门冬氨酸鸟氨酸对肝切除术后肝功能保护作用的研究

Objective To investigate the protective effects of L-Ornithine-L-Aspartate on liver function in patients after liver resection. Methods Eighty-two patients undergoing liver resection were randomly divided into study group and control group. Control group was treated with conventional therapy and study group had conventional therapy plus L-Ornithine-L-Aspartate for injection intravenously from the first day before operation to the seven day after operation. The fasting alanine aminotransferase (ALT), aspartate aminotransferase ( AST ), γ-glutamyl transpeptadase(GGT), total bilirubin(TB), direct bilirubin(DB) and blood ammonia(BA) levels were determined before operation and on days 1, 3 and 7 after operation. Results On days 1, 3 and 7 after operation, ALT and AST levels in the study group [ALT: ( 115.58 ± 69. 20), (81. 36 ± 14. 55 ), ( 61.24 ± 11. 32) U/L; AST: ( 127.29 ±33.61 ), (95.26 ± 16.83 ), (55.16 ± 14.83 )U/L] were significantly lower than those in the control group[ALT:(175.27 ±68.35), (97.37 ±34.24), (78.28 ± 19. 73) U/L;AST: (152. 29 ±31.65), (115.28 ±35.24),(82.49 ± 28.18) U/L] (P ＜ 0.05 ). In the study group of the porta blocked over 15 min, levels of AST, ALT were obviously lower than that of the control group( P ＜ 0. 05 ). Conclusions L-Ornithine-L-Aspartate for injection can alleviate the hepatic dysfunction after hepatectomy, especially in the long time of porta blocked and has protective advantage for liver function.     

门冬氨酸鸟氨酸对肝切除术后肝功能保护作用的研究

目的 探讨门冬氨酸鸟氨酸对肝切除患者术后肝功能的保护作用.方法 肝切除患者82例,随机数字法分为对照组40例和研究组42例.对照组给予常规护肝治疗.研究组在对照组治疗措施的基础上,术前1 d应用门冬氨酸鸟氨酸15 g加入5%葡萄糖注射液500 ml静脉滴注,连续用药7 d.分别于术前和术后1、3、7 d晨起空腹测定外周静脉血血清ALT、AST、GGT、胆红素、血氨含量.结果 2组术中肝门阻断的例数及阻断时间差异无统计学意义,同时2组患者肝脏切除方式、切除范围、术中出血量及手术时间差异亦无统计学意义.2组术后肝功能指标与术前相比,有一定程度的升高,差异有统计学意义(均P＜0.05).对照组术后1、3、7 d ALT、AST[ALT分别为(175.27±68.35)、(97.37±34.24)、(78.28±19.73)U/L,AST分别为(152.29 ±31.65)、(115.28±35.24)、(82.49±28.18)U/L]均明显高于研究组[ALT分别为(115.58±69.20)、(81.36±14.55)、(61.24±11.32)U/L,AST分别为(127.29±33.61)、(95.26±16.83)、(55.16±14.83)U/L],差异有统计学意义(均P＜0.05).对照组术后1、3 d的GGT水平明显高于研究组[对照组术后1、3d分别为(325.58±38.19)、(265.68±15.27)U/L,研究组分别为(284.58±19.35)、(204.35±12.35)U/L],差异有统计学意义(P＜0.05).2组术后胆红素水平差异无统计学意义(P＞0.05).肝门阻断＞15 min患者中,研究组患者术后AST、ALT水平明显低于对照组(P＜0.05).结论 门冬氨酸鸟氨酸对肝切除术尤其是肝门阻断时间长的肝损害具有明显保护作用,适合在肝脏围手术期使用.

Abstract：

Objective To investigate the protective effects of L-Ornithine-L-Aspartate on liver function in patients after liver resection. Methods Eighty-two patients undergoing liver resection were randomly divided into study group and control group. Control group was treated with conventional therapy and study group had conventional therapy plus L-Ornithine-L-Aspartate for injection intravenously from the first day before operation to the seven day after operation. The fasting alanine aminotransferase (ALT), aspartate aminotransferase ( AST ), γ-glutamyl transpeptadase(GGT), total bilirubin(TB), direct bilirubin(DB) and blood ammonia(BA) levels were determined before operation and on days 1, 3 and 7 after operation. Results On days 1, 3 and 7 after operation, ALT and AST levels in the study group [ALT: ( 115.58 ± 69. 20), (81. 36 ± 14. 55 ), ( 61.24 ± 11. 32) U/L; AST: ( 127.29 ±33.61 ), (95.26 ± 16.83 ), (55.16 ± 14.83 )U/L] were significantly lower than those in the control group[ALT:(175.27 ±68.35), (97.37 ±34.24), (78.28 ± 19. 73) U/L;AST: (152. 29 ±31.65), (115.28 ±35.24),(82.49 ± 28.18) U/L] (P ＜ 0.05 ). In the study group of the porta blocked over 15 min, levels of AST, ALT were obviously lower than that of the control group( P ＜ 0. 05 ). Conclusions L-Ornithine-L-Aspartate for injection can alleviate the hepatic dysfunction after hepatectomy, especially in the long time of porta blocked and has protective advantage for liver function.     

The protecting effects and mechanism of betaine hydrochloride on hepatic ischemia-reperfusion injury in rats

Objective To study the protecting effects and mechanism of betaine hydrochloride on hepatic ischemia-reperfusion injury in rats.Methods Fourty SD rats were randomly divided into 5 groups(8 animals in each group):sham-operated control group(A),hepatic ischemia-reperfusion group(B),200 mg·kg-1 400 mg·kg-1 800 mg·kg-1 betaine hydrochloride+hepatic ischemia-reperfusion group(C、D、E).betaine hydrochloride was administered to animals byoral route in group C、D、E for 7 days before ischemia.A、B group was administered with NS.Made the animal model of part hepatic ischemia-reperfusion.Serum alanine aminotransferase(ALT),aspartate aminotransferase(AST)levels in the blood and themalondialdehyde(MDA),superoxide dismutase(SOD),protein content in hepatic tissue were determined after the liver had been reperfused for 24 hours;the hepatic tissue was examined under lightmicroscope and the cell apoptosis was demonstrated with flow cytometry.Results ALT,AST,MDA increased and SOD decreased significantly in B group when compared those in the A group(P<0.05),Hepatic apoptosis was significantly increased;ALT,AST,MDA decreased and SOD increased significantly in betaine hydrochloride 200 mg·kg-1(C)group when compared those in the B group(P<0.05).Hepatic apoptosis was significantly lower,The histologic changes of the liver tissue under lightmicroscope in the C group was more easer than in the I/R group(B).Conclusions Betaine hydrochloride has the ability to scavenge oxygen free radical(OFR),reduce lipid peroxidation and inhibition of apoptosis.So it can protect the rats liver damaged by ischemia-reperfusion.     

corilagin protects non-alcoholic fatty liver disease in mice induced by high fat and high sugar diet via regulating AMPK-autophagy signaling北大核心CSCD

Aim To explore the effects of corilagin on non-alcoholic fatty liver disease induced by high-fat and high-sugar diet in mice via regulating AMPK-autophagy signaling. Methods Healthy 8-week-old male C57BL/6J mice were randomly divided into control group, model group and corilagin group. The mice of model group and corilagin group were fed with a high-fat and high-sugar diet for four weeks at the age of eight weeks. The corilagin group mice were also intraperitoneally injected with corilagin (20 mg • k g - 1 ), which was given once every 2 days for 4 weeks. The mice of the control group and the model group were given equal dose of normal saline. After modeling and administration, the mice were sacrificed and the liver weight recorded. The liver pathological changes of each group mice were assessed by HE staining, oil red O staining and Masson staining. The biochemical indexes in serum and liver tissue were detected by the ELISA kit. The p-AMPK and autophagy levels were detected by Western blot. Results The results showed that compared to control group, the liver weight of the model group increased, the AST and ALT levels in serum also significantly increased, there were a large number of fat vacuoles and severe lipid deposition and mild collagen fibrosis in liver, while the liver weight and TG level in liver significantly decreased, and the liver pathological changes were significantly improved after treated with corilagin. Western blot results showed the levels of autophagy related proteins such as Atg7 and Atg5 significantly decreased in the model group, and the p-AMPK level also significantly decreased. When treated with corilagin, p-AMPK and the autophagy levels were up-regulated. Conclusion corilagin can protect non-alcoholic fatty liver disease in mice induced by high fat and high sugar diet. The mechanism may involve increasing p-AMPK level and enhancing autophagy level in liver. © 2023 Publication Centre of Anhui Medical University. All rights reserved.     

肝纤维化血清学指标水平与肝癌的相关性研究

Objective To investigate the significance of serum fibrosis markers in liver fibrosis in liver neoplasms. Methods Radioimmunoassay was used to measure the level of serum procollagen (PC) Ⅲ, collagen type Ⅳ(Ⅳ-C), laminin LN and hyaluronic acid(HA) in 120 patients with liver neoplasms and 100 healthy people.Results Before therapy, the level of Ⅳ-C in the hepatocellular carcinoma group showed significant difference compared with those in control group (P＜0. 01 ). The levels of PCⅢ and LN in the hepatocellular carcinoma group were higher than those in control group ( P ＜ 0.05 ). Before therapy the levels of HA in metastatic cancer of liver group and extrahepatic malignant tumor group were higher than those in control group ( P ＜ 0. 05 ). Before and after the therapy the levels of hepatocellular carcinoma group serum PC Ⅲ, Ⅳ-C, LN and HA were significantly higher than those in the metastatic cancer of liver group ( P ＜ 0. 05). Before and after the therapy the levels of hepatocellula carcinoma group serum PC Ⅲ, Ⅳ-C, LN and HA were significantly difference ( P ＜ 0.05 ). Conclusions The levels of serum PC Ⅲ, Ⅳ-C, LN and HA are significantly related with the hepatocellular carcinoma. These markers can reflect the fibrosis degree of chronic hepatocellular carcinoma and will be an indicator of prognosis.     

乌体林斯和黄芪注射液联用治疗缓解期哮喘的临床观察

Objective To investigate the efficacy of acupoint injections of mycobaoterium phlei F.U.36 combined with huangqi, and cordate houttuynia for stable. Methods 56 patients with stable asthma were randomized to receive acupoint injections of mycobacterium phlei F.U.36, huangqi, and cordatehouttuynia every the other day (study group, 32 patients), or conventional therapy (control group, 24 patients). The efficacy was observed in the two groups. The changes in FVC, FEV1, and VC were determined. Results The study group was superior to the control group in the total effective rate (96.87% vs 79.17%; x2=10, P< 0.01). VC, FVC, and FEV1 were markedly improved in the study group ([2.91 ± 0.64]vs [1.79 ± 0.43]L, P < 0.05; [2.09 ± 0.62]vs [1.64 ± 0.46]L, P< 0.05; [1.35 ± 0.35]vs [0.92 ± 0.70]L, P< 0.05); while they did not differ significantly in the control group before and after treatment (P< 0.05). Conclusions The efficacy of acupoint injections of mycobacterium phlei F.U.36, huangqi and cordate houttuynia for stable asthma is better than that of conventional therapy.     

乌体林斯和黄芪注射液联用治疗缓解期哮喘的临床观察

Objective To investigate the efficacy of acupoint injections of mycobaoterium phlei F.U.36 combined with huangqi, and cordate houttuynia for stable. Methods 56 patients with stable asthma were randomized to receive acupoint injections of mycobacterium phlei F.U.36, huangqi, and cordatehouttuynia every the other day (study group, 32 patients), or conventional therapy (control group, 24 patients). The efficacy was observed in the two groups. The changes in FVC, FEV1, and VC were determined. Results The study group was superior to the control group in the total effective rate (96.87% vs 79.17%; x2=10, P< 0.01). VC, FVC, and FEV1 were markedly improved in the study group ([2.91 ± 0.64]vs [1.79 ± 0.43]L, P < 0.05; [2.09 ± 0.62]vs [1.64 ± 0.46]L, P< 0.05; [1.35 ± 0.35]vs [0.92 ± 0.70]L, P< 0.05); while they did not differ significantly in the control group before and after treatment (P< 0.05). Conclusions The efficacy of acupoint injections of mycobacterium phlei F.U.36, huangqi and cordate houttuynia for stable asthma is better than that of conventional therapy.     

肝纤维化血清学指标水平与肝癌的相关性研究

Objective To investigate the significance of serum fibrosis markers in liver fibrosis in liver neoplasms. Methods Radioimmunoassay was used to measure the level of serum procollagen (PC) Ⅲ, collagen type Ⅳ(Ⅳ-C), laminin LN and hyaluronic acid(HA) in 120 patients with liver neoplasms and 100 healthy people.Results Before therapy, the level of Ⅳ-C in the hepatocellular carcinoma group showed significant difference compared with those in control group (P＜0. 01 ). The levels of PCⅢ and LN in the hepatocellular carcinoma group were higher than those in control group ( P ＜ 0.05 ). Before therapy the levels of HA in metastatic cancer of liver group and extrahepatic malignant tumor group were higher than those in control group ( P ＜ 0. 05 ). Before and after the therapy the levels of hepatocellular carcinoma group serum PC Ⅲ, Ⅳ-C, LN and HA were significantly higher than those in the metastatic cancer of liver group ( P ＜ 0. 05). Before and after the therapy the levels of hepatocellula carcinoma group serum PC Ⅲ, Ⅳ-C, LN and HA were significantly difference ( P ＜ 0.05 ). Conclusions The levels of serum PC Ⅲ, Ⅳ-C, LN and HA are significantly related with the hepatocellular carcinoma. These markers can reflect the fibrosis degree of chronic hepatocellular carcinoma and will be an indicator of prognosis.     

Inhibitory effect of leflunomide on hepatic fibrosis induced by CCl4 in rats

AIM: To study the effect of leflunomide on CC14-induced hepatic fibrosis in rats. METHODS: Hepatic fibrosis was induced by subcutaneous injection with 50 % CCl4 in Sprague-Dawley rats. The amount of CC14 administered was 1 mg/kg. The alanine aminotransferase (ALT), aspartate aminotransferase (AST), nitric oxide (NO) levels in plasma and hydroxyproline (Hyp) contents in liver tissue were assayed by spectrophotometry. The hyaluronic acid (HA) and procollagen III (PC III) were assessed by radioimmunoassay. The transforming growth factor-β1(TGF-β1) in serum was determined by ELISA. The nuclear factor-kappa B (NF-κB) in liver tissue was examined by immunohistochemistry. Liver samples collected after 12 weeks ofCC14 treatment were stained with hematoxy-lin and eosin. RESULTS: Leflunomide (1, 3, and 9 mg/kg) significantly decreased indices of liver and spleen, the serum transaminase (AST, ALT) activities, HA and PC III levels, and Hyp contents in liver tissue in rats of hepatic fibrosis. Histopathological examination showed leflunomide had inhibitory effect on fibrogenesis and formation of pseudolobulus. Furthermore, leflunomide significantly inhibited NF-κB expression in liver tissue, and reduced elevated serum TGF-κB and NO levels in rats of hepatic fibrosis. CONCLUSION: Leflunomide showed inhibitory action on hepatic fibrosis induced by CC14 in rats.     

水飞蓟宾磷脂复合物对慢性乙型肝炎患者血清细胞因子及肝纤维化指标的影响

Objective To observe the influence of silybin capsules (SC) on hepatic fibrosis indexes and cytokines in patients with chronic hepatitis B(CHB). Methods Eighty-three patients with chronic hepatitis B were randomly divided into control group(n =42) and observation group(n = 41) acording to visiting order. The control group received general protective and supportive treatment with polarized solution, energy misture, potassium mag-nessium aspartape, hypoxanthine riboside, salvia miltiorrhiza and so on. Patients in observation group were added SC 105mg, three times per day. Serum precollagen type Ⅲ( PC Ⅲ), Ⅳ-typo collagen (CⅣ), hyaluronate (HA), laminin (LN) and transforming growth factor-beta (TGF-β), tumor necrosis factor alapha(TNF-α), interleukin 6 (IL-6) levels were measured by specific-RIA and ELISA methods before and after the treatment. Results After treatment, serum TGF-β[(174.4±49.7) μg/L], TNF-α[(89.5±25.8) μg/L], IL-6 [(232.6±61.7) μg/L], HA [(180.24±53.78) μg/L], PC Ⅲ[(171.33±48.65) μg/L], LN [ ( 168.06±38.57) μg/L] and CⅣ [(153.46±36.52) μg/L] levels in observation group were obviously decreased than those in control group. Conclusion Silybin capsules influences the levels of cytokines in patients with CHB and has anti-fibrosis effect on liver tissue.     

药物性肝损害与肝纤维化

近年来,随着药物种类的不断增多,药物性肝损害的发生率也相应增加,药物性肝损害的发生率仅次于皮肤粘膜损害和药物热。药物性肝损害较前两者不易发现,确切发生率也很难弄情楚,当肝损害达到相当严重程度,出现临床表现如ALT升高或黄疸时,才     

肝脏再造术治疗肝硬化疗效研究

目的研究肝脏再造术治疗肝硬化疗效。方法回顾性分析2016年8月～2018年7月我院接收的217例各种原因引起的肝硬化患者的临床资料,按照治疗方法的不同分为研究组(n=120)和对照组(n=97)。其中研究组给予肝脏再造术进行治疗,对照组给予常规对症治疗。比较分析两组患者治疗后的治疗效果、生化指标、血清肝纤维化指标和并发症发生情况。结果研究组患者的治疗总有效率(99.17%)明显高于对照组(83.51%),差异有统计学意义(P 0.05)。研究组患者治疗后的甲胎蛋白(AFP)、天门冬氨酸氨基转移酶(AST)和总胆红素(TBIL)明显低于对照组,肝功能白球比例(A/G)明显高于对照组,差异有统计学意义(P 0.05)。研究组患者治疗后的透明质酸(HA)、层黏蛋白(LN)、Ⅲ型前胶原(PCⅢ)明显低于对照组,差异有统计学意义(P 0.05)。研究组患者治疗后的并发症发生率(0.83%)明显低于对照组(15.46%),差异有统计学意义(P 0.05)。结论应用肝脏再造术治疗肝硬化疗效显著,明显改善患者生化指标和血清肝纤维化指标,降低并发症发生率,具有较高的应用价值。     

生物人工肝

肝脏是人体最重要的代谢器官，具有解毒、生物合成、代谢等多种功能。众多因素所致的肝衰竭必然导致机体代谢紊乱和毒性物质大量堆积．影响肝再生，并形成恶性循环，故病死率极高。生物人工肝治疗的目的是希望通过代偿肝脏功能的体外辅助支持治疗，为肝衰竭患者等待肝移植或肝再生的自然恢复争取时间．创造条件。     

边缘供体肝脏在成人肝脏移植中的应用

目的探讨不同边缘供体肝脏在成人肝脏移植中的应用。方法回顾性分析接受边缘供体肝脏的42例患者及供体的一般资料及生存情况。根据风险因子的不同,将所有供体分为E1、E2两组,比较接受两组供体的受体间生存率的异同。结果接受了两组供体的受者其0.5、1、2年生存率无显著性差异(P>0.05)。结论在注意供-受体匹配的情况下,边缘肝脏供体是可以应用的。     

A comparison of mirex-induced liver growth to liver regeneration

In intact rats given a single oral dose of mirex there was a dose-dependent increase in liver weight which peaked at 4 days. There were increases in hepatic RNA and protein, but DNA content per liver and DNA synthesis as measured by [3H]thymidine incorporation were unchanged. In partially hepatectomized rats dosed with mirex 24 h post-surgery, there was a dose-dependent increase in relative liver weight which peaked at 5 days. In partially hepatectomized rats simultaneously dosed with mirex, [3H]thymidine incorporation into DNA was unaltered. However, in rats dosed with mirex 24 h prior to partial hepatectomy, there was a 50% reduction in [3H]thymidine incorporation into hepatic DNA.     

肝窦内皮细胞在肝脏疾病中的作用

肝窦内皮细胞(liver sinusoidal endothelial cells,LSECs)作为肝脏中比例最高的非实质细胞,其窗孔结构和高内吞清除能力在肝脏生理病理过程中发挥不可或缺的作用。LSECs主要通过发挥抗炎、内吞、分泌促血管生成信号分子和维持HSCs表型等作用,参与调控非酒精性脂肪肝病(nonalcoholic fatty liver disease,NAFLD)、酒精性脂肪肝(alcoholic fatty liver,AFL)、肝细胞性肝癌(hepatocellular carcinoma,HCC)、肝再生、肝纤维化等肝脏病理过程。该文就LSECs正常生理功能及其在各种病理状态下发挥的不同作用作一综述,旨在通过靶向LSECs为治疗肝脏疾病提供新的观点。     

Review article: non-biological liver support in liver failure

Liver failure, whether acute or acute-on-chronic, remains an important cause of morbidity and mortality. The lack of liver detoxification, metabolic and regulatory functions of the liver leads to life-threatening complications, such as renal failure, altered immune response, hepatic coma and systemic haemodynamic dysfunction, eventually culminating in multiorgan failure. Current medical therapy involves the management of the precipitating event and treatment of complications until the liver eventually recovers, leaving us with no other treatment options than transplantation if these attempts fail. However, the shortage in cadaveric organs and other transplant-related problems, have prompted the need for alternative methods to provide liver support. As liver failure is often potentially reversible, considerable effort has been invested in the development of liver support systems. Currently, most of the experience is available for non-biological support systems. They represent the focus of this review, which aims to define the goals of liver support, to describe the design of the different existing devices and to analyse the available data to determine their current status in the management of patients with liver failure.     

The case for liver transplantation in end-stage alcoholic liver disease

Liver transplantation is now a routine procedure and is seen as a valid treatment option for end-stage liver disease. Alcoholism has been regarded as a relative or absolute contraindication to liver transplantation in many transplant units. Recent data document a success rate for transplantation in alcoholic patients that equals that in other patient groups. Issues relating to the ethical and scientific arguments surrounding this complex area of treatment are discussed. It is concluded that individual patients should be assessed in their own right for this treatment option. It is argued that patient groups should not be denied access to specific life-saving treatments.     

Metabolic studies of 5-ethyl-2'-deoxyuridine with liver extract, liver cells and liver cell culture

5-Ethyl-2'-deoxyuridine (EtUdR) was converted with rat liver extract, rat liver cells and rat liver cell cultures into its metabolites 5-ethyluracil and 5-(1-hydroxyethyl) uracil. The analytical identification of the metabolites as well as the investigation of the biotransformation process was performed by thin layer chromatography, autoradiography and high pressure liquid chromatography.     

肝功能检查对肝硬化治疗的临床价值

目的 探讨肝功能检查在肝硬化治疗过程中的作用,为临床诊疗提供参考.方法 回顾性收集本院2012年6月至2013年12月收治的确诊为肝硬化的180例患者作为观察对象,随机选择同期接受治疗的无心、肝肾等器质性疾病的180例患者作为对照组,比较两组患者肝功能检查的情况.结果 观察组患者总胆汁酸含量高于对照组,差异有统计学意义(P＜0.05);总胆固醇和清蛋白含量低于对照组,差异有统计学意义(P＜0.05).病例组180例患者中Child A级41例,Child B级58例,Child C级81例,总胆汁酸由高到低分别为Child C、Child B、Child A;总胆固醇和清蛋白由高到低依次为Child A、Child B、Child C.经正规治疗,观察组不同分级患者病情均有好转,进行肝功能测定时结果显示,治疗后病例组不同Child-Pugh分级间较治疗前均明显改善.结论 肝功能检测对肝硬化准确诊断及病情监测具有重要的参考价值.