肝细胞死亡的基础与临床研究

作为一个多功能器官,肝脏在机体代谢、生物合成、排泄,分泌与解毒等多方面发挥重要的作用.这些生物学效应的发挥为一耗能过程,亦决定了肝脏的高需氧特性和易损性,而多种因素造成的肝细胞死亡是大多数肝脏疾病的共同特征.一定比例的肝细胞死亡可以通过肝脏的再生修复功能得以补偿,一旦肝细胞损伤超过了肝脏的再生能力,则会出现致死性的肝脏衰竭.     

抗炎保肝药物的作用机制及地位

肝脏炎症坏死及其所致的肝纤维化是疾病进展的主要病理学基础.因此,如能找出病因,在对病因治疗的基础上有效控制肝组织炎症,有可能减少肝细胞破坏和延缓肝纤维化的发展.     

抗炎保肝治疗在肝病临床中的应用与地位

肝脏炎症坏死及其所致的肝纤维化是疾病进展的主要病理学基础,因此,如能找出病因,在对因治疗的基础上有效控制肝组织炎症,有可能减少肝细胞破坏和延缓肝纤维化的发展.     

间充质干细胞对心肌损伤修复的研究进展

在过去的10年中,干细胞已成功地应用于治疗各种疾病:胰岛移植治疗糖尿病;利用胚胎神经前体细胞和神经干细胞治疗神经系统疾病(帕金森综合征、癫痫、休克、脊髓损伤);肝细胞和肝的干细胞治疗肝脏疾病.近几年,干细胞移植治疗缺血性心脏病已成为一个热点话题.大量的动物实验和前期临床试验表明这种治疗对心肌细胞再生和心脏血流动力学改变有着明显的疗效.在各种干细胞中,由于骨髓间充质干细胞(mesenchymal stem cells, MSCs)具有取材方便、体外易培养和可诱导分化的特点,对其研究更加广泛和深入.现对MSCs在治疗心肌病中的应用作一综述.     

重视肝硬化患者的综合治疗与长期管理

肝硬化是慢性乙型肝炎、丙型肝炎、酒精性及非酒精性脂肪性肝病等多种慢性肝病的共同结局,主要表现为肝细胞功能障碍和门静脉高压症及其并发症。结合病史,可根据内镜、影像、生化、血液学指标做出肝硬化的临床诊断。肝硬化的诊断应尽可能明确病因、疾病分期和肝功能分级;治疗应尽可能包括病因治疗、综合支持治疗和针对各种并发症的治疗措施,并对患者进行长期随访和监测,以达到延缓疾病进展、延长生存期和提高生活质量的目标。     

内分泌系统疾病的肝脏表现

肝脏作为次级内分泌器官,与整个内分泌系统之间存在密切联系。多种内分泌系统疾病可影响到肝脏,如甲状腺功能亢进/减退症、糖尿病、肾上腺、性腺相关疾病等,并可表现为肝细胞损伤（转氨酶升高）、胆管损伤（胆汁淤积）、肝细胞脂肪变性、血管损伤及肝占位等多种形式。激素水平异常引起的直接、间接肝损伤、治疗内分泌疾病药物的不良反应是其常...     

多能干细胞源性肝细胞和类器官的培养

肝脏是人体最重要的器官之一,肝脏疾病也是威胁人类健康和寿命的主要原因之一。由于各种原因,肝失代偿的治疗相当困难,体外肝支持装置无法解决这一问题,原位肝移植供体严重短缺。用多能干细胞诱导肝细胞和肝类器官不仅可以研究肝细胞的命运决定、肝发育、肝再生机制和肝脏疾病的病理生理学,而且也可用于筛选药物,并为未来的移植治疗提供稳定...     

第57届美国肝病学会年会纪要

第57届美国肝病学会年会于2006年10月27日到31日在美国波士顿召开，来自世界各地的五千多名医生参加了会议。本次年会报道了近一年来肝脏疾病基础研究与临床治疗新进展；27日下午和28日全天为继续教育的内容，主题是“肝脏疾病：肝损伤的机制与新兴治疗”。分为六个部分，分别是急性肝损伤和衰竭、病毒性肝炎、脂肪性肝炎、肝脏再生和移植、肝病中的遗传因素以及肝胆肿瘤。各种病因引起的肝脏损伤导致肝细胞凋亡和肝脏炎症损伤，持续的凋亡和炎症又继续引起肝纤维化、肝硬化到终末期肝病。     

弹性成像技术在肝纤维化诊断中的应用

肝脏纤维化改变是肝脏对遭受的各种损伤的一种修复应变。肝脏星状细胞的胶原生成是肝脏纤维化的重要环节。肝脏损伤程度越重,修复的发生范围越大,持续时间越长,纤维化的影响越大。随之而来的是肝硬化和肝细胞癌发生几率的增加。早期明确肝脏纤维化并分期对治疗具有重要作用。     

肝细胞生成素的研究

急性肝衰竭的病死率极高,其预后主要取决于病损肝细胞的坏死程度和再生能力,因此,预防肝坏死与促进肝再生是目前各种治疗手段的出发点.以往临床上的治疗措施如支持疗法、活跃微循环、全血及血浆交换、体外吸附剂灌注及人工肝等技术,其目的均是以稳定内环境、延长患者生命、为残存肝细胞再生创造条件为主.这些措施虽有助于清除体内有毒物质,但无助于刺激病损肝脏的再生.因此,探索并找到既能阻止肝细胞坏死、又能促进肝脏再生的物质或药物一直是肝脏病学面临的重大课题[1].     

Chronic Radiation Injury to the Intestine: A Clinico-pathological Study

Abstract: Chronic radiation injury to the intestine: a clinico-pathological study. A. O. Kwitko, A. S. Pieterse, R. Hecker, R. Rowland and D. R. Wigg, Aust. N.Z. J. Med., 1982, 12, pp. 272–277. This paper draws attention to the continuing problem of chronic radiation injury to bowel. Fifty-seven symptomatic patients with this disorder were studied, 31 with predominantly small bowel injury and 26 with colonic disease. The mean latent interval following irradiation was 4 ? 7 years. Small bowel disease presented initially as intestinal obstruction (19 cases) or malabsorption (11 cases) and the radiation related mortality in small bowel disease was 32%, while that for colonic disease was 4%. There was a high incidence of prior pelvic surgery and of adjunctive chemotherapy in patients developing small bowel disease. Analysis of the radiotherapy techniques used highlighted that an unsatisfactory distribution of radiation dosage occurred when parallel opposed fields were used particularly where one field only was treated daily. Difficulty in matching external beams with intracavity sources may also have contributed to radiation injury.     

Ballistic injury

Wound profiles made under controlled conditions in the wound ballistics laboratory at the Letterman Army Institute of Research showed the location along their tissue path at which projectiles cause tissue disruption and the type of disruption (crush from direct contact with the projectile or stretch from temporary cavitation). Comparison of wound profiles showed the fallacy in attempting to judge wound severity using velocity alone, and laid to rest the common belief that in treating a wound caused by a high-velocity missile, one needs to excise tissue far in excess of that which appears damaged. All penetrating projectile wounds, whether civilian or military, therefore should be treated the same regardless of projectile velocity. Diagnosis of the approximate amount and location of tissue disruption is made by physical examination and appropriate radiographic studies. These wounds are contaminated, and coverage with a penicillin-type antibiotic should be provided.     

Injury severity determination: Requirements, approaches, and applications

Injury severity determination serves multiple purposes in trauma care systems by aiding prehospital triage, assisting clinical management, and facilitating outcome evaluation. Numerous authors have described methods for quantifying injury severity, most of which use physiologic status or anatomic injury. For prehospital triage, such determination assists decisions regarding patient priority, disposition, and destination. For clinical management, it provides essential information on initial condition and eventual course, including response to therapy. Finally, for outcome evaluation, it enables objective assessment of care quality, using techniques that determine appropriateness of disability, morbidity, mortality, and reimbursement, based on case mix.     

十二指肠损伤的诊断与治疗(附19例报告)

报告１９例十二指肠损伤属腹内脏器严重伤、治愈１７例，死亡２例。此类损伤的特点为相邻脏器合并伤多，术后并发症，诊治困难，预后差。伤后早期确诊，及时合适的处理，减少并发症的发生，是降低本病病死率的关键。