Localization and quantitative study of hepatic oval cells in patients with chronic liver diseases: A pathological analysis of 29 liver specimens

OBJECTIVE : To observe the morphological characteristics of oval cells in human chronic liver disease and to determine the relationship between the number of oval cells and the grading and staging of liver fibrosis. METHODS : Oval cells in paraffin‐embedded sections of three normal control livers and 29 chronically diseased livers were detected by using histoimmunochemistry. Cells were counted and scored if they satisfied the morphological criteria for oval cells and showed cytoplasmic staining. RESULTS : Oval cells were not observed in normal livers. In chronic liver disease, oval cells were characterized by the presence of an ovoid nucleus, a small‐sized cell and scanty cytoplasm, and were located predominantly in the periportal region and fibrous septa. The number of oval cells increased significantly (F = 22.60, P < 0.01) as the staging of fibrosis increased (7 ± 3, 12 ± 3, 25 ± 7, 33 ± 9, and 44 ± 10 in stages 0–4, respectively). There were significant differences between all stages (P < 0.05) except those in stages 0 and 1, and 1 and 2. The number of oval cells was significantly related to the staging of liver fibrosis (r = 0.88, P < 0.01). CONCLUSION : Oval cells are frequently detected in chronically diseased livers. Their presence is related to the staging of fibrosis.     

慢性重型肝炎患者肝组织内胆管增生的免疫组织化学研究

在慢性重型肝炎患者的肝组织切片中,除肝细胞大面积坏死、纤维组织增生、炎症细胞浸润及不同程度的肝细胞再生等病理特征外,还常有明显的胆管增生现象,但这种胆管增生的本质及意义尚不清楚。新近提出肝组织内胆管增生与肝干细胞     

Liver transplantation for acute and chronic viral hepatitis

Summary. Hepatotrophic viruses are responsible for a substantial proportion of cases of both end-stage chronic liver disease and of acute liver failure which are treated by liver transplantation. We review here current practice in transplantation for viral-induced liver disease addressing, in particular, the selection of patients for transplantation and the increasingly recognized problem of recurrent disease in liver grafts.     

The role of p28GANK in rat oval cells activation and proliferation

Abstract: Background: Human gankyrin gene product (p28^GANK) is a novel oncogenic protein ubiquitously overexpressed in hepatocellular carcinoma and also plays a role in cell cycle progression in normal hepatocytes and liver regeneration. However, little is known about the physiological role of p28^GANK in the liver oval cell activation and proliferation. We investigated the possible involvement of p28^GANK in oval cell‐mediated liver regeneration and cell cycle progression. Methods: We examined the different p28^GANK expression in 2‐acetylaminofuorene/partial heptectomy (2‐AAF/PH) rats, as a model of oval cell activation, and PH rats by Western blot and immunohistochemistry. Oval cells isolated from 2‐AAF/PH rat model were cultured in our study. p28^GANK expression was examined in the oval cells after mitogenic stimulation. Results: In 2‐AAF/PH rats, p28^GANK was expressed in the activated oval cells and located in the nucleus. p28^GANK protein expression was increased in 2‐AFF/PH rats after hepatectomy lasting for 96 h when retinoblastoma maintained hyperphosphorylation status at Ser‐795. The isolated oval cells express AFP, OV6, CK19, CD34, CD45, c‐kit and albumin. After epidermal growth factor stimulation, p28^GANK protein was up‐regulated in oval cells from 24 to 72 h, which coincided with increased expression of CyclinD1, CDK4 and decreased of Rb protein. Conclusions: p28^GANK expression was increased in oval cell‐mediated liver regeneration and oval cells after mitogenic stimulation. Thus, p28^GANK may play a role in oval cell‐mediated liver regeneration and liver oval cell cycle progression.     

庚型肝炎患者肝组织中HGV表达的免疫组化研究

目的探讨庚型肝炎病毒（ＨＧＶ）在庚型肝炎肝组织中的表达状况与临床意义．方法应用免疫组织化学ＰＡＰ方法以鼠抗ＨＧＶＮＳ５单克隆抗体对庚型肝炎患者２０例（急性肝炎２例，慢性肝炎８例，肝硬变１０例，血清ＨＧＶＲＮＡ皆阳性）肝组织中ＨＧＶ抗原进行检测．结果庚型肝炎患者２０例中，８例（４０％）肝组织中检出ＨＧＶ抗原；不同病期检出率分别为：急性肝炎０／２（０％），慢性肝炎２／８（２５％），肝硬变６／１０（６０％），各组间差异无显著意义；阳性信号位于肝细胞胞质；阳性细胞可位于炎症坏死灶周围；抗原阳性与阴性组间肝组织炎症活动度及血清谷丙转氨酶水平无明显差别，但阳性组纤维化指数较高．结论ＨＧＶ感染及其在肝组织中表达可能与肝组织纤维化有一定关系     

人类非嗜肝病毒性肝炎研究进展

人类非嗜肝病毒性肝炎是由非嗜肝病毒感染引起的肝损伤,随着临床检测手段的提高日益得到重视。非嗜肝病毒性肝炎的病原种类多样,临床表现程度不同,部分患者可导致死亡。本文按照非嗜肝病毒性肝炎的病原对其临床特点进行综述。     

The influence of host factors on the natural history of chronic hepatitis C viral infections

The natural history of hepatitis C is variable, with some patients progressing rapidly to cirrhosis and others showing no significant fibrosis over many decades. A number of studies have examined the factors that influence disease progression. Age at time of infection, gender, alcohol abuse and, perhaps, route of transmission, appear to have the greatest influence on the natural history of the hepatitis C virus with the possible exception of alcohol, the mechanism whereby these factors influence disease progression has yet to be determined.     

老年慢性病毒性肝炎患者血清微量元素的变化

目的研究老年慢性病毒性肝炎（ＣＶＨ）患者血清微量元素的变化。方法老年ＣＶＨ患者４７例，健康人４５例；非老年ＣＶＨ４５例，健康人４２例，测定其血清铜、锌、镉、锰、硒的含量，并对这些微量元素作两两直线相关分析。结果与非老年ＣＶＨ及健康人相比，老年ＣＶＨ患者血清铜（１１．８１±０．９４μｍｏｌ／Ｌ）、锌（９．３３±０．３１μｍｏｌ／Ｌ）、锰（０．３０±０．０３μｍｏｌ／Ｌ）、硒（０．５１±０．０７μｍｏｌ／Ｌ）含量明显减少（Ｐ＜０．０１），镉（７７．３４±６．７６ｎｍｏｌ／Ｌ）显著升高（Ｐ＜０．０１），血清锌、锰、硒之间两两呈正相关，与铜和镉为负相关（Ｐ＜０．０１）。结论老年ＣＶＨ患者血清微量元素含量与肝脏病变及衰老相关     

病毒性肝炎防治新形势下对中医药防治肝纤维化的思考

抗肝纤维化是中医药防治病毒性肝炎特色优势的重要体现。《2016-2021年全球卫生部门病毒性肝炎战略》、《中国病毒性肝炎防治规划(2017-2020)》的发布为中医药防治肝纤维化带来机遇。如何提高肝纤维化的疗效、研发更多抗肝纤维化的有效中药新药是新形势下中医药防治肝纤维化研究的挑战。以提高临床疗效为目的,从肝纤维化发生发展的不同阶段着手,发挥中医辨证论治的优势,早期干预,并联合精准医学、中医特色慢病管理等手段开展临床与基础研究,进一步建立并推广应用中医药防治肝纤维化的临床诊疗指南及中医药防治肝纤维化的中医特色慢病管理指南是未来中医药防治肝纤维化研究的重要内容。     

妊娠期病毒性肝炎临床特点分析

目的了解妊娠期病毒性肝炎的临床特点。方法回顾性分析2009年1月至2013年3月于广州市第八人民医院因病毒性肝炎住院的77例妊娠妇女的临床资料,分析肝炎病因、血清病毒学特点、肝损害程度与孕期的相关性。计量资料的组间比较采用Kruskal-Wallis H检验。结果病因:乙型肝炎多见,共72例(93.51%),有10.27%患者感染甲、乙或戊型肝炎病毒所致急性病毒性肝炎;肝损害程度:中度肝损害64例(83.12%),重度肝损害7例(9.09%),肝衰竭3例(3.90%);肝炎发作时孕期:妊娠早期16例(20.78%),妊娠中期49例(63.64%),妊娠晚期12例(15.58%);肝功能指标:总胆汁酸(TBA)、TBil、白蛋白(Alb)、ALT、AST、凝血酶原活动度(PTA)在HBeAg阳性和阴性患者间,以及在HBV DNA106IU/ml和HBV DNA≤106IU/ml患者间差异均无统计学意义(P0.05)。结论妊娠期病毒性肝炎主要由HBV引起,多数引起中度肝损害,重度肝损害或肝衰竭常发生于妊娠中晚期,因此育龄妇女妊娠期须注意防治慢性乙型肝炎。     

Microtubular aggregates in human chronic non-A,non-B hepatitis with bridging hepatic necrosis and multinucleated hepatocytic giant cells

ABSTRACT— A case of chronic non-A, non-B (NANB) hepatitis in a 17-year-old male is reported. The special feature was microtubular aggregates described so far only in experimental NANB hepatitis in chimpanzees. Additional characteristics were a severe chronic active hepatitis with confluent necrosis in a late stage, multinucleated hepatocytic giant cells and nuclear aggregates of 20–27 nm viruslike particles.     

Acute viral hepatitis: An aetiological study of 253 patients

Two hundred and fifty-three cases of acute viral hepatitis admitted to Ibn Al-Khateeb Infectious Disease Hospital, Baghdad, were studied prospectively regarding the viral aetiological agent. The most common cause was infection with one of the non-A, non-B viruses (51%). The second most common cause was infection with the hepatitis B virus (32%); two of these patients had hepatitis delta-co-infection. Hepatitis A virus was responsible for 15% of the cases, and hepatitis delta-virus superinfection in 2% of the cases.     

Clearance of hepatitis C virus in HIV-infected patients with multiple chronic viral hepatitis

Viral interferences between hepatitis C (HCV) and hepatitis B (HBV) viruses were investigated in a case-control study conducted in 107 human immunodeficiency virus (HIV)-infected patients with HCV antibodies. Overall, 15 (68%) of 22 hepatitis B surface antigen (HBsAg)-positive patients had negative serum HCV-RNA while it occurred in only nine (10%) of 85 HBsAg-negative counterparts (P = 0.02). After adjusting for age, antiretroviral therapy, plasma HIV-RNA and CD4 counts, being HBsAg-positive was strongly associated with having negative serum HCV-RNA (odds ratio: 23; 95% confidence interval: 6-59; P < 0.001). Thus, HBV may favour the elimination of HCV in HIV-infected patients, which may influence liver disease and therapeutic decisions.     

病毒性肝炎遗传修饰动物模型研究进展

病毒性肝炎在全球的广泛分布和传播是一个严重的公共卫生问题,探索治疗病毒性肝炎的方法及预防用疫苗的研发都离不开合适的动物模型。本文对相关受体的发现和遗传修饰动物模型的发展、用途及优缺点进行综述,并对未来动物模型的研究发展方向进行了展望。     

重视慢性病毒性肝炎合并脂肪肝的诊断与治疗

中国是慢性HBV感染的高发区,慢性HCV感染在中国亦不少见,然而仅有部分慢性病毒性肝炎患者最终发展为肝硬化和肝细胞癌[1].为此,有必要探讨加重慢性病毒性肝炎患者肝组织学损伤以及导致其预后不良和抗病毒治疗应答差的危险因素,而酒精性和非酒精性脂肪性肝病(fatty liver disease,FLD)可能就是这类危险因素之一[1-5].     

慢性重型肝炎患者中性粒细胞超微结构的改变

目的观察慢性重型肝炎患者中性粒细胞超微结构的改变及其意义。方法采用透射电镜对１５例慢性重型肝炎患者中性粒细胞超微结构进行观察，并以１５例正常人为对照。结果慢性重型肝炎患者中性粒细胞有明显异常，表现为胞浆稀疏，吞噬空泡，细胞器及细胞颗粒明显减少，线粒体水肿、空化、退变，细胞核浓缩等，病情严重及继发严重感染者尤著。结论观察中性粒细胞的超微结构变化对判断慢性重型肝炎患者防御细菌感染能力以及肝衰竭程度有一定的参考价值。     

人工肝支持系统治疗慢性重型肝炎的临床研究

目的探讨利用普通血液透析机进行人工肝(血浆置换联合血液透析)治疗慢性重型肝炎的临床疗效。方法对68例慢性重型肝炎进行186次人工肝支持治疗,观察治疗前、后临床症状的变化,血生化肝、肾功能指标的变化,预后情况及不良反应。结果全部病例均出现精神状态好转,肝性脑病程度减轻,乏力、腹胀减轻,食欲改善,尿量增加,全身水肿减轻;肝功能指标有明显改善:TBIL、ALT、AST、TBA、BUN、Cr、NH3均明显降低,ALB、PA 均明显提高(P<0.001～<0.05)。早、中期患者存活率明显高于晚期患者,两者比较有显差异(P<0.001)。结论利用普通血液透析机进行人工肝(血浆置换联合血液透析)治疗慢性重型肝炎操作方便,治疗安全、有效;人工肝治疗时应掌握时机,早期治疗。