栀子苷降尿酸作用研究

目的：探讨栀子苷对高尿酸血症小鼠的影响。方法：用氧嗪酸钾连续7 天灌胃造成小鼠高尿酸血症模型,同时每天灌胃栀子苷（50、100、200 mg?kg-1）,检测小鼠血清尿酸（SUA）、尿尿酸（UUA）、肝脏黄嘌呤氧化酶活性（XOD）。结果：栀子苷中、高剂量能显著降低高尿酸血症小鼠血清尿酸水平（P<0.01）。结论：栀子苷可通过促进尿酸排泄降低高尿酸血症小鼠的血清尿酸水平。     

眩晕定方对血管性眩晕模型家兔体重及肝组织DNA含量的实验研究

目的：研究眩晕定方对血管性眩晕气虚血瘀证模型家兔干预后,家兔体重及肝组织DNA含量的变化。方法：建立实验性血管性眩晕气虚血瘀证家兔模型,采用苯酚法提取兔肝DNA,紫外吸收法测定其DNA含量,观察眩晕定方干预后家兔体重及肝组织DNA含量的改变情况。结果：眩晕定方作用于气虚血瘀型血管性眩晕动物模型后,中剂量组体重为（2.54±0.13）kg,高于西比灵对照组的（2.06±0.10）kg,差异有显著统计学意义（P〈0.01）;中剂量组肝组织DNA含量为（1.1029±0.0916）kg,低于于西比灵组的（1.4236±0.1115）kg,差异有显著统计学意义（P〈0.01）。结论：眩晕定方可增加家兔体重,降低该模型家兔的肝组织DNA含量,从而改善气虚证候。     

自拟软坚利水二瓜汤结合西药治疗晚期血吸虫病腹水疗效观察

目的观察自拟软坚利水二瓜汤结合西药治疗晚期血吸虫病腹水的临床疗效。方法将65例晚期血吸虫病腹水患者分成2组,对照组30例,给予常规西药治疗,治疗组35例,在对照组治疗基础上加服自拟软坚利水二瓜汤治疗,2周为1个疗程,均治疗2个疗程。结果治疗组临床疗效总有效率为82.9%,对照组为63.3(%P<0.05);2组治疗后腹水消退时间比较,治疗组优于对照组(P<0.05);2组治疗后血清ALT、TBIL、Alb以及A/G值比较,治疗组优于对照组(P<0.05,P<0.01);1年后腹水复发率治疗组为22.8%,对照组为56.6%,治疗组优于对照组(P<0.01)。结论软坚利水二瓜汤结合西药治疗晚期血吸虫病腹水疗效良好。     

80例成人肝移植的供肝动脉变异、损伤与植入前重建

目的研究供肝肝动脉变异、取修肝损伤与植入前重建的相互关系,对动脉并发症的影响。方法回顾分析2004年3月至2006年7月单个医疗组完成的80例成人肝移植资料。植入前供肝动脉重建方法:整形获得变异或受损动脉的根部袖片或斜面端口,与合适部位吻合成具有共同主干的动脉树,尽可能单次吻合。3mm以下吻合口采用8/0prolene线间断缝合,3mm及以上吻合口采用7/0prolene线四点连续锁边缝合。术后以彩色多普勒超声、CT或MRI动脉造影监测动脉血流情况,随访6～34个月。结果供肝动脉变异发生率25.0%(20/80),变异肝左动脉6.25%,变异肝右动脉12.50%,二者并存3.75%,变异肝总动脉2.50%。全组取修肝动脉损伤发生率7.5%(6/80),变异组与无变异组损伤发生率(25.0%vs1.7%)有统计学差异(P<0.01)。损伤部位以变异肝右动脉损伤最为常见,占42.9%(3/7),占变异组损伤部位的50.0%。损伤时间在取肝、修肝期各占一半(3/6),变异组损伤的60.0%(3/5)发生在修肝期,无变异组未发生修肝损伤。取肝期动脉损伤率,在变异组与无变异组间(10.0%vs1.7%)存在统计学差异(P<0.05)。全组植入前动脉重建率13.8%(11/80),变异组为55.0%(11/20),76.9%的变异肝右动脉接受了植入前重建,均来自肠系膜上动脉。无变异组未行重建。动脉重建组中,63.6%(7/11)的变异/损伤动脉与脾动脉吻合。随访期内,全组无肝动脉血栓形成,肝动脉狭窄发生率3.8%(3/80)。变异组与非变异组肝动脉狭窄发生率(5.0%vs3.3%)比较,植入前重建组与非重建组(9.1%vs2.9%)比较,均无统计学意义(P>0.05)。全组假性动脉瘤发生率1.25%,吻合口出血发生率1.25%,均在无变异组。结论肝右动脉变异是供肝动脉变异的最常见类型,常需要植入前整形重建。供肝动脉变异增加取肝、修肝过程的动脉损伤发生率,本组变异肝右动脉损伤最常见。供肝动脉变异、合适的植入前重建并不增加移植后肝动脉血栓形成、动脉狭窄的发生率。     

Primary ovarian abscess in virginal young woman with huge endometriosis cyst: A case report

Rationale:Primary ovarian abscess which develops as an isolated lesion without simultaneous tubal infection is a rare entity. Ovarian abscess (OA) is a serious complication of pelvic inflammatory disease (PID) rarely seen in virginal girls. Early diagnosis and treatment are essential to prevent further sequela including infertility, ectopic pregnancy, and chronic pelvic pain.Patient concerns:A 19-year-old virginal girl who presented with abdominal pain and pelvic mass with no risk factors.Diagnoses:Laparoscopic surgery was performed to confirm a primary ovarian abscess in the adolescent virginal female with a huge endometriosis cyst.Intervention:Ovarian abscess with extensive intestinal adhesions was determined during the laparoscopic operation. Abscess drainage and postoperative antibiotic therapy cured the patient.Outcome:After the surgery, the CRP level on the day of discharge was 3.18 mg/d. The histological findings revealed a cystic tissue sample with the fibrous wall infiltrated by neutrophilic granulocytes, and ectopic endometrium, suggesting abscess formation in the ovary and endometriosis cyst.Lessons:Although primary ovarian abscess in an adolescent virginal female is rare, given the severity of outcomes following ovarian abscess, this pathology should be considered in the differential diagnosis of virginal adolescents with fever and abdominal pain.     

甲磺酸阿帕替尼治疗晚期原发性肝癌的近期疗效观察

目的 探讨阿帕替尼治疗晚期原发性肝癌的近期疗效与安全性.方法 收集2015年6月至2017年12月于我院接受口服阿帕替尼500 mg·d-1治疗的20例晚期原发性肝癌患者的临床资料,回顾性分析经过2个疗程(28 d/疗程)后患者的治疗效果,并对不良反应进行分析.结果 可评估的18例患者中,部分缓解2例(11.1％),疾...     

钆塞酸二钠增强MRI肝胆期高信号病变影像表现与特征分析

目的 探讨钆塞酸二钠（Gd-EOB-DTPA）增强MRI肝胆期高信号病变的影像学特征并进行分型。方法 回顾性纳入经手术病理或典型影像表现及临床随访证实为肝脏局灶性病变的病人124例,平均年龄（55.1±15.8）岁。分析肝脏局灶性病变124个,包括肝细胞癌（HCC）52个、胆管细胞癌（ICC）7个、混合型肝细胞癌-胆管癌（cHCC-CC）4个、转移瘤（HM）6个、局灶性结节增生（FNH）及FNH样变42个、肝腺瘤（HCA）2个、异型增生结节（DN）5个、肝海绵状血管瘤（CHL）6个。所有病人均行肝脏Gd-EOB-DTPA增强MRI检查,观察分析肝胆期高信号病变特征并对其进行分型。同一病变中不同分型间占比的比较采用Fisher确切概率检验。计算肝胆期病灶-肝脏信号强度比（LLR）,不同病变间LLR的比较采用Kruskal-Wallis检验。结果 HCC、ICC、HM、FNH/FNH样变和DN病变中不同分型间占比的差异均有统计学意义（均P<0.05）。HCC病灶中28个可见包膜（53.85%）,各分型中Ⅱb型最多（23/52,44.23%）;ICC病灶中Ⅱa型和Ⅲ型最多（均为3/7,...     

肝海绵状血管瘤的诊治

目的 探讨肝海绵状血管瘤的诊断及治疗方法,总结其外科治疗的经验。方法 根据肿瘤的不同情况,分别采用不同的方法对肝海绵状瘤进行治疗,其中,手术切除60例,其他方法7例（介入栓塞、硬化等）。结果 所有患的临床症状、体征均不同程度消失或改善,随访3－9年,除1例失访外,均未见增大。结论 肝海绵状血管瘤的治疗需根据患的具体情况选择适当的方法,手术治疗在该病的处理中具有重要的作用,治疗效果明显,预后较好。     

Nonlinear pharmacokinetics of TAK-044, a new endothelin antagonist, in rats.

The mechanism of the nonlinear pharmacokinetics of TAK-044 in rats was shown from in vivo and in vitro studies to be due to capacity-limited hepatic uptake. In the rats, which were given intravenous injections of (14)C-labeled TAK-044 ([(14)C]TAK-044) (1, 3, 10, 30 and 100 mg/kg), the AUC(inf) per unit dose of unchanged compound increased remarkably. An analysis model indicated that the CL(tot), V(1) and k(12) values of TAK-044 decreased significantly with increasing dose, whereas the k(el) values remained constant over the doses examined. The uptake clearance of [(14)C]TAK-044 by several tissues was investigated by an integration plot at doses from 0.3 to 60 mg/kg. This study showed that the liver played the principal role in the removal of TAK-044 from the plasma, while hepatic uptake was capacity-limited at doses greater than 30 mg/kg. The hepatic uptake study using rat hepatocytes indicated that a carrier-mediated transport system contributed to the hepatic uptake of TAK-044, and this system had high affinity (K(m,in vitro); 8.4 micromol/L) with low capacity (V(max,in vitro); 86.3 pmol/mg protein/min). These results show that the saturation of hepatic uptake by the carrier-mediated transport system could explain the nonlinear pharmacokinetics of TAK-044 in rats.     

Quantitative assessment of the contribution of sodium‐dependent taurocholate co‐transporting polypeptide (NTCP) to the hepatic uptake of rosuvastatin,pitavastatin and fluvastatin

Hepatic uptake transport is often the rate‐determining step in the systemic clearance of drugs. The ability to predict uptake clearance and to determine the contribution of individual transporters to overall hepatic uptake is therefore critical in assessing the potential pharmacokinetic and pharmacodynamic variability associated with drug–drug interactions and pharmacogenetics. The present study revisited the interaction of statin drugs, including pitavastatin, fluvastatin and rosuvastatin, with the sodium‐dependent taurocholate co‐transporting polypeptide (NTCP) using gene transfected cell models. In addition, the uptake clearance and the contribution of NTCP to the overall hepatic uptake were assessed using in vitro hepatocyte models. Then NTCP protein expression was measured by a targeted proteomics transporter quantification method to confirm the presence and stability of NTCP expression in suspended and cultured hepatocyte models. It was concluded that NTCP‐mediated uptake contributed significantly to active hepatic uptake in hepatocyte models for all three statins. However, the contribution of NTCP‐mediated uptake to the overall active hepatic uptake was compound‐dependent and varied from about 24% to 45%. Understanding the contribution of individual transporter proteins to the overall hepatic uptake and its functional variability when other active hepatic uptake pathways are interrupted could improve the current prediction practice used to assess the pharmacokinetic variability due to drug–drug interactions, pharmacogenetics and physiopathological conditions in humans. Copyright © 2013 John Wiley & Sons, Ltd.