丹参素对肝硬变大鼠肝部分切除术后肝再生的影响

<正>肝脏是体内重要的代谢器官,具有较强的再生能力。在我国,原发性肝癌及肝内胆管结石仍然是常见病、多发病,常合并有肝硬变。目前肝叶切除术是上述疾病的主要治疗措     

探讨细胞不同初始接种密度对转染效率的影响

目的：探讨不同初始接种密度对细胞转染效率的影响。方法：利用Lipofectamine 2000（Lipo）介导GCLC基因（γ-谷氨酰半胱氨酸合成酶催化亚单位）及绿色荧光蛋白（GFP）表达载体转染大鼠肺泡上皮L2细胞,通过双萤光素酶报告基因系统检测萤光素酶活性值、荧光显微镜和流式细胞仪检测其GFP表达情况,来探讨细胞不同初始接种密度对转染效率的影响。结果：细胞初始接种密度不同,其转染效率也不同。结论：细胞不同初始接种密度对转染效率有显著性影响,转染细胞数适宜才能得到较高的转染效率。     

丹参素和泮托拉唑对肝硬化大鼠肝部分切除术后肝再生的影响研究

目的以肝硬化大鼠为动物模型,研究药物对肝硬化大鼠肝部分切除术后肝再生的影响。方法取健康的Wistar雄性大鼠64只,以60%CCl4油溶液0.3ml/100g皮下注射,同时饮用5%酒精溶液,45d后制成肝硬化动物模型。模型大鼠随机分为4组,16只/组。全麻下均行左、中叶肝切除术。术后各组按以下方案处理:对照组皮下注射生理盐水1mg·kg-1·d-1,丹参素组腹腔注射18mg·kg-1·d-1,泮托拉唑组皮下注射0.2mg·kg-1·d-1,两药合用组同时给予丹参素(tanshinol)腹腔注射18mg·kg-1·d-1,泮托拉唑(pantoprazole)皮下注射0.2mg·kg-1·d-1,连续给药2周,抽取静脉血样,取肝脏组织,检测肝功能、有丝分裂指数(MI)、增生细胞核抗原(PCNA)、细胞核DNA含量。结果丹参素组、泮托拉唑组及两药合用组MI、PCNA阳性染色细胞量、细胞核DNA含量均高于对照组(P<0.05),两药合用组MI、PCNA阳性染色细胞量、细胞核DNA含量均高于丹参素组、泮托拉唑组(P<0.05),但各组间肝功能变化无明显差异。结论丹参素、泮托拉唑及两药合用均对肝硬化大鼠肝部分切除术后肝细胞再生有促进作用。     

肝部分切除术对利多卡因药代动力学的影响

目的　研究肝脏部分切除对利多卡因在体内药代动力学的影响。方法　以肝部分切除术为试验组,以上腹部手术为对照组。硬膜外利多卡因首剂量4mg·kg-1给药后,以2mg·h·kg-1恒速滴注,于给药后不同时间取静脉血,用荧光偏振免疫法测定利多卡因血浆浓度,计算其药代动力学参数。结果　利多卡因试验组和对照组在体内的消除过程均呈一室模型,其主要药代动力学参数t1 /2分别为(147. 03±67. 05), (157. 16±33. 19)min;C120分别为(2. 90±0. 57),(2. 71±0. 38)μg·mL-1;Vd分别为(1. 60±0. 40), (1. 65±0. 26)L; AUC分别为(844. 32±295. 82), (896. 09±240. 77)μg·min·mL-1。结论　肝脏部分切除术对麻醉剂量利多卡因的体内药代动力学无明显影响。     

肝部分切除术治疗肝内胆管结石的疗效

目的探讨肝部分切除术治疗肝内胆管结石的临床效果。方法抽取收治的110例肝内胆管结石患者及其临床资料进行回顾性分析,并对结石分布、术式选择、疗效和并发症等加以统计分析。结果 110例患者中,术后发生胆漏、胆道出血及膈下脓肿等并发症共7例,1例因肝肾衰竭致死。102例经随访,其中复查彩色多普勒超声发现7例复发,再次收住院,行胆总管切开取石术;2例肝内胆管结石合并胆管细胞癌患者术后12个月时因肿瘤复发死亡。结论规则性肝叶/段切除术治疗肝内胆管结石,疗效显著。     

肝细胞肝癌应用精准肝切除术与非规则性切除的近远期预后及对肝功能的影响

目的:对比肝细胞肝癌(HCC)应用精准肝切除术(PH)与非规则性切除术(IR)治疗的近远期预后及对患者肝功能的影响。方法:回顾性分析87例HCC患者的临床资料,根据术式分为PH组(n=57)和IR组(n=30)。比较两组围手术期指标,统计术后复发率及生存率。手术前后测定总胆红素(TBIL)、直接胆红素(DBIL)、谷草转氨酶(AST)和谷丙转氨酶(ALT)。结果:PH组手术时间高于IR组,但术中出血量、术中输血量、住院时间及切缘阳性率均显著低于IR组(P<0.05)。术后3 d和7 d,PH组的TBIL,DBIL,ALT及AST水平均显著低于IR组(P<0.05)。PH组并发症发生率为22.81%,显著低于IR组的56.67%(P<0.05)。PH组1年、3年复发率分别为21.05%,26.32%,显著低于IR组的40.00%,56.67%(P<0.05);PH组1年、3年生存率分别为91.23%,74.58%,IR组分别为80.00%,60.00%,PH组3年生存率显著高于IR组(P<0.05)。结论:PH较IR治疗HCC创伤小、术后康复快、并发症发生率及早期复发率低、远期生存率高,且有利于减轻肝功能损伤。     

非酒精性脂肪肝大鼠部分肝切除术后p21的表达变化

目的探讨非酒精性脂肪肝（Nonalcoholic fatty liver disease，NAFLD）大鼠部分肝切除术后肝再生过程中p21的表达变化及意义。方法通过高脂饲料喂养建立非酒精性脂肪肝大鼠模型（F组），同时设立正常饲料组（C组）作为对照，在喂养12w时对F及C组动物分别进行70％部分肝切除术，分别于：术后0h、1h、12h、24h、36h收集残肝标本，利用免疫组化法检测PCNA（Proliferating cell nuclear antigen）的阳性表达率；采用RTPCR及Western blot法分别检测p21的mRNA及蛋白表达变化。结果对高脂喂养12w的中．重度脂肪肝大鼠进行70％部分肝切除术成功建立了NAFLD肝再生动物模型。F组PCNA阳性表达率在术后12h、24h、36h均明显低于C组（P〈0．01），p21的mRNA及蛋白表达水平与C组存在显著性差异（P〈0．01），F组明显高于C组。结论NAFLD大鼠部分肝切除术后p21的mRNA及蛋白表达水平明显高于正常对照组．同时NAFLD肝再生中细胞增殖能力下降．     

控制性低中心静脉压对肝部分切除术中酸碱平衡的影响

目的观察控制性低中心静脉压(CLCVP)对肝部分切除术中酸碱平衡的影响。方法选取需行肝部分切除术的患者60例,分为低中心静脉压肝部分切除术组(L组,低中心静脉压组,n=30)和正常中心静脉压肝部分切除术组(C组,正常中心静脉压组,n=30)两组。分别于麻醉用药前10 min(T_1)、开腹前10 min(T_2)、肝切除开始前10 min(T_3)、肝切除开始后30 min(T_4)、肝切除完成后10 min(T_5)及关腹前10 min(T_6)进行动脉血气分析及电解质检测,并记录切肝手术时间、术中出血量、输血量。结果在T_1～T_6的统计中,低中心静脉压组的pH、BE值与正常中心静脉压组的pH、BE值差异无统计学意义(P>0.05),低中心静脉压组切肝手术时间、术中出血量和输血量明显低于正常中心静脉压组(P<0.05)。结论实施控制性低中心静脉压对肝部分切除术中的酸碱平衡无明显影响,并且可以减少肝部分切除术的手术时间,明显减少肝部分切除术的出血量及输血量。     

肝部分切除术治疗肝内胆管结石疗效观察

肝内胆管结石(Hepatolithiasis,HL)指的是两侧肝管汇合处以上部分胆管内的结石,临床常与肝外胆管结石并存。该病在东亚国家较为常见,因此又称为东方肝胆结石病[1]。该病由于发病率、治疗后结石残留率及再手术率均较高,成为肝胆外科较为常见的难题[2]。该病可因结石引起胆管阻塞从而导致急性梗阻性化脓性胆管炎,严重者可危及生命[3]。笔者采用肝部分切除术治疗肝内胆管结石患者60例,报告如下。     

肝部分切除术治疗肝内胆管结石临床体会

目的:探讨手术治疗肝内胆管结石。方法:回顾分析42例肝内胆管结石病人手术治疗的临床资料。结果:治愈38例,好转3例,死亡1例,疗效优良率90.0%。结论:肝部分切除术治疗肝内胆管结石疗效满意。     

雷公藤红素对肝叶部分切除老年小鼠术后认知功能及海马Tau蛋白磷酸化的影响

目的：观察肝叶部分切除术后老年小鼠认知功能的变化及海马内Tau蛋白磷酸化位点Ser396、Ser199/202的变化和雷公藤红素对老年小鼠术后认知功能障碍时的神经保护作用。方法：C57BL/6老年小鼠随机分为3组（n=48）：假手术组（S组）、肝叶部分切除术组（O组）和肝叶部分切除术加雷公藤红素组（C组）。每组再根据不同时间点分为12h、1d、3d和7d4个亚组,每个时间点12只动物。三组小鼠采用Mor-ris水迷宫检测小鼠认知功能,免疫组织化学法和Western blotting方法检测各组小鼠海马Tau蛋白磷酸化的变化。结果：与S组同时点比较,O组术后3d和7d时水迷宫成绩下降（P〈0.05）;C组术后3d和7d水迷宫成绩好于O组（P〈0.05）,而与S组接近（P〉0.05）。免疫组织化学染色阳性数和Western blotting显示O组Tau蛋白磷酸化位点Ser396、Ser199/202表达多于S组（P〈0.01）,而C组表达少于O组（P〈0.01）,与S组接近（P〉0.05）。结论：雷公藤红素对老年小鼠肝叶部分切除术造成的认知功能障碍具有明显的保护作用,其机制可能与抑制Tau蛋白异常磷酸化有关。     

异甘草酸镁在肝脏部分切除患者中的临床应用

目的观察异甘草酸镁在肝脏部分切除术患者中的临床应用效果。方法 A组在多烯磷脂酰胆碱注射液基础上加用异甘草酸镁进行护肝治疗,B组单用多烯磷脂酰胆碱注射液护肝治疗。两组均持续用药在术前3d～术后7d,并且记录患者术后不良反应的发生率及术前及术后第2天,第7天的肝功能测值。结果 A组术后不良反应发生率明显低于B组(P<0.05),术后第2天两组患者肝功能指标均高于术前(P<0.05),但是术后第7天A组肝功能指标与术前比较差异无统计学意义(P>0.05),B组肝功能指标仍然高于术前(P<0.05)。结论异甘草酸镁对肝脏部分切除引起的肝功能损害有显著的保护作用。     

右美托咪定通过调节CX3CL1-CX3CR1信号通路对老年大鼠肝部分切除术后认知功能障碍的改善作用研究

目的 观察右美托咪定通过调节CX3CL1-CX3CR1信号通路对老年大鼠肝部分切除术术后认知功能障碍(POCD)的改善作用.方法 60只SPF级老年SD大鼠随机分为假手术组、模型组、阳性对照组、右美托咪定组和CX3CL1抗体+右美托咪定组.阳性对照组大鼠于术前3 d给予布洛芬混悬液35 mg/kg,ig给药,8 h/次...     

Effect of frusemide on the reactivity of rat portal vein

Short lengths of rat portal vein were suspended in Krebs bicarbonate solution. Contractile responses to noradrenaline and angiotensin II and the parameters of spontaneous contractions were determined before and after addition of frusemide at 10–⁶ and 10–⁴ g/ml. Frusemide at 10–⁶ g/ml slightly suppressed the amplitude of spontaneous contractions and slightly decreased the responses to noradrenaline and angiotensin II. At 10–⁴ g/ml the drug had a much greater inhibitory effect on endogenous and exogenous stimulation. The concentrations used appear to be similar to those achieved during effective diuretic and hypotensive treatment. It is postulated that frusemide may have a direct inhibitory action on the reactivity of vascular smooth muscle mrticularlv in the capacitance vessels.     

Change in caspase-3-like protease in the liver and plasma during rat liver regeneration following partial hepatectomy

Recent studies have shown that many factors orchestrate liver regeneration after a two-thirds partial hepatectomy (PH). However, the termination mechanism in liver regeneration has not been thoroughly studied. In this paper, we report that the activity of liver caspase-3-like protease, which is specifically activated in apoptosis, increases 18, 36, and 48 hr after PH during maximal hepatocyte proliferative activity. This is the first study that shows the activation of an apoptosis-executing enzyme during physiological liver regeneration. These results suggest that apoptosis is induced in each surge of DNA synthesis as the termination mechanism. When phenoxybenzamine, an alpha-blocker that has been reported to inhibit DNA synthesis during liver regeneration, was injected 8 hr after PH, the caspase-3-like activity in the liver peaked at 15 hr after PH and the enzyme activity also increased in plasma at 18 and 24 hr after PH in sharp contrast to the case of normal regeneration. These results indicate that extensive apoptosis is caused by phenoxybenzamine and that the secondary necrosis of apoptotic cells results in the increase of caspase-3-like protease activity in the plasma.     

Effect of partial hepatectomy on the expression of seven rat sulphotransferase mRNAs

1. The effect of partial hepatectomy on the expression of sulphotransferase (SULT) mRNA was studied. SULTs fall into two distinct classes based on substrate preference: phenol SULT1 family (SULT1A1, SULT1B1, SULT1C1 and SULT1E2) and hydroxysteroid SULT2 family (SULT20/21, SULT40/41 and SULT60). 2. Hepatic expression of SULT mRNA was analysed in the sham-hepatectomised rat (sham) and in the partially hepatectomised (PH) rat at various times after PH. Northernblot analysis with [alpha-32 P]dATP-labelled oligonucleotide probes specific for individual SULT mRNAs was used to monitor hepatic SULT mRNA expression. In general, SULT mRNAs underwent a decrease in expression after PH and the magnitude of decrease was dependent on the SULT isoform. 3. The decrease in SULT mRNA expression was resolved and even induced (SULT40/41 in the female rat) by 10-30 days after PH. Of the phenol SULT isoforms, both SULT1C1 and SULT1E2 mRNAs were significantly decreased by 18-24 h after PH in the male rat. The other phenol SULTs (SULT1A1 and SULT1B1) tended to decrease in the male rat after PH, but the decreases were not statistically significant. Expression of SULT20/21 mRNA was decreased in the female rat (80% at 24 h) and fully recovered by 10 days. SULT40 41 mRNA tended to decrease after PH; however, the decrease was not statistically significant. SULT 60 mRNA was decreased from 24 to 96 h after PH. 4. Thus, during the period of rapid liver growth that occurs after partial hepatectomy, SULT mRNA expression is decreased. The phenomenon of decreased SULT mRNA expression is similar to other states of rapid liver growth (e.g. cancer tissue and young animals) in which expression of SULT enzymes is characteristically low.     

Effect of partial hepatectomy on the expression of seven rat sulphotransferase mRNAs.

1. The effect of partial hepatectomy on the expression of sulphotransferase (SULT) mRNA was studied. SULTs fall into two distinct classes based on substrate preference: phenol SULT1 family (SULT1A1, SULT1B1, SULT1C1 and SULT1E2) and hydroxysteroid SULT2 family (SULT20/21, SULT40/41 and SULT60). 2. Hepatic expression of SULT mRNA was analysed in the sham-hepatectomised rat (sham) and in the partially hepatectomised (PH) rat at various times after PH. Northern-blot analysis with [alpha-32P]dATP-labelled oligonucleotide probes specific for individual SULT mRNAs was used to monitor hepatic SULT mRNA expression. In general, SULT mRNAs underwent a decrease in expression after PH and the magnitude of decrease was dependent on the SULT isoform. 3. The decrease in SULT mRNA expression was resolved and even induced (SULT40/41 in the female rat) by 10-30 days after PH. Of the phenol SULT isoforms, both SULT1C1 and SULT1E2 mRNAs were significantly decreased by 18-24 h after PH in the male rat. The other phenol SULTs (SULT1A1 and SULT1B1) tended to decrease in the male rat after PH, but the decreases were not statistically significant. Expression of SULT20/21 mRNA was decreased in the female rat (80% at 24 h) and fully recovered by 10 days. SULT40/41 mRNA tended to decrease after PH; however, the decrease was not statistically significant. SULT 60 mRNA was decreased from 24 to 96 h after PH. 4. Thus, during the period of rapid liver growth that occurs after partial hepatectomy, SULT mRNA expression is decreased. The phenomenon of decreased SULT mRNA expression is similar to other states of rapid liver growth (e.g. cancer tissue and young animals) in which expression of SULT enzymes is characteristically low.     

卡环可摘局部义齿与附着体义齿咀嚼效率的比较

目的:比较卡环可摘局部义齿和附着体义齿的咀嚼效率。方法:选择20例下颌牙列末端游离缺损患者,每例分别在卡环可摘局部义齿和附着体义齿修复后1个月,采用吸光度法测试其咀嚼效率,佩带两种义齿后的咀嚼效率进行自身前后比较,作配对t检验。结果:卡环活动义齿的平均吸光度值为0.813,附着体义齿的平均吸光度值为0.894,两种义齿的咀嚼效率比较,差异有显著性(P<0101)。结论:在下颌游离缺损修复中,冠外附着体义齿的咀嚼效率高于卡环可摘局部义齿。