脂肪性肝病的流行现状与自然转归

脂肪性肝病(FLD)是遗传-环境-代谢应激相关性疾病,包括酒精性肝病(ALD)和非酒精性脂肪性肝病(NAFLD)两大类.当前ALD的患病率居高不下,而NAFLD的发病率不断攀高且起病渐趋低龄化,已成为发达国家和地区慢性肝病第一大病因,并且,ALD与NAFLD、FLD与病毒性肝炎可以合并存在.     

酒精性与非酒精性脂肪性肝病

脂肪性肝病(FLD)根据有无过量饮酒史,分为酒精性肝病(ALD)和非酒精性脂肪性肝病(NAFLD)两大类。两者享有FLD的许多共性特征,但又各有其独特之处。 1.酒精性与非酒精性FLD的异同:NAFLD的肝组织学改变与ALD相似,包括单纯性脂肪肝、脂肪性肝炎及肝硬化。我国及日本学者认为ALD还应包括轻症ALD、酒精性重型肝炎及酒精性肝纤维化,事实上NAFLD均有其相对应的临床病理类     

消化内科医师谈脂肪肝干预:肝功能保护与抗炎治疗

<正>脂肪性肝病(fatty liver disease,FLD)简称脂肪肝,是一组遗传-环境-代谢应激相关的异质性疾病,根据病因分为酒精性肝病(alcoholic liver disease,ALD)、非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)以及特殊原因所致脂肪肝。ALD的疾病谱包括酒精性脂肪肝、酒精性肝炎及酒精性肝硬化。NAFLD的疾病谱包括单纯性脂肪肝(simple     

罗格列酮与非酒精性脂肪性肝病

脂肪性肝病(FLD)是遗传-环境-代谢应激相关因素所致的以肝细胞脂肪变性为主的临床病理综合征.FLD包括酒精性肝病(ALD)和非酒精性脂肪性肝病(NAFLD).随着社会经济的发展,生活水平的提高,NAFLD已成为健康体格检查肝功能异常的主要原因.     

解读非酒精性脂肪性肝病诊治指南

随着肥胖与糖尿病患者的日趋增多,脂肪性肝病(FLD)目前已成为全球性的重要肝病。临床上FLD分为酒精性肝病(ALD)与非酒精性脂肪性肝病(NAFLD);研究表明,NAFLD与肥胖、代谢综合征、2型糖尿病和心血管疾病密切相关。2006年和2010年中华医学会相继制定了中国NAFLD诊疗指南,较全面和广泛地反映了目前NAFLD的临床诊疗现状,与国际上颁布的一些诊治指南相比存在差异。本文就NAFLD诊治指南及相关问题进行解读。     

过氧化物酶体增殖物激活受体α在脂肪性肝病发病机制中的作用

脂肪性肝病（fatty liver disease，FLD）具有多样病因和多种形态谱，包括单纯性脂肪肝、脂肪性肝炎、脂肪性肝纤维化，以及其进一步进展为肝硬化和肝细胞癌。根据病因FLD被分成两大类：酒精性脂肪性肝病（alcoholic fatty liverdisease，AFLD）和非酒精性脂肪性肝病（nonalcoholic fatty liver disease，NAFLD）。两者的病理变化过程没有明显差异，提示两者可能具有一个复杂但共同的发病机制。     

脂肪性肝病的诊断与识别

脂肪性肝病（FLD）是一种临床概念，由多种病因引起的获得性疾病，指病变主体在肝小叶，以弥漫性肝细胞大泡性脂肪变为病理特征的临床综合征，临床上根据有无过量饮酒史，分为酒精性FLD（酒精性肝病，AFLD）和非酒精性FLD（NAFLD）。包括单纯性FLD、脂肪性肝炎、脂肪性肝硬化三种类型。半乳糖血症、糖原累积病、     

受控衰减参数在脂肪肝诊断中的应用

<正>脂肪性肝病(fatty liver disease,FLD)是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,主要包括酒精性肝病(alcoholic liver disease,ALD)和非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD),疾病谱包括单纯性脂肪肝、脂肪性肝炎及其相关肝硬化[1]。随着肥胖、糖尿病和酒精滥用成为全球化的流行趋势,无论是NAFLD还是ALD都已成为重要的公共健康问题,并且酒精性和非酒精性FLD     

脂肪性肝病与肝癌

脂肪性肝病（FLD）系由多种病因引起的肝脏脂质代谢紊乱及动态平衡失调，以致肝细胞内脂质蓄积，肝细胞脂肪变性，从而产生的一系列临床病理综合征。FLD包括单纯性脂肪肝、脂肪性肝炎、脂肪性肝硬化3种类型。在西方发达国家脂肪肝的发病率为10％～24％。近年来，随着人们生活水平和饮食结构的变化，我国FLD的发病率也日趋增高，已成为居病毒性肝炎之后的第二大肝病。FLD根据病因可分为酒精性脂肪性肝病（AFLD）和非酒精性脂肪性肝病（NAFLD）两大类。FLD不再仅被认为是良性病变，单纯性脂肪肝可发展为脂肪性肝炎、肝硬化。许多学者报道FLD与肝细胞癌（HCC）关系密切。     

瘦素与脂肪性肝病

脂肪性肝病(fatty liver disease，FLD)是遗传一环境一代谢应激相关因素所致的以肝细胞脂肪变性为主的临床病理综合征。FLD包括由酒精所致的酒精性肝病(alcoholic liver disease，ALD)和肥胖、高脂等代谢紊乱所致的非酒精性脂肪性肝病(non-alcoholic fatty liver disease，NAFLD)。在病理上分为单纯性脂肪肝、脂肪性肝炎、脂肪性肝纤维化和脂肪性肝硬化。在FLD的发生发展过程中，瘦素的作用日益受到重视。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.