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肝纤维化是各种慢性肝病重要的病理特征,也是进一步向肝硬化发展的必经阶段,早期诊断和治疗对阻止肝纤维化发展为肝硬化具有重要意义。肝活检仍是诊断肝纤维化的金标准,但具有创性,不易动态观察,临床应用受到限制,因此需寻求理想的无创诊断方法。在过去的十年中,肝纤维化进展相关的血清标志物研究取得了很大的进展,为肝纤维化的无创诊断带来了新希望。 相似文献
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肝纤维化是各种慢性肝病向肝硬化发展过程中的关键步骤和影响慢性肝病患者预后的重要环节。尽管目前对肝纤维化尚无确切的有效干预手段,但无论是临床医师还是患者仍急切需求对其进行早期诊断和评估。因此,需要加强肝纤维化早期诊断和评估的研究,为临床诊治和预后判断提供更好的依据[1]。尽管这些年很多学者对肝纤维化的诊断和评估做了大量的研究工作,尤其是在非创伤性诊断和评估方面,包括一些无创血清诊断模型和影像学检查等非创伤性检测方法,对肝纤维化有较高的诊断价值,但由于各存缺陷和准确性差强人意,目前肝活检仍然是诊断肝纤维化的“金标准”。 相似文献
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肝纤维化是各种肝病的共同特征,目前肝活检仍是其诊断的金标准,但由于肝活检的有创性,限制了在临床的应用,因此非创伤性检查评估肝纤维化的程度仍是目前研究的热点.此文通过近几年国内外对非创伤性检查方法的研究,较全面地分析了各种方法对肝纤维评估的价值. 相似文献
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肝纤维化是各种慢性肝病共同的病理表现。肝纤维化在早期乃至晚期都可以发生逆转。故预测及早期诊断肝脏纤维化对整个疾病的进程和治疗特别重要。肝活检仍是诊断肝纤维化的金标准,因有创性限制了其在临床上的广泛应用。目前,Fi-broScan作为一种无创性诊断方法成为研究热点,广泛应用于肝纤维化的诊断,此文就FibroScan临床应用进展作一综述。 相似文献
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《中国肝脏病杂志(电子版)》2016,(4)
超声弹性成像是一种可对肝纤维化进行定量的无创性新技术,本文基于国内外弹性成像技术的发展现状,归纳了此项技术的应用范围、诊断价值、临界值确定和实际应用中的优缺点。近年来,超声弹性成像发展迅速,在肝纤维化诊断和评价研究方面取得了显著进展。这种无创性诊断方法首先在慢性丙型肝炎患者中得到应用,并且正逐渐扩展至其他慢性肝病如非酒精性脂肪性肝病、慢性乙型肝炎和酒精性肝病等,减少了对肝组织活检的需求。 相似文献
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The immunoneuroendocrine role of melatonin 总被引:19,自引:0,他引:19
Georges J. M. Maestroni 《Journal of pineal research》1993,14(1):1-10
Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ. 相似文献
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Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland 总被引:2,自引:0,他引:2
Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland. 相似文献
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Martinez-Cecilia D Arjona-Sanchez A Gomez-Alvarez M Torres-Tordera E Luque-Molina A Valenti-Azcarate V Briceno-Delgado J Padillo FJ Lopez-Cillero P Rufian-Pena S 《World journal of gastroenterology : WJG》2008,14(12):1949-1951
Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs. 相似文献
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Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage. 相似文献
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H.P.J.M. Noteborn P.P. van Balen A.A. van der Gugten I.C. Hart I. Ebels C.A. Salemink 《Journal of pineal research》1993,14(1):11-22
Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the Mr range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [125I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (Ka of 4.7 ± 0.2 × 109 M-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of Mr 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL. 相似文献
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Gary S. Goldberg B.A. Bruce A. Orkin M.D. Lee E. Smith M.D. 《Diseases of the colon and rectum》1994,37(5):439-443
PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae
(16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum
was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy. 相似文献