核转录因子κB在非酒精性脂肪肝大鼠肝组织中的表达

目的观察高脂饮食诱导的非酒精性脂肪肝大鼠肝组织核转录因子κB(NF-κB)的表达、脂质过氧化损伤及血清细胞因子的变化情况,探讨非酒精性脂肪肝的发病机制.方法20只大鼠随机分为正常组10只、模型组10只,模型组予高脂饲料喂养,正常组予普通标准饲料喂养,连续12周,观察肝组织的病理改变,免疫组化法检测大鼠肝组织NF-κBp65的表达,TBA法检测肝匀浆MDA含量,黄嘌呤氧化酶法检测肝匀浆SOD活力,放免法测定血清中TNF-α、IL-6的含量,硝酸还原酶法检测血清NO含量.结果模型组大鼠肝组织可见重度脂肪变、炎症细胞浸润、肝细胞坏死、汇管区渗出.NF-κBp65在模型组大鼠肝组织中表达较在正常组中明显增高(P＜0.01),模型组大鼠肝匀浆MDA含量和血清TNF-α、IL-6、NO含量均较正常组明显升高,肝匀浆SOD活力则较正常组明显降低(P＜0.01或P＜0.05).结论高脂饮食可引起大鼠肝脏发生非酒精性脂肪变性,NF-κB参与了高脂饮食诱导的非酒精性脂肪肝损伤过程,在其发生发展中可能起重要作用.     

核转录因子κB在非酒精性脂肪肝大鼠肝组织中的表达

目的观察高脂饮食诱导的非酒精性脂肪肝大鼠肝组织核转录因子κB（NF-κB）的表达、脂质过氧化损伤及血清细胞因子的变化情况，探讨非酒精性脂肪肝的发病机制。方法20只大鼠随机分为正常组10只、模型组10只，模型组予高脂饲料喂养，正常组予普通标准饲料喂养，连续12周，观察肝组织的病理改变，免疫组化法检测大鼠肝组织NF-κB p65的表达，TBA法检测肝匀浆MDA含量，黄嘌呤氧化酶法检测肝匀浆SOD活力，放免法测定血清中TNT-α、IL-6的含量，硝酸还原酶法检测血清NO含量。结果模型组大鼠肝组织可见重度脂肪变、炎症细胞浸润、肝细胞坏死、汇管区渗出。NF-κB p65在模型组大鼠肝组织中表达较在正常组中明显增高（P〈0.01），模型组大鼠肝匀浆MDA含量和血清TNF-α、IL-6、NO含量均较正常组明显升高，肝匀浆SOD活力则较正常组明显降低（P〈0.01或P〈0.05）。结论高脂饮食可引起大鼠肝脏发生非酒精性脂肪变性，NF-κB参与了高脂饮食诱导的非酒精性脂肪肝损伤过程，在其发生发展中可能起重要作用。     

参芪肝康颗粒对非酒精性脂肪肝大鼠丙二醛、超氧化物歧化酶的影响

目的:探讨参芪肝康颗粒对非酒精性脂肪肝大鼠脂质过氧化物(LPO)的降解产物丙二醛(MDA)和超氧化物歧化酶(SOD)的影响。方法:通过高脂饮食来建立大鼠非酒精性脂肪肝模型,在造模成功以后给予"参芪肝康颗粒",干预3周后进行各组大鼠血清和肝匀浆MDA、SOD的含量变化的检测。结果:模型组大鼠血清和肝匀浆中MDA含量明显高于正常组,SOD水平明显低于正常组;在给药治疗以后,参芪肝康颗粒各组与模型组相比,血清及肝匀浆中MDA含量显著降低,SOD水平均明显增高;和阳性对照组相比,大鼠肝匀浆MDA含量降低及SOD含量升高以参芪肝康颗粒预防组和高剂量组最为显著。结论:参芪肝康颗粒提高血清和肝组织的抗氧化能力显著,能够明显抵御肝细胞的过氧化和氧应激,避免损伤肝细胞,以达到预防和治疗非酒精性脂肪肝的目的。     

非酒精性脂肪性肝炎大鼠血管内皮细胞分泌功能的研究

目的探讨非酒精性脂肪性肝炎（nonalcohol steatohepatitis NASH）大鼠血管内皮细胞分泌功能的变化在其发病机制中的意义。方法健康雄性Wistar大鼠16只,随机分为正常组和模型组,分别以标准大鼠饲料和高脂饲料喂养,连续12周后处死大鼠,HE染色观察大鼠肝脏组织病理学变化,脂酶法检测肝组织匀浆TG、CHOL含量,黄嘌呤氧化酶法检测血及肝组织匀浆中SOD含量,TBA法检测血及肝组织匀浆中MDA含量,放免法测定血浆ET、TXB2、6-Keto-PGF1α含量,发色底物法测定血浆t-PA、PAI含量,硝酸还原酶法检测血清NO含量。结果模型组大鼠肝组织均有重度脂肪变,并伴有肝细胞气球样变,肝细胞碎屑样坏死、炎症细胞浸润和汇管区渗出,未见肝纤维化和肝硬化形成。模型组大鼠肝组织匀浆TG、CHOL含量较正常组明显升高（P〈0．01）;血清及肝组织匀浆中MDA含量较正常组明显增高（P〈0．05）,SOD活力均较正常组明显下降（P〈0．05）;血ET、NO、TXB2、6-Keto-PGF1α、PAI含量以及ET／NO、TXB2／6-Keto-PGF1α、PAI／t-PA值均较正常组明显升高（P〈0．01,P〈0．05）;t-PA水平与正常组相比差异无显著性（P〉0．05）。结论高脂饲料可成功诱导大鼠非酒精性脂肪性肝炎;大鼠在非酒精性脂肪性肝炎时出现了血管活性因子分泌的紊乱,表明非酒精性脂肪性肝炎存在着血管内皮的损伤。     

高脂饮食诱导的非酒精性脂肪性肝病大鼠肝组织PPARα和CPT—ⅠmRNA的表达

[目的]探讨过氧化物酶体增殖物激活受体(PPAR)α和肉碱棕榈酰转移酶(CPT-Ⅰ)在高脂饮食诱导的非酒精性脂肪性肝病(NAFLD)大鼠肝组织中的表达及其意义。[方法]模型组SD大鼠给予高脂饲料喂养,对照组大鼠予以普通饲料喂养,12周末处死,HE染色,光镜下观察各组大鼠肝组织的病理改变;测定肝组织匀浆中CHO、TG含量;用自动生化分析仪检测血清ALT、AST、CHO、TG、LDL-C和HDL-C水平,比色法检测血清FFA含量,放免法测定血清TNF-α含量;以RT-PCR法检测大鼠肝组织中PPARαmRNA和CPT-ⅠmRNA表达。[结果]模型组大鼠血清ALT、AST、FFA及TNF-α水平显著高于正常对照组(P<0.01),血清CHO、TG、LDL-C水平和肝匀浆CHO、TG的含量也较正常对照组显著增高(P<0.05,P<0.01),而血清HDL-C明显低于正常对照组(P<0.01);模型组大鼠脂肪变程度积分和炎症较正常组明显升高(P<0.01),而肝组织PPARαmRNA和CPT-ⅠmRNA的表达水平则显著下降(P<0.01)。[结论]持续12周的高脂饮食可以诱导NAFLD大鼠模型,模型组大鼠肝组织PPARαmRNA和CPT-ⅠmRNA的表达降低,在肝细胞成脂性改变中起重要作用。     

蜕皮甾酮对大鼠非酒精性脂肪性肝病核因子κB与PPAR-γmRNA表达的影响

目的 研究蜕皮甾酮对非酒精性脂肪性肝病大鼠模型核因子κB与PPAR-γ mRNA表达的影响,并探索其可能的作用机制.方法 采用改良高脂膳食喂养法,建立大鼠非酒精性脂肪性肝病模型.健康成年雄性SD大鼠48只,随机分为正常对照组、模型组、蜕皮甾酮处理组与吡格列酮处理组,每组12只.模型组应用改良高脂饲料喂养,蜕皮甾酮组与吡格列酮组在高脂饲料喂养同时应用药物灌胃,正常对照组应用基础饲料喂养.实验16周末,处死所有大鼠,观察检测肝脏指数、血清与肝组织生化指标及肝组织病理改变;免疫细胞化学法检测各组大鼠肝组织中核因子κB蛋白表达情况;实时荧光定量PCR技术检测PPAR-γmRNA 水平变化.结果 蜕皮甾酮组和吡格列酮组血清胆固醇(TC)、甘油三酯(TG)、丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)明显低于模型组(P<0.05);蜕皮甾酮和吡格列酮组与模型组相比,肝组织丙二醛(MDA)水平降低明显,超氧化物歧化酶(SOD)活力增加显著;蜕皮甾酮肝脏指数显著降低;肝组织脂肪变性程度和炎症活动度明显减轻(P<0.05).蜕皮甾酮和吡格列酮组与模型组相比核因子κB水平明显降低(P<0.01),PPAR-γ mRNA显著增加(P<0.05).结论 蜕皮甾酮具有改善高脂饮食诱发的非酒精性脂肪性肝病大鼠肝脏酶学,通过增加肝组织SOD的含量和减少MDA的含量来减轻肝组织氧化应激水平,增加肝组织PPAR-γmRNA和减少核因子κB改善胰岛素抵抗,减轻肝脏炎症,发挥防治非酒精性脂肪性肝病的作用.     

高脂饮食致非酒精性脂肪肝大鼠血清瘦素水平的变化

目的检测高脂饮食大鼠不同时期血清瘦素水平,研究瘦素在非酒精性脂肪肝病（NAFLD）发病机制中的作用和意义。方法66只大鼠随机分成正常组10只、高脂组56只。正常组予以普通饲料喂养,高脂组予以高脂饮食喂养,分别于4、8、12、16、20和24周末分批处死。用免疫放射法检测各组大鼠血清瘦素、胰岛素及C肽水平,HE染色观察肝脏病理变化,苏丹Ⅲ染色观察肝脏脂质蓄积情况。结果高脂饮食摄入成功建立大鼠脂肪肝模型。高脂组与正常组比较,血清瘦素、胰岛素、C肽水平、肝湿重及体重均显著升高（P〈0．001）,并随时间的延长而升高（P〈0．01）,瘦素与c肽及体重呈明显正相关（P〈0．01）,与胰岛素及肝湿重无明显相关性。结论高脂饮食摄入可使大鼠发生非酒精性脂肪性肝病,高脂组大鼠血清的瘦素、胰岛素和C肽水平升高,瘦素抵抗可能是脂肪肝发病的一个重要机制。     

改良后高脂饮食所致大鼠非酒精性脂肪性肝病模型的建立

目的:探讨非酒精性脂肪性肝病动物模型的一种快速的建立方法。方法:将30只雄性大鼠随机分为正常组和模型组,分别喂养普通基础饲料和改良后高脂饲料10 w。比较两组大鼠血清ALT、AST、DBIL、HDL-C、LDL-C、TC和肝组织匀浆GGT、TG、GSH含量的变化及肝脏组织学变化。结果:与正常组比较,第10周时模型组大鼠血清ALT、AST、DBIL、HDL-C、LDL-C、TC、TC/HDL-C均明显升高(P<0.05);肝组织匀浆GGT、TG含量升高,GSH含量降低(P<0.05)。正常组大鼠肝组织未见明显脂肪变性及炎症,模型组大鼠在小泡性脂肪变性的基础上伴随淋巴细胞浸润和灶状坏死。结论:改良后高脂饲料可加快非酒精性脂肪性肝病的造模进程,值得推广。     

粗叶悬钩子总生物碱对非酒精性脂肪肝的抗氧化作用

目的 探讨粗叶悬钩子总生物碱对模型大鼠的抗氧化作用. 方法SD大鼠30只,随机分为空白对照组、模型组、粗叶悬钩子总生物碱组,高脂饲料喂养12周,制备非酒精性脂肪肝大鼠模型,连续给药4周后取材,HE染色,观察肝组织病理变化,比色法检测血清中ALT、AST、SOD、MDA的含量变化,RT-PCR和免疫组化法检测COX-...     

大鼠非酒精性脂肪性肝炎形成中氧化应激水平变化及山楂叶总黄酮对其影响

目的研究高脂饮食诱导的大鼠非酒精性脂肪性肝炎形成中氧化应激/脂质过氧化的变化,观察山楂叶总酮对NASH的防治作用,探讨其作用机制。方法110只大鼠随机分为正常组40只、模型组40只、易善复组10只、山楂叶总黄酮高剂量及低剂量组各10只。正常组每天予以普通标准饲料喂养,其余各组每天均予以高脂饲料喂养;在造模的同时,易善复组灌服易善复混悬液195.4mg/(kg.d),山楂叶总黄酮高、低剂量组分别灌服山楂叶总黄酮250、125mg/(kg.d),正常组及模型组大鼠均灌服等量蒸馏水。实验开始后第2周、第4周、第8周末正常组及模型组分别随机处理大鼠10只,实验第12周末处理剩余所有大鼠。观察肝组织的病理改变,血清ALT、AST水平,肝组织匀浆TG、CHOL含量、血及肝匀浆MDA含量,SOD、GSH-PX、T-AOC的活力。结果(1)高脂饲料喂养2～12周,大鼠肝组织脂肪变程度逐渐加重,肝内TG、CHOL含量也逐渐增加;至12周肝组织炎细胞浸润明显,血清ALT、AST水平明显增高,呈现了NASH病变的渐进性发展过程。(2)高脂饲料喂养4周起血及肝匀浆MDA含量逐渐增高,SOD活力逐渐下降,肝组织匀浆的T-AOC也逐渐下降,且随炎症的进展而升高或降低。(3)山楂叶总黄酮高、低剂量组大鼠肝组织炎症程度、肝匀浆CHOL含量和血清ALT、AST水平较同期模型组明显减轻;血及肝组织MDA含量较同期模型大鼠显著减少,SOD、GSH-PX及T-AOC活性则较同期模型大鼠显著升高,且其抗氧化及减少脂质过氧化作用优于易善复。结论氧化应激/脂质过氧化在NASH的发生、发展中起重要作用。山楂叶总黄酮能有效防治NASH的发展,能明显缓解NASH大鼠的氧化应激,减少脂质过氧化,显著增强机体抗氧化能力,这是其防治NASH发生发展的重要作用机制。     

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.     

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>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     

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

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     

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。     

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

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     

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.