL-8、TNF-α水平显著改善(P0.05),肝功能明显好转(P0.05),肝纤维情况明显改善(P0.05),差异均有统计学意义。结论:恩替卡韦联合复方鳖甲软肝片治疗乙型肝炎患者能够改善血清IL-6、IL-8、TNF-α水平以及肝功能,降低肝纤维化的发生,减轻肝损伤,起到保护肝脏的作用,值得在临床推广使用。     

前列地尔对慢性重型肝炎患者血清TNF-α、IL-8的影响

目的观察前列地尔脂微球载体注射液(Lipo-PGE1)对慢性重型肝炎患者血清肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平的影响。方法采用ELISA法检测44例慢性重型肝炎患者治疗前后血清中TNF-α、IL-8水平的动态变化。结果慢性重型肝炎患者血清TNF-α、IL-8水平明显高于慢性肝炎及健康人(P<0.05~0.01)。Lipo-PGE1治疗组慢性重型肝炎患者TNF-α、IL-8水平明显下降(P<0.05~0.01),死亡率也明显低于一般综合治疗组(P<0.05)。Lipo-PGE1治疗组血清胆红素浓度下降与血清TNF-α、IL-8水平下降呈正相关(P<0.05~0.01)。结论TNF-α、IL-8水平可以反映慢性重型肝炎损伤的程度及判断预后,Lipo-PGE1注射液能改善慢性重型肝炎免疫状态,降低慢性重型肝炎患者血清TNF-α、IL-8的水平,是其治疗慢性重型肝炎的作用机制之一。     

Liver

Alleviation of ischemia-reperfusion injury in rat liver donors by induction of exogenous hTERT gene;Effects of surgical technique on acute renal failure after orthotopic liver transplantation in patients with end-stage liver disease at high risk： a report of 90 eases;Timing for liver transplantation for chronic severe hepatitis;Analysis of bacterial variance and drug resistance after orthotopic liver transplantation;The influence of splenectomy on orthotopic liver transplantation and its management     

Liver

<正>209461 Intraoperative ligation of recipient’s portasystemic shunt in liver transplantation/Chen Litian(,Organ Transplant Center,Tianjin 1st Centr Hosp Tianjin 300192)…∥Chin J Gen Surg.-2009,25(4).-489～491Objective To investigate the clinical significance of ligating the portasystemic shunt confirmed by preoperative CT evaluation during orthotopic liver transplantation.Methods From January 2007 to August 2008,35 patients in Tianjin First Central Hospital underwent preoperative three-dimensional CT scan,among them 23 patients had spontaneous major portasystemic shunts,the other 12 patients did not have portasystemic shunts.16 out of the 23 cases with significant shunts underwent shunt ligation based on portal blood flow volume measured by intraoperative portal vein flowmetry.The shunt of the other 7 patients were left untreated.Results The portal blood flow in the 12 patients without portasystemic shunt judged by preoperative CT scanning were(1 101±70)ml/min.The shunts in 7 patients with portal blood flow greater than 1 000 ml/min were not ligated,that of the 16 patients with portal blood flow volume lower than 1 000 ml/min were ligated.The portal blood flow volume in those 16 patients before and after ligating the shunt were(657±112)ml/min and(1 136±161)ml/min,respectively(P<0.05).Postoperatively 2 patients suffered from portal vein thrombosis,among them 1 patients suffered from intermittent disturbance of consciousness,2 patients died within 3 months,with one died of respiratory failure from pulmonary aspergillus infection,one died of hepatic failure in 2 months after operation because of graft dysfunction.The other 19 patients with normal blood flow and well-functioning graft were alive.Conclusion The ligation of portasytemic shunt is mandatory in patients when pretransplant CT evaluation showing a major porto-systemic shunts and portal blood flow volume was less than 1 000 ml/min.5 refs,2 figs.     

Liver

<正>209293 Probing into indication of living-related Liver Transplantation for Wilson’s disease/Cheng Feng(Liver Transplant Center,1st Hosp Nanjing Med Univ,Key Lab Living Donor Liver Transplant,Minist Public Health,Nangjing 210029)…∥Chin J Surg.-2009,47(6).-437~440Objective To probe into indication of living-related liver transplantation(LRLT)for Wilson’s Disease.Methods From January 2001 to February 2007,thirty-seven living-related liver transplants were performed.A retrospective analysis was carried on outcome of those patients.The indications for LRLT were acute hepatic failure in 3 patients and chronic advanced liver disease in 32 patients including 13 patients with Wilsonian neurological manifestations.Two patients presented with severe Wilsoian neurological manifestations even though their liver functions were stable.According to the scoring system for evaluation of the neurological impairment in Wilsion disease based on neurological signs and functions(total score was 30),the pre-transplantation score of those patients with neurological manifestations was 15.9±4.3(n=15).Results Thirty-seven patients were followed up for 20-93 months.The survival rates of post-transplant patients and grafts at 1,3,and 5 year were 91.9%,83.8%,75.7%,and 86.5%,78.4%,75.7%,respectivly.Postoperative surgical complications occurred in 2 donors with bile leakage required drainage,in 2 recipients with hepatic thormbosis underwent retransplantation of cadeveric liver and in 1 recipient with hepatic stenosis required balloon dilatation.Neurological function was improved in all recipients and the score of posttransplantation at 6,12,18,24,and 30 months was 17.5±3.7(n=13);21.0±4.3(n=12);23.9±3.9(n=10);26.6±2.2(n=10)and 28.1±1.9(n=7)respectively.Conclusion Patients with acute hepatic failure or patients with severe liver disease unresponsive to chelation tratment should be treated with LRLT.Early transplantation in patients with an unsatisfactory response medical tratment may prevent irreversible neurologica     

Liver

<正>209604 The suppressive effect of CD8+ CD28-regulatory T cells from spontaneous tolerance models on the acute rejection responses in rat liver transplantation/Chen Ning(陈宁,Dept Gastroenterol,Peking Univ Peop Hosp,Beijing 100044)…∥Chin J Organ Trans-plant. -2009,30(9). -524 ～526     

探讨脂肪肝供肝在肝脏移植中的价值

目的探讨应用不同脂肪沉着程度供肝对肝移植患者预后的影响。方法选取64例进行肝移植术患者,依据供肝浸润程度,随机分为轻度脂肪肝组、中度脂肪肝组、重度脂肪肝组、无脂肪肝组共四组,每组各16例,比较四组患者肝功能(主要观察ALT、AST指标)、入住ICU的平均时间、1年移植物成活率、移植物原发无功发生率。结果轻度脂肪肝组入住ICU的平均时间、ALT和AST水平、移植物原发无功发生率与无脂肪肝组接近;中度脂肪肝组入住ICU平均时间、ALT和AST水平均较轻度组和无脂肪肝组明显增高,P0.05;重度脂肪肝组入住ICU平均时间、ALT和AST水平、移植物原发无功发生率明显较前三组为高,P0.05。结论轻、中度肝脏脂肪浸入可作为肝移植供肝,重度脂肪肝不能作为供肝的选择目标。     

Liver

<正>209087 Clinical analysis of outcome of invasive fungal infection after kidney transplantation/Chen Guodong(陈国栋,Dept Transplant Surg,1st Hosp,Sun Yat sen Univ, Guangzhou 510080)…∥Chin J Organ Transplant. -2009, 30(10). -616～619 Objective To explore the outcome of invasive fungal infection in kidney transplantation and the influencing factors.     

Liver

Prevention and treatment of artery complication after liver transplantation by HBO , Clincal feature of cytomegabvirus pneumonia in orthtopic liver-transplantation and treatments, Risk factors of diabetes mellitus following orthotopic liver transplantation , Re-infection of hepatitis B virus after liver transplantation , Diagnosis and treatment of fungal infection after orthotopic liver transplantation , Two successful adult-to-adult living donor liver transplantation using dual grafts     

Microenvironment of Liver Regeneration in Liver Cancer

The occurrence and development of liver cancer are essentially the most serious outcomes of uncontrolled liver regeneration. The progression of liver cancer is inevitably related to the abnormal microenvironment of liver regeneration. The deterioration observed in the microenvironment of liver regeneration is a necessary condition for the occurrence, development and metastasis of cancer. Therefore, the use of a technique to prevent and treat liver cancer via changes in the microenvironment of liver regeneration is a novel strategy. This strategy would be an effective way to delay, prevent or even reverse cancer occurrence, development and metastasis through an improvement in the liver regeneration microenvironment along with the integrated regulation of multiple components, targets, levels, channels and time sequences. In addition, the treatment of "tonifying Shen (Kidney) to regulate liver regeneration and repair by affecting stem cells and their microenvironment" can regulate "the dynamic imbalance between the normal liver regeneration and the abnormal liver regeneration"; this would improve the microenvironment of liver regeneration, which is also a mechanism by which liver cancer may be prevented or treated.     

化肝汤1号治疗酒精性肝纤维化症状及肝功能改变

目的观察活血化瘀、软坚散结药配伍治疗肝纤维化时对患者主、次症状改变及肝功能的影响。方法将确诊为酒精性肝纤维化患者90例,随机分为三组,治疗组采用自制方剂化肝汤1号(醋鳖甲、黄芩、柴胡、赤芍等),对照组1采用凯西莱治疗,对照组2采用化肝汤1号和凯西莱联合治疗,疗程3个月。观察三组患者治疗前后主、次症状改善情况,血清天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、γ谷氨酰转肽酶(γ-GT)变化。结果三组治疗后的临床疗效比较差异无统计学意义(H=2.5897,P>0.05)。三组治疗后肝功能指标均有改善,与治疗前比较,差异有统计学意义(P<0.05)。结论化肝汤1号可有效地降低肝细胞的损害程度,促进受损细胞修复,从而改善肝功能。