五味子及其与丹参 灵芝 柴胡配伍对慢性肝损伤的影响

目的 观察五味子和五味子与丹参、柴胡、灵芝配伍对慢性肝损伤的治疗作用。方法 采用四氯化碳（CCl4)和D－氨基半乳糖（D－GlaN)多次注射造成两种慢性肝损伤模型,给予同一剂量的药物,测定血清谷丙转氨酶（ALT）、胆碱酸酶（CHE）、肝匀浆ALT、CHE、谷胱苷肽（GSH）、丙二醛（MDA）和碱性磷酸酶（ALP）,HE染色观察肝组织形态学。结果 五味子对CCl4慢性肝损伤所至的血清与匀浆ALT显著降低（P＜0.01),CHE升高（P＜0.01),ALP与MDA下降（P＜0.01)。五味五＋丹参对慢性肝损伤酶的作用与五味子相似,组织形态学结果与生化结果基本一致。五味子＋柴胡与五味子＋灵芝的作用弱于前者,但病理组织形态学结果不支持二者的治疗作用。对D－GlaN所致慢性肝损伤五味子能加强枯否细胞的吞噬功能,增加蛋白合成,消除MDA对细胞的损伤,改善细胞代谢。五味子＋丹参的生化结果与组织形态学结果显示其治疗作用强于五味子,对纤维组织增生的抑制作用是其特点。五味子＋灵芝虽有降ALT和升高CHE作用（P＜0.05,P＜0.01),但对匀浆CHE无效,而组织形态学显示受损的肝细胞无改善。五味子＋柴胡对酶的作用较差,组织形态学显示受损的肝细胞无明显改善。结论 五味子对两种慢性肝损伤有较好的治疗作用,五味子与丹参配伍的作用强于五味子,对纤维组织增生有明显抑制作用是其特点。     

五味子甲素和五味子醇甲对四氯化碳所致肝脏损伤的保护作用

 目的研究五味子甲素(Deoxyschizandrin)和五味子醇甲(schizandrin)对血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血清白蛋白(ALB)和总蛋白(TP)的影响。方法复制小鼠CCL4肝损伤模型,用五味子甲素和五味子醇甲防治,用生化方法测定血清ALT、AST、ALB和,TP。结果与CCL4组相比,五味子醇甲组和五味子甲素组ALT、AST均显著降低(P＜0.01),ALB和TP无显著性差异(P＞0.05);五味子醇甲组和五味子甲素组之间各项指标均无显著差异(P＞0.05)。结论五味子甲素和五味子醇甲均对CCL4所致肝损伤具有一定的保护作用,二者作用效果无显著差异。     

茵陈总黄酮对四氯化碳所致大鼠慢性肝损伤的保护作用

 目的 探讨茵陈总黄酮对四氯化碳(CCl₄)致肝损伤模型大鼠的肝脏保护作用。方法 选择雄性清洁级SD大鼠112只, 实验分为6组, 即正常对照组、模型对照组、茵陈总黄酮低、中、高剂量组、阳性对照组(茵栀黄口服液组)。正常对照组12只, 其余每组20只。测定大鼠的体重和存活率, 测定大鼠血清的丙氨酸氨基转移酶(alanine aminotransferase, ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase, AST)活性、蛋白浓度及肝组织羟脯氨酸的含量, 并取肝脏组织作病理检查。结果 茵陈总黄酮高剂量组大鼠血清ALT为(2659.8±923.8) nmol/(s·L), 与模型对照组(6274.3±2018.3)nmol/(s·L)相比显著性降低, 且茵陈总黄酮各组大鼠血清ALT活性随剂量增加而降低。大鼠血清AST变化趋势与ALT相同。与模型对照组相比, 茵陈总黄酮组的总蛋白和白蛋白浓度有所增加, 而茵陈总黄酮各组肝组织病理学评分均有不同程度的降低(P<0.01), 其中高剂量组病理组织学评分为(1.92±0.79), 与模型对照组(3.86±0.43)相比降低得最明显, 此外茵陈总黄酮还能降低肝组织羟脯氨酸含量及抑制肝纤维化作用。结论 茵陈总黄酮对CCl₄所致大鼠慢性肝损伤具有保护作用。
     

黄芪胶囊对化学性肝损伤的预防作用

目的:通过黄芪胶囊对CCl4大鼠慢性肝损伤的预防试验,评价黄芪胶囊保肝降酶的作用.方法:给予大鼠黄芪胶囊灌胃22 d,从给药1 w后开始,皮下注射10% CCl4 5 ml/kg,2次/w,连续给药5次,观察黄芪胶囊对CCl4造成大鼠慢性肝损伤的预防作用.结果:黄芪胶囊显著降低大鼠血清ALT,升高TP、ALB,减轻肝组织病理损伤的程度,并增加肝细胞中肝糖原含量.结论:黄芪胶囊通过降低转氨酶,升高白蛋白和肝糖原水平,从而起到对CCl4引起大鼠肝损伤的保护作用.     

冬虫夏草菌丝体多糖对免疫性肝损伤小鼠的保护作用

目的 探讨冬虫夏草菌丝体多糖对小鼠肝损伤模型的保护作用.方法 采用卡介苗联合脂多糖(BCG+LPS)建立小鼠免疫性肝损伤模型.60只NIH小鼠随机均分为正常对照组,模型组,菌丝体多糖高、中、低剂量(100、50、25mg/kg)组和联苯双酯(150mg/kg)组,每组10只.检测小鼠血清ALT、AST及NO水平;制备肝组织匀浆,检测IL-1β3、TNF-α含量;Real-time PCR检测小鼠肝组织IL-6、iNOS基因mRNA表达水平.结果 在小鼠免疫性肝损伤模型中,高、中剂量冬虫夏草菌丝体多糖可明显降低血清ALT、AST水平(P＜0.01),高剂量冬虫夏草菌丝体多糖可明显降低血清NO和肝组织IL-1β、TNF-α含量(P＜0.01).与模型组相比,高、中剂量冬虫夏草菌丝体多糖可明显下调IL-6、iNOS mRNA的表达(P＜0.01).结论 冬虫夏草菌丝体多糖对免疫性肝损伤具有一定的保护作用.     

葛根制剂对小鼠乙醇性肝损伤的保护作用研究

目的研究葛根制剂对小鼠乙醇性肝损伤的保护作用.方法采用乙醇肝损伤模型小鼠,以海王牌金樽片为阳性对照,观察葛根制剂低、中、高剂量组对模型小鼠MDA、GSH、AST、ALT及病理损伤的保护作用.结果葛根制剂中、高剂量组均可降低乙醇诱发肝损伤小鼠MDA含量,升高GSH水平,低、中剂量组对小鼠的肝脏病理损害有一定的改善作用.结论葛根制剂对小鼠乙醇性肝损伤有保护作用.     

肝能滴丸对小鼠试验性肝损伤的保护作用研究

目的　观察肝能滴丸对小鼠试验性肝损伤的保护作用,评价保肝降酶作用。方法　采用化学毒物四氯化碳(CCl4)致小鼠肝脏损伤,测定其生化指标并观察病理组织学改变。结果　肝能滴丸0 .2 34、0 .117g·kg-1均能显著降低CCl4肝损伤所致的小鼠血清谷丙转氨酶(ALT)和谷草转氨酶(AST)升高(P <0 .0 1)。结论　结果表明,肝能滴丸对小鼠试验性肝损伤具有明显的保护作用。     

肝素对刀豆蛋白A诱导昆明小鼠急性肝损伤的保护作用

为了观察肝素预处理对刀豆蛋白A（ConA)诱导昆明小鼠急性肝损伤的保护作用,将24只昆明小鼠随机均分为A、B、C3组。A组为正常对照组;B组经小鼠尾静脉一次性注射给予一定剂量ConA,造成急性重型肝损伤;C组在给予ConA同时皮下注射肝素100U。结果发现,与单纯ConA处理组相比,肝素预处理组小鼠8h死亡率明显降低,血清ALT水平下降（P＜0．05）,肝窦瘀血及肝脏炎症程度明显减轻,肝组织匀浆中MDA水平显著降低,因此认为,肝素预处理对ConA诱导昆明小鼠肝损伤具有保护作用。     

水芹总酚酸对小鼠CCl4肝损伤的保护作用

目的观察水芹总酚酸（OJTPA）对四氯化碳（CCl4）致小鼠急性肝损伤的保护作用。方法将180只小鼠随机分为正常组,联苯双酯阳性药物组,CCl4模型对照组和OJTPA高、中、低（500、250、125mg·kg^-1）3个剂量组。应用0．1％CCl4腹腔注射致小鼠急性肝损伤模型,通过测定小鼠血清中谷丙转氨酶（ALT）、谷草转氨酶（AST）活性以及小鼠肝组织中丙二醛（MDA）含量和超氧化物歧化酶（SOD）活力,并观察肝脏组织病理学变化,对OJTPA的保肝作用进行研究。结果模型组小鼠肝功能明显异常,肝组织变性、坏死严重;OJTPA组能明显改善CCl4中毒小鼠肝功能,其降酶率（ALT）以高、中、低剂量分别为74．74％、55．87％、7．25％;肝组织切片镜检证实,OJTPA能减轻中毒小鼠肝细胞损伤程度。结论OJTPA对急性肝损伤小鼠有较好的保肝作用。     

慢性肝病与神经系统损伤的临床研究

目的 :对慢性肝病并发神经系统疾病的特点和机理进行探讨。方法 :对 3 2例慢性肝病并发神经系统疾病的患者进行了肝功、肝炎病原学及相关的影象学及喉镜检查。结果 :慢性肝病并周围神经损伤、面神经麻痹 7例 ;慢性肝病并吞咽、喉返神经损伤 5例 ;中央桥脑髓鞘质溶解征 (CPM) 1例 ;肝性脊髓病 3例 ;肝硬化并椎体束损伤 2例 ;肝炎肝硬化活动期并肝脑变性14例。讨论 :肝炎病毒可引起多种类型的神经系统疾病     

肠道菌群与肠道辐射损伤的关系及其机制研究进展

近些年,越来越多的研究人员开始重视肠道菌群与人体健康的关系,并试图探讨其在辐射损伤中的作用。越来越多的证据表明,正常的肠道菌群通过Toll样受体、免疫途径和炎症反应等维持人体的健康。改善肠道菌群、调节菌群的平衡已作为治疗某些疾病的手段之一。本文综述肠道菌群与肠道辐射损伤的关系和机制,以期为放射性肠炎及其他疾病的治疗提供理论依据和指导。     

肝脏损伤诊治进展

随着影像学诊断和治疗技术的进展,肝脏损伤的非手术治疗越来越多地被接受.但对于有致命性大出血的严重肝脏损伤,尤其伴有肝后静脉损伤时,多予手术治疗,且死亡率和并发症发生率高.按照肝脏损伤的级别合理采用综合手术治疗方法,将明显改善治疗效果,第一肝门阻断(Pringle法)下肝切除是一重要治疗手段.肝后静脉损伤的主要对策是全肝血流阻断或转流下肝切除或肝切开显露和修补肝后静脉;难以耐受此术式时,肝周填塞是明智的选择.     

Quantitative and qualitative comparison of 3.0T and 1.5T MR imaging of the liver in patients with diffuse parenchymal liver disease

Purpose

The purpose of our study was to compare signal characteristics and image qualities of MR imaging at 3.0 T and 1.5 T in patients with diffuse parenchymal liver disease.

Materials and methods

25 consecutive patients with diffuse parenchymal liver disease underwent abdominal MR imaging at both 3.0 T and 1.5 T within a 6-month interval. A retrospective study was conducted to obtain quantitative and qualitative data from both 3.0 T and 1.5 T MRI. Quantitative image analysis was performed by measuring the signal-to-noise ratios (SNRs) and the contrast-to-noise ratios (CNRs) by the Students t-test. Qualitative image analysis was assessed by grading each sequence on a 3- and 4-point scale, regarding the presence of artifacts and image quality, respectively. Statistical analysis consisted of the Wilcoxon signed-rank test.

Results

the mean SNRs and CNRs of the liver parenchyma and the portal vein were significantly higher at 3.0 T than at 1.5 T on portal and equilibrium phases of volumetric interpolated breath-hold examination (VIBE) images (P < 0.05). The mean SNRs were significantly higher at 3.0 T than at 1.5 T on T1-weighted spoiled gradient echo (SGE) images (P < 0.05). However, there were no significantly differences on T2-weighted short-inversion-time inversion recovery (STIR) images. Overall image qualities of the 1.5 T non-contrast T1- and T2-weighted sequences were significantly better than 3.0 T (P < 0.01). In contrast, overall image quality of the 3.0 T post-gadolinium VIBE sequence was significantly better than 1.5 T (P < 0.01).

Conclusions

MR imaging of post-gadolinium VIBE sequence at 3.0 T has quantitative and qualitative advantages of evaluating for diffuse parenchymal liver disease.     

动态MRI对臂丛根性损伤和颈髓损伤的鉴别诊断意义

目的探讨动态MRI诊断臂丛神经根性损伤的影像学表现及其诊断价值，以及在与颈髓损伤的鉴别诊断中的临床意义。方法对8例臂丛神经根性损伤患者行动态MRI检查，结合CT薄层扫描和肌电图随访；所有8例患者均手术证实为臂丛根性损伤。结果本组患者在伤后早期1～2d内均无位于椎间孔及椎间孔外的创伤性脊膜囊肿、神经根断裂等支持臂丛根性损伤的MRI异常表现；4例患者有颈椎骨折或颈髓损伤的MRI表现。伤后7～15d（平均10d）后，再次行颈椎MRI检查，出现典型的MRI臂丛根性损伤表现：椎间孔及椎孔外臂丛神经走行处T2WI高信号的创伤性脊膜囊肿、脊髓移位和神经根缺失及走行异常等。结论动态MRI检查对臂丛根性神经损伤具有损伤节段定位准确、椎管外部分同样能够显示、无创、操作简单、准确性高等特点；其短期内特征性的动态变化易于诊断臂丛根性损伤，同时又能与颈髓损伤相鉴别。     

Long-term outcome of knee and ankle injuries in elite football

To estimate the risk and evaluate the long-term outcome of knee and ankle injuries in former national team elite football, 69 players were randomly selected, followed by clinical and stress radiographic examinations. Thirty-nine players (49 knees) had had knee injuries and 29 ankle injuries (35 ankles). The median time from injury until study examination was 25 years. The knee injuries were tears of the medial collateral ligament (MCL) in 24 cases combined with rupture of the anterior cruciate ligament (ACL) and meniscus lesions in three. Meniscus lesions had occurred in 17 cases including three combined with ACL and MCL and another two with ACL ruptures. Isolated rupture of the ACL had occurred in four cases. The ankle lesions were in 26 of 35 cases ruptures of the lateral ligaments. In all, 12 players had completely stopped football and three had changed occupation. Signs of arthritis were present in 63% of the injured knees and in 33% of the injured ankles. The incidence of arthritis in the group of 17 uninjured players was 26% in the knee and 18% the ankle. In elite football players knee and ankle injuries seem to have a serious long-term outcome, but also uninjured players have a higher risk of developing arthritis than the normal population.     

海水浸泡对腹部开放伤实验犬肝脏功能及形态学的影响

目的 探讨腹部开放伤后海水浸泡对实验犬肝功能及肝脏病理形态学的影响.方法 20只实验犬致伤后随机分为对照组(n=10)和浸泡组(n=10).对照组为单纯腹部外伤,浸泡组于致伤后置入人工配制的海水中.分别于致伤前(0h)及出水后4、8、12、16、20h取血测定总胆红素(TB)、ALT、AST、LDH、血氨(NH3)、凝血酶原时间(PT)、肿瘤坏死因子-α(TNF-α)、白介素6(IL-6)、内毒素(ETX)水平,于24h处死动物对肝组织进行病理检查.结果 与对照组比较,浸泡组TB、ALT、AST和PT增高,16h后升高明显.浸泡组伤后4h和12h LDH明显高于对照组,伤后4h血NH3明显高于对照组(P＜0.05).TNF-α、IL-6和ETX的变化与肝功能的损害程度呈正比.与对照组比较,浸泡组肝脏的病理形态学改变明显.结论 海水浸泡可导致实验犬的肝功能损伤和肝细胞病理形态学变化.     

Association between training volume and lower extremity overuse injuries in young female athletes: implications for early sports specialization

Background: Recent studies indicated greater risk of overuse injuries among young female athletes than their male counterparts. However, few studies have focused on female athletes and the effect of single-sport participation on lower extremity overuse injuries.

Objective: The objective of this study is to identify an independent risk variable for lower extremity overuse injuries based on status of sport participations (single- and multisports) in young female athletes.

Methods: In this cross-sectional study, 12–18-year-old female athletes were asked to complete electronic questionnaires describing their current sport participation and previous injury history. Range of motion (ROM), muscular strength, and performance parameters were measured at the time of completion of electronic questionnaires. Potential risk variables were compared between single- and multisport athletes and entered into a logistic regression model. Adjusted odds ratio (aOR), 95% confidence intervals (95% CIs), and p values were recorded to find an association with increased likelihood of lower extremity overuse injuries.

Results: The study cohort comprised 236 female young athletes (single-sport athletes: N = 60, multisport athletes: N = 176). A few variables including age, BMI, weekly hours of training for a sport, knee ROM, ankle ROM, and knee extensor strength were identified as potential risk variables. A logistic regression analysis showed an independent association between increased weekly hours of training for a sport and greater likelihood of histories of lower extremity overuse injuries (aOR = 1.091, 95% CIs: 1.007–1.183, p = .034).

Conclusion: Although status of single- or multisports participation was not a significant risk variable, increased training volume was found to be an independent contributing factor for greater likelihood of lower extremity overuse injury histories in 12–18 years female athletes. The current study identified that single-sport athletes trained nearly twice as many hours per week when compared to multisport athletes, which may explain an underlying mechanism of sports specialization.     

MR imaging of the biliary tract with Gd-EOB-DTPA: Effect of liver function on signal intensity

Objective

To quantitatively evaluate the signal intensity of the biliary tract in gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) imaging and to investigate the effect of liver function on the signal intensity of the biliary tract.

Materials and methods

A total of 32 patients with and without chronic liver disease (normal liver group, n = 15; chronic liver disease group, n = 17) were included in this study. All patients were prospectively enrolled for evaluation of known or suspected focal liver lesions. In the chronic liver disease group, the etiologies were chronic hepatitis C virus infection (n = 12) and chronic hepatitis B virus infection (n = 5). The median Child-Pugh score was 5 (range, 5-7). Each patient received the standard dose of Gd-EOB-DTPA (0.025 mmol/kg of body weight). Post-contrast T1-weighted MR images were obtained at 5, 10, 15, 20, 25, and 30 min after administration of Gd-EOB-DTPA. Maximum signal intensities (SIs) of the right and left hepatic ducts, common hepatic duct, and common bile duct were measured. Relative signal intensity was calculated as follows: relative SI = maximum SI_bile duct/mean SI_muscle. Serum albumin level, serum total bilirubin level, prothrombin time, indocyanine green retention rate at 15 min (ICG-R15), and estimated glomerular filtration rate were entered into regression analysis.

Results

The signal intensity of the bile duct reached a peak 30 min after administration of Gd-EOB-DTPA. The mean relative signal intensity of the right and left hepatic ducts at the peak time point was not significantly different between the two groups, while increase in signal intensity was delayed in the chronic liver disease group. The mean relative signal intensity of the common hepatic duct and that of the common bile duct at the peak time point were significantly different between the two groups (Wilcoxon rank-sum test, P = 0.03, respectively). Stepwise regression analysis revealed that ICG-R15 was a significant predictor of the signal intensity of the bile duct (right and left hepatic ducts, P = 0.04; common hepatic duct, P = 0.008; common bile duct, P = 0.003).

Conclusions

The results of our study demonstrate that the presence of chronic liver disease significantly affects the signal intensity of the bile duct in Gd-EOB-DTPA-enhanced MR imaging. ICG-R15 was only a significant predictor of the signal intensity of the bile duct. The signal intensity of the bile duct may reflect underlying liver function.