肝硬化食管胃底静脉曲张及出血的非侵入性临床检查研究

目的 研究分析非侵入性临床检查在肝硬化食管胃底静脉曲张及出血的应用,为临床诊断提供参考意见.方法 选取肝硬化食管胃底静脉曲张及出血患者作为观察组(n=20),并选取同期住院患者中明确诊断为肝硬化合并食管胃底静脉曲张未破裂出血的病例作为对照组(n=20)进行研究,对比分析2组患者血小板计数(PLT)、血小板压积(PCT)、血小板平均体积(MPV)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT),腹部超声及CT相关指标即门静脉直径(PV)及脾静脉直径(SV)等.结果 观察组患者PLT、PCT、MPV较对照组明显降低(P相似文献   

加味赤石脂禹余粮汤联合热敏灸治疗肝硬化腹水并顽固性腹泻疗效观察

【目的】观察加味赤石脂禹余粮汤联合热敏灸对肝硬化腹水并顽固性腹泻的临床疗效。【方法】选择肝硬化腹水并顽固性腹泻患者60例,随机分为治疗组与对照组各30例,对照组采用西医常规疗法加中药加味赤石脂禹余粮汤治疗,治疗组在对照组治疗基础上加用热敏灸疗法,观察2组患者腹泻、腹水及肝功能指标[总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、白蛋白(ALB)、前白蛋白(PA)]改善情况。【结果】(1)腹泻疗效:治疗组总有效率为100.00%,优于对照组的86.67%(P<0.05)。(2)腹水疗效:经彩超检查,治疗后2组的肝硬化腹水均有显著改善(P<0.05),且治疗组疗效优于对照组(P<0.05)。(3)肝功能作用:治疗后,2组TBIL、ALT、AST、ALB、PA指标均显著改善(P<0.05),且治疗组的改善作用均优于对照组(P<0.05)。(4)不良反应及随访情况:治疗过程中,治疗组与对照组均未发生明显不良反应。3个月后随访,对照组腹泻治愈患者中复发5例,治疗组无复发病例。【结论】加味赤石脂禹余粮汤联合热敏灸对肝硬化腹水并顽固性腹泻患者疗效显著,具有止泻迅速、应用方便、安全可靠等优点,并且有加速腹水消退、促进肝功能恢复的作用。     

Characterization of SCCA-IgM as a biomarker of liver disease in an Asian cohort of patients

Viral hepatitis infection is a major global issue and a leading cause of liver disease and associated deaths. Over time, patients infected with hepatitis B (HBV) or C virus (HCV) develop cirrhosis and, eventually, hepatocellular carcinoma (HCC). For this reason, they need to be constantly monitored. Current Asian guidelines recommend the determination of serum alpha-fetoprotein (AFP) together with liver ultrasounds every six months to detect HCC nodules. However, both methods have several limitations, and other biomarkers have been studied for monitoring cirrhosis, including SCCA-IgM, an immune-complex formed by Squamous Cell Carcinoma Antigen and IgM. To date, SCCA-IgM has been validated as a novel biomarker for liver diseases only in European populations. The aim of our study was to analyze SCCA-IgM as a biomarker to monitor cirrhosis evolution in an Asian cohort of patients and to compare its performance to that of AFP. We analyzed the concentration of AFP and SCCA-IgM in serum samples obtained from a group of Asian adult patients with cirrhosis or HCC and a control group of patients admitted for gastrointestinal disorders. In untreated patients and similarly to AFP, SCCA-IgM levels were significantly higher in patients with cirrhosis compared to those with HCC. In addition, SCCA-IgM, but not AFP serological levels, were significantly lower in HCC patients who were treated with surgical resection compared to those who received a different therapy.     

Real-time elastography evaluation of differential penetrating liver trauma in a rabbit model

Background

Real-time ultrasound elastography (RTE) is used to examine liver fibrosis and benign and malignant lesions, but its use for the diagnosis of liver trauma has not been examined. The purpose of this study was to examine the use of RTE for the evaluation of differential penetrating liver trauma in a rabbit model.

Morphological and Molecular Discrimination of Fasciola Species Isolated From Domestic Ruminants of Urmia City,Iran

Background:

The trematodes of the genus Fasciola (the liver flukes) are among the well-known instances of food-borne parasites worldwide. Differentiation of Fasciola species is important because of their different transmission and epidemiological characteristics. The current study was undertaken to discriminate Fasciola species in the domestic ruminants of Urmia city, Iran.

Methods:

Adult flukes were isolated from the naturally infected livers of the slaughtered water buffaloes and sheep. The flukes were initially identified based on morphological and morphometric parameters. A 618-bp-long fragment of the 28SrRNA gene of Fasciola was amplified by polymerase chain reaction (PCR). The amplified fragment was digested by DraII or AvaII enzymes for a restriction fragment length polymorphism (RFLP) analysis and sequenced for the phylogenetic tree construction.

Results:

Based on the morphometric examination, the flukes belonged to F. hepatica, F. gigantica and an intermediate Fasciola form. The PCR-RFLP analysis was able to differentiate F. hepatica from F. gigantica. While the phylogenetic reconstruction justified, to some extent, the morphological diagnosis, it failed to segregate F. hepatica from F. gigantica identified in this and the previous studies.

Conclusion:

To resolve fully the problem of taxonomy and evolution in Fasciola species, employing a broad range of molecular and morphological approaches is necessary. This is crucial for epidemiological surveys and successful clinical management of their infection.     

帕瑞昔布钠对肝炎肝硬化患者术后镇痛效果及凝血功能的影响

目的探讨麻醉诱导前应用帕瑞昔布钠在肝炎肝硬化患者术后镇痛效果及对凝血功能的影响。方法择期行脾切除断流手术的肝炎肝硬化患者40例随机均分为两组,P组于麻醉前10min静脉注射帕瑞昔布钠40mg,C组应用等体积生理盐水。两组术毕均行舒芬太尼静脉自控镇痛(PCIA)。记录术后24h内PCIA泵按压次数,计算舒芬太尼总量,观察不良反应发生情况。检测用药前、用药后30min和12h的凝血酶原时间(PT)、凝血酶时间(TT)、激活部分凝血酶原时间(APTT)、纤维蛋白原(Fib)和血小板计数(Plt)。结果 P组术后24h内PCIA泵按压次数、有效按压次数、恶心、呕吐发生率和舒芬太尼总量均少于C组(P<0.05)。两组各时间点PT、TT、APTT、Fib和Plt比较均无统计学差异。结论肝炎肝硬化患者麻醉诱导前应用帕瑞昔布钠40mg可减少术后镇痛药用量及不良反应的发生,且不影响凝血功能。     

Protective effect of gastrodin on bile duct ligation-induced hepatic fibrosis in rats

Gastrodin has been showed to possess many beneficial physiological functions, including protection against inflammation and oxidation and apoptosis. Studies showed inflammation and oxidation play important roles in producing liver damage and initiating hepatic fibrogenesis. However, it has not been reported whether gastrodin has a protective effect against hepatic fibrosis or not. This is first ever made attempts to test gastrodin against liver fibrosis in bile duct ligation (BDL) rats. The aim of the present study is to evaluate the effect of gastrodin on BDL-induced hepatic fibrosis in rats. BDL rats were divided into two groups, BDL alone group, and BDL-gastrodin group treated with gastrodin (5 mg/ml in drinking water). The effects of gastrodin on BDL-induced hepatic injury and fibrosis in rats were estimated by assessing serum, urine, bile and liver tissue biochemistry followed by liver histopathology (using hematoxylin & eosin and sirius red stain) and hydroxyproline content measurement. The results showed that gastrodin treatment significantly reduced collagen content, bile duct proliferation and parenchymal necrosis after BDL. The serum alanine aminotransferase (ALT) and serum aspartate aminotransferase (AST) decreased with gastrodin treatment by 15.1 and 23.6 percent respectively in comparison to BDL group did not receive gastrodin. Gastrodin also significantly increased the level of serum high density lipoprotein (HDL) by 62.5 percent and down-regulated the elevated urine total bilirubin (TBIL) by 56.5 percent, but had no effect on total bile acid (TBA) in serum, bile and liver tissues. The immunohistochemical assay showed gastrodin remarkably reduced the expressions of CD68 and NF-κB in BDL rats. Hepatic SOD levels, depressed by BDL, were also increased by gastrodin by 8.4 percent. In addition, the increases of hepatic MDA and NO levels in BDL rats were attenuated by gastrodin by 31.3 and 38.7 percent separately. Our results indicate that gastrodin significantly attenuated the severity of BDL-induced hepatic injury and fibrosis by attenuating oxidative stress and inflammation. Taken together, these findings suggest that gastrodin might be an effective antifibrotic drug in cholestatic liver disease.     

地沟油对小鼠肝肾功能及脂肪代谢的影响

目的观察摄食地沟油对小鼠肝肾功能及脂肪代谢的影响。方法将72只小鼠平均分为6组,其中地沟油组与食用油组各3组,按照5、10和20μL/g剂量的地沟油或食用油连续隔天给予小鼠灌胃8周,比较两组小鼠灌胃前后丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、血尿素氮(BUN)、血肌酐(Scr)、甘油三酯(TG)和总胆固醇(TC)水平。结果地沟油的水分含量、酸价和过氧化值指标均超标。连续灌胃8周后,5μL/g剂量地沟油组小鼠ALT明显高于食用油组(P0.05);10μL/g剂量地沟油组小鼠AST高于食用油组(P0.05)。5、10和20μL/g剂量地沟油组小鼠Scr均高于同剂量食用油组(P0.05);10和20μL/g剂量地沟油组小鼠BUN均高于同剂量食用油组(P0.05);但相同剂量地沟油和食用油组小鼠的TG和TC未见统计学差异(P0.05)。结论连续8周摄食地沟油对小鼠肝、肾功能均有明显损害作用。     

兔肝VX2瘤血供程度对HIFU作用效果影响的初步研究

目的 探讨兔肝VX2瘤实质期血供程度对高能聚焦超声(HIFU)后肿瘤靶点处温度及凝固性坏死体积(V)大小的影响,为进一步精确控制HIFU剂量、提高治疗效率提供实验依据.方法 制作瘤兔24只并分成:10、15、20 d、无血供组(10 d成模后处死)4组,在对应时间进行相同参数HIFU辐照,对靶点实时测温,做出时间-温度曲线(TTC),测量V,对坏死周边残存肿瘤组织及正常肝组织进行微血管密度(MVD)计数.结果 (1)肿瘤MVD:10 d组＞15 d组＞20 d组(P＜0.05).(2)峰值温度(Tmax)、峰值时间(T1)、温升斜率(k1):10 d组、15 d组、20 d组之间比较差异无统计学意义(P＞0.05),此三组与无血供组比较差异有统计学意义(P＜0.05).(3)温降斜率(k2):10 d组＞15d组＞20 d组＞无血供组(P＜0.05);温降时间(T2):10 d组＜15 d组＜20 d组＜无血供组(P＜0.05);(4)V:10 d组＜15 d组＜20 d组＜无血供组(P＜0.05).结论 肿瘤血供程度对HIFU“温升”过程无显著影响,而对“冷却”过程有显著的影响.肿瘤血供越丰富,辐照后散热越快,组织越易恢复到正常温度,形成V越小.