非酒精性脂肪肝中医运动处方的构建思路

<正>脂肪肝(Fatty Liver Disease,FLD)是由各种原因导致脂肪在肝细胞内异常积累,引起一系列的并发症和病变的相关疾病。脂肪性肝病已成为仅次于病毒性肝炎的第二大肝病,被认为是肝癌和肝硬化的早期原因之一~([1-2])。临床上根据是否有过量酒精摄人,将脂肪肝分为酒精性脂肪性肝病(AFLD)和非酒精性脂肪性肝病(NAFLD)两大类。资料显示,脂肪肝发生率以非酒精性脂肪肝为主~([3-4]),近年来其发病率在不断上升,并可发     

非酒精性脂肪性肝病诊疗指南(2010年1月修订)

非酒精性脂肪性肝病(nonalcoholic htty liver disease,NAFLD)是一种与胰岛素抵抗(insulin resistance,IR)和遗传易感密切相关的代谢应激性肝脏损伤,其病理学改变与酒精性肝病(alcoholic liver disease,ALD)相似,但患者无过量饮酒史,疾病谱包括非酒精性单纯性脂肪肝(nonalcoholicsimple fatty liver,NAFL)、非酒精性脂肪性肝炎(nonalcoholicsteatohepatitis,NASH)及其相关肝硬化和肝细胞癌"~([1-2]).     

部分炎症因子活化11β-HSD1参与非酒精性脂肪肝发生的研究进展

正非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD)是指非过度饮酒及其它明确损肝因素所致的,以肝细胞内大量脂肪沉积为主要特征的,包含非酒精性脂肪肝以及由其发展来的非酒精性脂肪性肝炎、非酒精性脂肪性肝硬化和肝细胞癌在内的一系列进展性疾病的统称。中国多个发达地区(北京、上海、香港等)流行病学研究发现:普通成人的NAFLD患病率已高达20%以上~([1-3]),并且随着生活水平提     

非酒精性脂肪性肝病与动脉粥样硬化

一、流行病学 非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)是一种与酒精性肝病表现非常相似,但无过量饮酒史的临床病理综合征,根据其病理学改变和临床表现严重程度可以分为单纯性脂肪肝、非酒精性脂肪性肝炎、肝脏纤维化和肝硬化等不同病变类型~([1]).     

非酒精性脂肪性肝病与动脉粥样硬化

一、流行病学 非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)是一种与酒精性肝病表现非常相似,但无过量饮酒史的临床病理综合征,根据其病理学改变和临床表现严重程度可以分为单纯性脂肪肝、非酒精性脂肪性肝炎、肝脏纤维化和肝硬化等不同病变类型~([1]).     

非酒精性脂肪性肝病与动脉粥样硬化

一、流行病学 非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)是一种与酒精性肝病表现非常相似,但无过量饮酒史的临床病理综合征,根据其病理学改变和临床表现严重程度可以分为单纯性脂肪肝、非酒精性脂肪性肝炎、肝脏纤维化和肝硬化等不同病变类型~([1]).     

血小板在脂肪性肝炎及肝癌发病中的作用

正非酒精性脂肪性肝病(NAFLD)又称代谢相关脂肪性肝病,是肥胖、糖尿病、代谢综合征导致的脂肪性肝病。疾病谱包括非酒精性脂肪肝(NAFL)、非酒精性脂肪性肝炎(NASH)及其相关肝硬化和肝细胞癌(HCC)~([1-3])。随着肥胖、糖尿病在全球的流行,NAFLD已成为慢性肝病的首要原因。改变生活方式是目前NAFLD的基础治疗,迄今为止并无针对NAFLD的特效药物,抑制其进展为肝硬化、HCC等终末期肝病是目前研究的重点,而血小板在NAFL进展为NASH及HCC的过程中可能起着关键作用~([4])。传统观点认为,血小板通过黏附于破损的血管内皮细胞,激活凝血级联反应,主要参与机体的止凝血反应,也与肥胖、动     

非酒精性脂肪性肝病中医诊疗专家共识意见(2017)

<正>非酒精性脂肪性肝病(NAFLD)是一种与胰岛素抵抗和遗传易感密切相关的代谢应激性肝损伤,包括非酒精性单纯性脂肪肝、非酒精性脂肪性肝炎及其相关肝硬化。本病是临床常见病和多发病,其发病率及检出率逐年增加,据文献~([1])报道,普通成人NAFLD患病率达20%~33%。中华中医药学会脾胃病分会已于2009年制订了《非酒精性脂肪性肝病中医诊疗共识意见》~([2])。近年来,中医药在辨证治疗、证候规律研     

高尿酸血症及降尿酸药物对非酒精性脂肪性肝病影响研究进展

正非酒精性脂肪性肝病(NAFLD)是代谢综合征的肝脏表现~([1])。NAFLD的病理过程一般包括单纯性脂肪肝、非酒精性脂肪性肝炎(non-alcoholic steatohepatitis,NASH)、肝纤维化、肝硬化和肝细胞癌~([2])。据统计表明NAFLD在世界范围内患病率为6%～35%~([3]),近年来,NAFLD我国国民中的患病率也呈快速上升趋势。中心型肥胖、高血压、2型糖尿病、血脂异常等均是NAFLD的常见危险因素~([4])。尿酸是人体嘌呤代谢的最终产物,尿酸生成与     

非酒精性脂肪性肝病并发肝细胞癌的高危因素

正非酒精性脂肪性肝病(NAFLD)是与遗传易感和代谢功能障碍相关的慢性脂肪性肝病,疾病谱包括非酒精性脂肪肝(NAFL)、非酒精性脂肪性肝炎(NASH)及其相关肝纤维化、肝硬化和肝细胞癌(HCC)~([1-3])。近20年来NAFLD的发病率增长迅速,现已累及全球25%的人口,成为慢性肝病的第一大病因,NAFLD相关肝脏并发症和死亡病例越来越多,严重危害人类健康。当前NAFLD的患病率地区差异不再明显,亚洲国家NAFLD患病率甚至高于西欧和北美,并且NAFLD的起病渐趋低龄化~([1])。然而,至今国内外尚缺乏治疗NAFLD的特效药物,生活方式干预虽能兼顾防治NAFLD和代谢心血管危险因素但是难以实施。     

The immunoneuroendocrine role of melatonin

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.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

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.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

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.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

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.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

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 M_r 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 (K_a 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 M_r 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.     

Microbiology of human immunodeficiency virus anorectal disease

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.