AFU和AFP联合检测对原发性肝癌的诊断价值

目的:探讨联合检测血清a-L-岩藻糖苷酶(alpha-L-fucosidase AFU)和甲胎蛋白(alpha -fetoprotein AGP)对原发性肝癌的诊断价值.方法:分别采用显色多肽基质检测法和放免法对71例原发性肝癌、28例其它消化系统恶性肿瘤、75例良性肝病及20例健康体检者的血清AFP水平和AFU活性进行联合检测.结果:原发性肝癌组血清AFU、AFP水平分别为(678.6±154.5)nmol/(mL.h)和(506.7±183.2)μg/L,明显高于肝硬化组(384.8±240.3)nmol/(mL·h),(54.5±21.4)μg/L、肝炎组(332.4±129.3)nmol/(mL·h),(47.3±12.6)μg/L、消化道肿瘤组(275.4±182.1)nmol/(mL·h),(54.1±12.3)μg/L和正常对照组(205.4±108.5)nmol/(mL·h),(6.19±2.3)μg/L.原发性肝癌组中AFU、AFP的敏感性分别为76%、74.5%.联合检测AFU、AFP,其诊断的敏感性可提高到93.0%.结论:AFU、AFP联合检测具有互补作用,可提高原发性肝癌的早期诊断率.     

血清HBV-DNA与a-L-岩藻糖苷酶对慢性乙肝病毒感染者临床价值

目的探讨在慢性乙肝病毒感染者中血清HBVDNA水平与a-L-岩藻糖苷酶（AFU）活性的临床价值。方法收集377例慢性乙肝病毒感染者,分为慢性乙型肝炎组233例,肝炎肝硬化组105例,原发性肝癌组39例。其中慢性乙型肝炎组分为轻度组159例、中度组29例、重度组45例,检测血清HBVDNA水平与a-L-岩藻糖苷酶活性并统计分析。结果 （1）在所有病例中,慢性乙型肝炎组HBV-DNA水平最高,其次肝炎肝硬化组,原发性肝癌组最低,3组间两两比较,慢性乙型肝炎组其他2组比较有显著性差异P〈0.01;而3组间AFU水平无显著差异,P〉0.05。（2）在慢性乙型肝炎组中,轻度组HBVDNA水平最高,其次中度组,重度组为最低,3组间两两比较,轻度组与重度组HBV-DNA水平比较有显著差异性,P〈0.01;重度组血清AFU活性水平最高,其次中度组,轻度组最低,3组间两两比较,轻度组与中度、重度组血清AFU活性水平比较有差异性,P〈0.05。结论慢性乙肝病毒感染者的肝脏损害程度与HBV-DNA水平、AFU的活性有密切关系,联合检测HBV-DNA水平、AFU活性可以作为乙肝病毒感染者肝脏炎症程度的指标,受肝脏炎症活动影响,AFU作为肝癌血清标志物特异性较差。     

血清HBV-DNA与a—L-岩藻糖苷酶对慢性乙型肝炎病毒感染者的临床诊断价值

目的探讨慢性乙型肝炎病毒（HBV）感染者中血清HBV-DNA水平与a—L-岩藻糖苷酶（AFU）活性的临床价值。方法收集377例慢性HBV感染者,分为慢性乙型肝炎（以下简称慢乙肝）组233例,肝炎肝硬化组105例,原发性肝癌组39例。其中慢乙肝组分为轻度组159例、中度组29例、重度组45例,检测血清HBV-DNA水平与AFU活性并进行统计分析。结果①在所有病例中,慢性乙型肝炎组HBV-DNA水平最高,其次肝炎肝硬化组,原发性肝癌组最低,三组间两两比较,慢乙肝组与肝炎肝硬化组及原发性肝癌组比较有显著的统计学差异（P〈0．01）;而三组间AFU水平无显著差异,P〉0．05。②在慢乙肝中,轻度组HBV-DNA水平最高,其次中度组,重度组为最低,三组间两两比较,轻度组与重度组HBV-DNA水平比较有显著性差异（P〈0．01）;重度组血清AFU活性水平最高,其次中度组,轻度组最低,三组间两两比较,轻度组与中度、重度组血清AFU活性水平比较有显著性差异P〈0．05。结论慢性HBV感染者的肝脏损害程度与HBV-DNA水平、AFU的活性有密切关系,联合检测HBV-DNA水平、AFU活性可以作为HBV感染者肝脏炎症程度的指标,受肝脏炎症活动影响,AFU作为肝癌血清标志物特异性较差。     

血清α-L-岩藻糖苷酶活性与乙型肝炎相关性研究

目的探讨血清α-L-岩藻糖苷酶（AFU）活性与非癌性肝脏损害程度的相关性。方法设定乙肝患者肝功能（ALT）正常组、乙肝患者肝功能（ALT）异常1组（40U/L400U/L）、肝硬化组、正常对照组,比较各组血清中AFU水平;分析乙肝患者肝功能（ALT）异常组血清AFU水平与ALT水平相关性;比较接受治疗前后乙肝与肝硬化患者AFU水平的变化。结果乙肝患者肝功能（ALT）正常组、乙肝患者肝功能（ALT）异常1、2组与正常对照组相互间比较差异无显著性（P〉0.05）;乙肝患者肝功能（ALT）异常3组和肝硬化组与正常对照组相互间比较差异有显著性（P〈0.01）;乙肝患者肝功能（ALT）异常1、2组与3组间相互比较差异有显著性（P〈0.01）;乙肝患者血清ALT升高程度与AFU相关性系数为r=0.810,P〈0.001。结论乙肝病人一旦经抗肝炎治疗后,血清ALT活性下降,AFU活性也迅速下降,ALT活性持续不变或上升者,AFU活性也不下降;肝硬化患者血清AFU活性长期升高提示常易发展为肝癌,所以血清AFU活性测定,有助于乙肝和肝硬化患者预测的观察。     

血清α-L-岩藻糖苷酶对原发性肝癌的诊断价值

目的探讨血清α-L-岩藻糖苷酶(alpha-L-fucosidase,AFU)在原发性肝癌(primary hepatic carcinoma,PHC)诊断中的应用价值.方法对60例正常人,27例肝癌患者、32例肝硬化患者、18例肝炎患者、6例梗阻性黄疸患者、8例转移性肝癌患者和30例其它恶性肿瘤患者所测的血清AFU活性值进行统计,比较各组测定的AFU水平差异.结果肝癌组血清AFU水平明显高于正常对照组、肝硬化组、转移性肝癌组和其它恶性肿瘤组,但不能区分于肝炎组和梗阻性黄疸组.结论 AFU可作为PHC的肿瘤标记物.     

肝病患者血清a-岩藻糖苷酶活性测定的临床意义

目的:了解a-岩藻糖苷酶(AFU)在肝病诊断和治疗中的意义.方法:使用全自动生化分析对201例各种肝病(急性肝炎、慢性肝炎、重症肝炎、肝硬化、肝癌)和100例正常人血清中八项常规项目和AFU进行检测,对检测结果进行统计学分析.结果:在急性肝炎和肝硬化时AFU均显著升高,在重型肝炎时AFU降低,肝癌时AFU显著升高.结论:在急性肝炎、肝硬化和肝癌时对AFU的检测具有很高的检测价值.     

原发性肝癌患者血清AFP、AFU、CA199联合检测的临床意义

目的探讨原发性肝癌患者血清AFP、AFU、CA199含量及意义。方法分别应用放射免疫法和生化法对46例原发性肝癌患者血清AFP、AFU、CA199含量进行检测,并与42名肝炎肝硬化患者和40名正常人进行比较。结果原发性肝癌患者血清AFP、AFU、CA199含量显著高于肝炎肝硬化组及正常人组(P<0.01)。AFP、AFU、CA199三项指标在原发性肝癌中的阳性率分别为76.09%、71.74%、80.43%,AFP AFU、AFP CA199、AFP AFU CA199联合检测的阳性率分别为89.13%、84.78%、95.65%。结论联合检测血清AFP、AFU、CA199含量可以提高对原发性肝癌的诊断阳性率。     

多肿瘤标志物联合应用对肝癌的诊断价值

目的探讨多肿瘤标志物联合应用对肝癌的诊断价值。方法选择156例肝癌患者(肝癌组)、148例肝炎患者(肝炎组)及120例同期健康体检者(对照组)作为研究对象,对肝癌组、肝炎组及对照组受试者的甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原199(CA199)、α-L-岩藻糖苷(AFU)等4种肿瘤标志物进行检测,比较其血清水平及异常率。结果肝癌组患者血清AFP、CEA、CA199和AFU水平和异常率均显著高于肝炎组和对照组,差异有统计学意义(P<0.05);原发性肝癌患者血清AFP和AFU的水平高于转移性肝癌患者,血清CEA水平低于转移性肝癌患者,差异均有统计学意义(P<0.05);AFP、CEA、CA199和AFU联合检测对肝癌诊断灵敏度为87.4%。结论 AFP、CEA、CA199和AFU联合检测有利于肝癌的筛查。     

IL-18结合蛋白在慢性肝炎及肝癌中的表达意义

目的:检测原发性肝癌(肝癌)、慢性乙型肝炎(慢乙肝)、肝炎后肝硬化(肝硬化)和正常人血清白介素-18结合蛋白(IL-18BP)的浓度,并检测同期肝癌、癌周、慢乙肝、肝硬化和正常肝脏组织中IL-18BP的表达;探讨IL-18BP在慢乙肝、肝硬化及肝癌发病过程中的作用.方法:ELISA法检测肝癌25例、肝硬化20例、慢乙肝20例、正常人15例血清中IL-18BP的浓度.利用sP免疫组化染色法检测同期肝癌患者癌组织、癌周组织各41例;肝硬化组织11例;慢乙肝组织9例;正常5例(肝囊肿患者的正常肝组织)肝脏组织IL-18BP表达.结果:正常组、慢乙肝组、肝硬化组和肝癌组血清中IL-18BP的浓度分别为(3.3±0.5),(6.2±1.5),(14.9±1.4),(20.4±1.9)ug/L,4组间两两比较均有显著的统计学差异(P<0.01).肝癌的癌周组织、癌组织、肝硬化组织和慢乙肝组织阳性表达率分别为97.6%,34.2%,36.4%和22.2%:正常肝组织表达量极少;癌周组织评分值分别与癌组织、慢性肝炎组织、肝硬化组织比较有统计学差异(P<0.01).结论:随着炎症的进展,血清IL-18BP含量逐渐升高,但肝癌患者血清中IL-18BP含量最高.组织学检测结果提示肝癌癌周组织及癌组织中残存的肝细胞大量表达IL-18BP,肝癌组织有一定量的表达.IL-18BP高表达除受炎症因素的调控外,可能还参与调控肿瘤的生成和发展,血清或/和肝组织中IL-18BP水平检测,可能有助于疾病的早期诊断及预后评估.     

慢性乙型肝炎、肝硬化患者血清过氧化脂质变化的研究

研究慢性乙型肝炎 (CHB)、肝硬化病人血清过氧化脂质 (LPO)浓度的变化。方法 :用改良硫代巴比妥酸 (TBA)法测定 186例慢性乙型肝炎和 2 3例肝硬化患者及 10 0例正常人血清LPO浓度。结果 :慢性乙型肝炎轻度、中度、重度及肝硬化患者血清LPO分别为 (4.81± 0 .87) μmol/L ,(5 .5 3± 1.12 ) μmol/L ,(5 .96±1.0 1) μmol/L及 (6 .0 1± 0 .74 ) μmol/L ,较正常对照组 (3.86± 0 .75 ) μmol/L明显升高 (P <0 .0 1)。结论 :LPO浓度随肝炎病情发展而升高 ,测定血清LPO可作为动态观察病情 ,判断肝炎预后的指标之一。     

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。     

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.     

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     

脂肪肝患者血清肝纤维化指标分析

目的探讨脂肪肝患者血清肝纤维化指标特点，寻找可能引起脂肪肝肝纤维化改变的相关因素。方法记录脂肪肝组和正常对照组临床资料与血清生化指标以及肝纤维化指标，分析各项指标的异常及脂肪肝组肝纤维化指标及其他指标的相关关系。结果脂肪肝组和正常对照组血清生化指标和肝纤维化指标之间的比较：脂肪肝患者组血清FPG、TG、Tc、ALT、HA、LN、PCⅢ、CIV、CG与对照组比较差异有统计学意义（P〈0．05）。血清肝纤维化指标HA与年龄（≥50岁）、酗酒、男性、CG增高、ALT增高、高血压病有线性回归关系；血清肝纤维化指标LN与酗酒、肥胖、糖尿病有线性回归关系；血清肝纤维化指标CIV与高脂血症，ALT增高有线性回归关系；血清肝纤维化指标PcⅢ与年龄（I〉50岁）、高脂血症、高血压病有线性回归关系。结论通过多元线性回归分析显示：男性，年龄≥50岁，酗酒，肥胖，伴发高血压病、高脂血症、糖尿病，出现CG增高，ALT增高，可能是促进脂肪肝发生肝纤维化的危险因素。     

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     

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     

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。