肝病患者血清HA、PⅢP和Un水平与肝功能、肝脏B超检查结果的关系探讨

目的:探讨肝病患者血清透明质酸(HA)、Ⅱ型前胶原肽(PⅢP)、粗纤维调节素(Un)水平与肝功能、肝脏B超结果的关系,评价其临床应用价值。方法:199例各型肝病,用RIA法检测血清HA、PⅢP,用ELISA法检测血清Un,同时检测肝功能(ALT、TBil、Glb)、肝脏B超,并进行相关分析。结果:慢性肝病各组的HA、PⅢP和Un均高于急性肝炎组(P<0.01,P<0.05),各种慢性肝病组间差异有显著性意义,以活动性肝硬化为最明显。PⅢP、Un与ALT相关(P<0.05),HA与ALT无相关(P>0.05),3者与Glb均相关(P<0.01)。HA、PⅢP和Un与TBil均不相关(P>0.05)。B超异常组的HA、PⅢP和Un水平高于B超正常组(P<0.05,P<0.01)。结论:HA、PⅢP和Un均是诊断肝纤维化的良好指标,但PⅢP、Un与肝炎活动有一定关系,在临床诊断时应与肝功能、B超检查结果综合分析。     

安络化纤丸对慢性肝病肝纤维化指标的影响

[目的] 观察安络化纤丸对慢性肝病患者肝功能、细胞免疫功能、补体、血清肝纤维化和B超肝脾指标的影响。[方法] 67例慢性肝病患者随机分为两组:治疗组(37 例)在常规护肝治疗基础上再给予安络化纤丸每次6g,早晚各1次,服用3个月。对照组(30例)只给予常规护肝治疗。两组治疗结束后1 个月复查肝功能、肝纤维化指标、免疫功能指标和肝胆B超。[结果] 治疗组治疗后血透明质酸(HA)、层黏连蛋白(LN)、Ⅲ型前胶原(PⅢNP)、Ⅳ型胶原(C Ⅳ)较治疗前明显下降(P<0 .05或<0 .01),且HA、PⅢNP的下降幅度明显优于对照组(P<0 .01);治疗组治疗后转氨酶、球蛋白明显降低,CD4+T、CD4+T/CD8+T明显升高(P<0. 05)。[结论] 安络化纤丸能较好的改善机体细胞免疫功能,促进肝功能的恢复,改善血清肝纤维化指标,对慢性肝病具有一定抗纤维化作用和肝保护作用。     

肝病5号胶囊治疗肝炎肝纤维化的临床研究

目的:观察自制中药肝病5号胶囊对慢性乙型肝炎肝纤维化的临床疗效.方法:按照<病毒性肝炎诊断标准>和自订的纳入标准,将95例慢性乙型肝炎肝纤维化患者随机分为两组:治疗组48例,服用肝病5号胶囊,对照组47例,服用大黄(庶虫)虫丸;治疗前后采用荧光免疫法检测患者血清HA、LN、PC-Ⅲ、Ⅳ-C的水平,观察主要症状和体征,肝功能等指标及肝脏B超声像图情况 .结果:治疗组治疗前后HA、LN、PC-Ⅲ、Ⅳ-C的水平比较,差异有非常显著性意义(P＜0.01).两组间在脾脏回缩、AST、Alb、GGT及HA、LN、PC-Ⅲ方面比较,差异有非常显著性意义(P＜0.01).结论:肝病5号胶囊对慢性乙型肝炎肝纤维化患者有较好的抗肝纤维化作用,其疗效优于大黄庶(庶虫)虫丸.     

大黄虫丸与丹参抗乙肝后肝纤维化的研究

观察丹参、大黄虫丸单用或联合用对乙肝后肝纤维化的疗效。结果显示 ,大多数患者经治疗后血清透明质酸 ( HA)、层粘连蛋白 ( LN)和 型胶原 ( · C)有不同程度的下降 ,以联用组下降更明显 ( P<0 .0 1)。认为丹参与大黄虫丸二者联用疗效更好。     

恩替卡韦联合大黄■虫丸对乙型肝炎肝硬化患者血清学指标及门静脉压力的影响

目的: 评价恩替卡韦( ETV) 联合大黄■虫丸对乙型肝炎肝硬化患者肝功能、肝纤维化、T 淋巴细胞亚群及门静脉压力的影响。方法: 选择 2018 年 6 月至 2020 年 9 月天津市第二人民医院收治的 100 例乙型肝炎肝硬化患者,随机分为 ETV 联合大黄■虫丸治疗的观察组和单用 ETV 治疗的对照组,每组各 50 例,疗程 24 周。测定并比较两组患者治疗前后的血清肝功能( ALT、TBil、Alb) 、肝纤维化指标( HA、LN、PC-Ⅲ、Ⅳ-C) 、肝纤维化壳酶蛋白( Fibro-CHI) 、T 淋巴细胞亚群( CD4⁺% 、CD8⁺% 以及 CD4⁺/ CD8⁺)及肝脏瞬时弹性指标( LSM) 、B 超影像学指标( 门静脉直径、脾厚度) 。结果: 治疗 24 周后,两组患者的上述各检测指标结果均较治疗前改善,且观察组患者的改善程度明显高于对照组,差异有统计学意义( P < 0. 05) 。治疗后观察组患者各项指标结果也优于对照组。两组比较,差异有显著性意义( P < 0. ...     

血清透明质酸Ⅲ型前胶原Ⅳ型胶原及脯氨酸肽酶对肝组织纤维化诊断的意义

探讨肝病患者血清透明质酸（HA）,Ⅲ型前胶原（PCⅢ）,型胶原（CⅣ）及脯氨酸肽酶（PLD）水平与肝纤维化程度的关系。用酶联免疫（ELISA）法及生化比色法检测225例各种肝病患者血清中HA、PCⅢ、CⅣ及PLD水平,并与肝活检病理炎症分级和纤维化分期相比较。四项指标与肝组织炎症坏死及纤维化程度均呈显著相关（P〈0．05）。HA、PCⅢ及CⅣ与肝纤维化相关性高于炎症,PLD与炎症的相关性高于纤维化。血清学指标与肝组织病理病变程度一致,联合检测肝病患者血清HA、PCⅢ、CⅣ及PLD水平,既可反映肝纤维化严重程度,又能了解肝坏死情况,为临床诊断治疗提供参考。     

黄芪联合大黄蜇虫丸治疗酒精性肝纤维化的临床研究

目的 观察黄芪联合大黄蜇虫丸对酒精性肝纤维化的治疗效果.方法 将50例酒精性肝纤维化患者随机分为对照组和联合治疗组,观察治疗前、后肝纤维化指标(HA、LN、PC-Ⅲ、Ⅳ-C)、肝功能的变化.结果 治疗后两组各项指标均较治疗前有明显改善(P<0.05),且治疗组优于对照组(P<0.05).结论 黄芪联合大黄蜇虫丸具有显著的抗酒精性肝纤维化的作用且无严重不良反应.     

肝纤维化血清学指标的临床应用价值

肝纤维化是各种慢性肝病向肝硬化发展的共同途径和病理改变 ,早期发现肝纤维化并进行动态观察临床意义极大。近年来 ,关于肝纤维化的血清标志物有不少报道 ,多数学者认为肝病患者血清 I、 、 型胶原和透明质酸 (HA)、层粘连蛋白 (LN)水平是反映早期肝纤维化的良好标志物 ,但因其试剂盒价格昂贵 ,目前尚难以推广。为筛选能较准确反映肝纤维化进程和程度的血清学指标 ,指导肝病的诊断、治疗及预后判断 ,1 998～ 2 0 0 0年 ,我们对 1 48例肝病患者进行了血清 、 型胶原和 HA、LN检测 ,现报告如下。1　资料与方法本文肝病组 1 48例 ,其中男 …     

大黄(庶虫)虫丸抗大鼠免疫性肝纤维化研究

目的:研究大黄廑虫丸预防和治疗肝纤维化的作用。方法:运用牛血清白蛋白致大鼠免疫损伤性肝纤维化模型,观察大廑黄虫丸对肝组织病理学、肝组织羟脯氨酸(HyP)和血清透明质酸(HA)及肝功能的影响,并设秋水仙碱作对照。结果:大黄廑虫丸预防和治疗组肝纤维化率分别为72.7％和71.4％,而模型组和秋水仙碱组肝纤维化率为92.3％～100％,尤其是大黄廑虫丸治疗试验组肝HyP含量下降最显著,与模型组比较,P<0.05。结论:大黄廑虫丸有一定的抗肝纤维化作用,尤适用于对肝纤维组织的降解。     

肝纤维化血清学指标诊断价值的验证研究

目的研究血清肝纤维化指标透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、IV型胶原(IVC)及层粘连蛋白(LN)与肝纤维化程度的关系,验证其在肝病不同阶段的诊断价值。方法用放射免疫法测定267例慢性肝炎患者血清HA、PCⅢ、IVC及LN水平,同时做肝组织活检,对肝组织进行炎症分级和纤维化分期,分析上述血清学指标水平与肝组织分级和分期之间的关系。结果上述指标水平与慢性肝炎发展的阶段一致,与肝组织炎症坏死和纤维化程度均呈正相关。结论血清HA、LN、PCⅢ、IVC可以做为反映肝纤维化程度的指标;联合检测有助于肝纤维化的诊断。     

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.     

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.     

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.     

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.