中医肝脏生理与病理理论对于我国眼科学发展的意义

整体恒动观是中医核心理念。中医认为：肝主目;眼为五脏之精,肝为五脏之长;肝主疏泄,条畅情志;肝生血气,藏血藏魂;肝主血海、主谋略;肝生“相火”,萌发元阳;肝为将军之官,主攘外安内;肝主筋主动,为罴极之本;肝为泪。中医强调：百病从肝治;上医治未病;治病求本,以人为本。根据中医肝脏生理与病理理论,很多感染性与包括肿瘤的免疫性眼病、代谢性与退行性眼病、缺血性与出血性和血管增生性眼病、干眼症与全身病相关眼病都能够从根本上防治,减少甚至避免抗生素与免疫抑制剂等药物、激光与手术治疗,进而推动眼科医学模式变革,提高我国眼病防治科学水平。中医肝脏生理与病理理论能够对于我国以及世界眼科学的发展做出重大贡献。     

异甘草酸镁联合降脂治疗非酒精性脂肪型肝炎及对肝功能的影响

目的：探析异甘草酸镁联合降脂治疗非酒精性脂肪型肝炎疗效及对肝功能影响。方法以该院2011年5月-2014年10月期间所收治92例非酒精性脂肪型肝炎患者展开研究,对照组给予以调脂为主综合治疗,观察组加用异甘草酸镁,比较两组治疗前后PCⅢ、C-ⅠV、HA及ALT、AST、TBIL、γ-GT等肝纤维化指标。结果两组治疗前各肝纤维化指标的比较无统计学意义(P>0.05);治疗后,观察组PCⅢ、C-ⅠV、HA等指标均显著降低,与治疗前比较差异有统计学意义(P<0.05),与对照组治疗后的组间比较差异有统计学意义(P<0.05)。组间比较上,两组治疗前ALT、AST、TBIL、γ-GT等肝功能指标的比较无统计学意义(P>0.05),治疗后两组各指标的比较差异有统计学意义(P<0.05);组内比较上,两组治疗前后各指标的比较差异有统计学意义(P<0.05)。结论异甘草酸镁可保护肝细胞,与降脂治疗联合应用于NASH患者可有效抑制肝细胞纤维化,促进肝功能的恢复,应用价值高。     

综合护理干预在肝癌介入治疗中的应用研究

目的：探讨综合护理干预在肝癌介入治疗中的应用效果。方法随机选取2011年5月-2013年5月于该院接受介入治疗的80例肝癌患者为研究对象,依循随机平均分配原则将其分为两组。于介入治疗过程中,对照组实施常规护理,观察组实施综合护理干预。比较两组患者护理干预前后患者负性情绪改善情况、术后并发症发生率及术后15个月生存率。结果经护理干预后,观察组患者SDS及SAS评分均显著低于对照组,比较差异具有统计学意义（P<0.05）;观察组术后并发症发生率为12.5%,对照组为57.5%,观察组预后效果显然优于对照组,两者比较差异具有统计学意义（P<0.05）;比较两组患者术后15个月生存率,观察组为82.3%,对照组为62.5%,两者比较差异具有统计学意义（P<0.05）。结论综合护理干预在肝癌介入治疗中的应用,可显著改善患者负性情绪,降低术后并发症发生率,提高生存率,值得临床推广应用。     

腹腔镜手术再灌注肝损伤与损伤修复的临床研究

目的：研究分析腹腔镜手术再灌注肝损伤与损伤修复在治疗慢性结石性胆囊炎的临床应用。方法随机选取该院于2012年8月-2014年7月收治的慢性结石性胆囊炎患者,随机分为实验组和对照组两组,实验组患者在术前1 d、2 h、术后1、2、3d给以药物干预,对照组不做任何干预措施,两组患者都定时抽取空腹外周静脉血液送检,记录与检测手术基本指标(出凝血时间、手术时间以及手术费指标共11项,对比分析两组数据。结果两组患者手术的出凝血时间、手术时间、气腹压力、气腹时间和手术费用等基本指标对比,差异无统计学意义(P>0.05),且不会增加患者手术经济负担。结论腹腔镜手术中辅助药物修复再灌注肝损伤具有较高的安全性,药物川芎嗪与七叶皂苷钠不会改变患者的出凝血时间、气腹压力和气腹时间,最终也不会增加患者手术经济负担。     

肝脏不典型腺瘤样增生结节的MRI应用价值

目的：探讨肝脏不典型腺瘤样增生结节的MRI应用价值。方法选取该院2003年1月—2014年5月肝脏不典型腺瘤样增生结节的病人50例,常规T1 T2WI序列及正反相位序列,LAVA序列动态增强扫描。结果50例病人60个病灶,所有病灶均表现为T1WI高或稍高信号,T1WI脂肪抑制序列病灶为高信号或稍高信号,反相位序列病灶仍为高信号或稍高信号,T2WI加强病灶为低或稍低信号,该组60个病灶,其中55个病灶动态增强扫描动脉期门静脉期及延迟期病灶无强化,5个病灶呈轻中度强化。结论肝脏不典型腺瘤样增生结节的MRI表现具有一定特征性,MRI可以很好显示肝脏不典型腺瘤样增生结节病灶,是诊断肝脏不典型腺瘤样增生结节首选的影像方法,具有重要的临床应用价值。     

肝豆状核变性合并肝脏损害的临床误诊分析

目的 探讨肝豆状核变性(hepatolenticular degeneration,HLD)合并肝脏损害患者的临床误诊情况,提高该病的诊疗水平.方法 回顾性分析20例确诊为HLD患者的临床资料(包括临床表现、实验室及影像学资料等).结果 20例患者均有诊断延误,首诊被误诊为慢性肝炎2例、肝炎后肝硬化代偿期6例及肝硬化失代偿期11例、自身免疫性肝病1例,经长期低铜饮食、口服青霉胺等药物维持,以及护肝、对症支持治疗,20例患者均达到临床缓解,病情好转.结论 对该病缺乏认识和警惕,是导致临床误诊的主要原因.临床对类似病例,需有高度警惕性,尽早完善相关检查,以便能早期确诊.     

Clinico-immunological profile in a case of hepatic tubercular abscess: A rare manifestation of extrapulmonary TB in an immunocompetent child

Tubercular liver abscess is a rare entity even in an endemic area for TB. We report here a rare case of pediatric tuberculous liver abscess, the etiology of which was established using recently introduced Cartridge based nucleic acid amplification test (CBNAAT). A 7 years old male child presented with vomiting, pain abdomen and fever. Hepatomegaly was found on examination. Ultrasound of abdomen revealed two liver abscesses in the right lobe. Patient remained symptomatic even after empirical antimicrobial therapy. On diagnostic tap Gram stained smear of the pus showed polymorphs with negative culture. CBNAAT was positive for Mycobacterial tuberculosis and sensitive to rifampicin. Subjecting difficult extrapulmonary specimens to relevant microbiological investigations along with CBNAAT and other newer methods may improve diagnosis of tuberculosis in such rare cases thus leading to an early management and decrease in morbidity.     

Role of polymer–drug conjugates in organ-specific delivery systems

Polymers have been utilized to deliver the drug to targeted site in controlled manner, achieving the high-therapeutic efficacy. Polymeric drug conjugates having variable ligands as attachments have been proved to be biodegradable, stimuli sensitive and targeted systems. Numerous polymeric drug conjugates having linkers degraded by acidity or intracellular enzymes or sensitive to over expressed groups of diseased organ/tissue have been synthesized during last decade to develop targeted delivery systems. Most of these organs have number of receptors attached with different cells such as Kupffer cells of liver have mannose-binding receptors while hepatocytes have asialoglycoprotein receptors on their surface which mainly bind with the galactose derivatives. Such ligands can be used for achieving high targeting and intracellular delivery of the drug. This review presents detailed aspects of receptors found in different cells of specific organ and ligands with binding efficiency to these specific receptors. This review highlights the need of further studies on organ-specific polymer–drug conjugates by providing detailed account of polymeric conjugates synthesized till date having organ-specific targeting.     

Short-term Treatment of Daumone Improves Hepatic Inflammation in Aged Mice

Chronic inflammation has been proposed as one of the main molecular mechanisms of aging and age-related diseases. Although evidence in humans is limited, short-term calorie restriction (CR) has been shown to have anti-inflammatory effects in aged experimental animals. We reported on the long-term treatment of daumone, a synthetic pheromone secreted by Caenorhabditis elegans in an energy deficient environment, extends the life-span and attenuates liver injury in aged mice. The present study examined whether late onset short-term treatment of daumone exerts anti-inflammatory effects in the livers of aged mice. Daumone was administered orally at doses of 2 or 20 mg/kg/day for 5 weeks to 24-month-old male C57BL/6J mice. Increased liver macrophage infiltration and gene expression of proinflammatory cytokines in aged mice were significantly attenuated by daumone treatment, suggesting that short-term oral administration of daumone may have hepatoprotective effects. Daumone also dose-dependently suppressed tumor necrosis factor-α (TNF-α)-induced nuclear factor-κB (NF-κB) phosphorylation in HepG2 cells. The present data demonstrated that short-term treatment of daumone has anti-inflammatory effects in aged mouse livers possibly through suppression of NF-κB signaling and suggest that daumone may become a lead compound targeting aging and age-associated diseases.