幼儿园824名3－6岁幼儿肝功能、乙肝表面抗原检测结果分析

为了解幼儿的肝功能和ＨＢｓＡｇ携带情况，我们于１９９１年肝炎发病高峰季节对我县四所幼儿园共８２４名幼儿进行了ＡＬＴ、ＴＴＴ、ＺｎＴＴ、ＨＢｓＡｇ检测。结果ＡＬＴ、ＴＴＴ均升高１例，有体征；ＡＬＴ单项升高６例，无症状；ＨＢｓＡｇ阳性５８例，其中９例ＡＬＴ升高，４例ＴＴＴ升高。幼儿园是幼儿集中的地方、同吃、同住、接触密切，对ＨＢｓＡｇ阴性者接种乙肝疫苗，对ＡＬＴ升高者不能忽视以免发生肝炎流行。     

检测各型乙肝患者血小板功能的临床意义

检测198例各型乙肝患者血小板功能的五个项目：血小板总数、粘附试验、聚集试验、血块退缩、血小板第3因子有效性，发现各期乙肝患者血小板功能的异常有显著性差异（P＜0．01）．并提示乙肝患者除有血小板数量的改变外，还有质量的改变，因此，全面的血小板功能检测可作为估计乙肝患者肝损害程度的辅助指标．     

MR imaging of the brain in patients with hepatic form of Wilson''s disease

The aim of this study was to detect the sites and frequency of possible lesions by brain magnetic resonance imaging (MRI; 1,5T) in a group of 16 neurologically asymptomatic patients with hepatic form of Wilson's disease (WD; seven untreated and nine under treatment). Abnormal MR findings of the brain were found in 75% of patients. Lesions in brain parenchyma were detected in all untreated, drug-naive patients and in 44% of treated patients. Abnormal signal in globus pallidus, putamen, and caudate nucleus was revealed in 86, 71 and 71% of treated and in 33, 33 and 22% of untreated patients, respectively. In five of eight patients with putaminal pathology (62.5%) and in four of seven patients with caudate nuclei involvement (57%), only proton density 2-weighted sequence (PDW) exhibited sensitivity for lesion detection, with both T1W and long echo T2W sequences being insensitive. This superiority of PDW sequence was even more pronounced in the group of untreated patients in whom 80% of putaminal pathology was visible exclusively on this sequence. The lower frequency of lesions in the group of treated in comparison with untreated patients indicated that they might be reversible in the course of chronic chelating therapy.     

提高抗肝癌药物的肝脏浓度并降低心脏,血液浓度的实验研究

实验研究结果表明：阿霉素（ＡＤＭ）在采用推进法注射时，经肝血管或外周静脉途径二者的肝、心与血液浓度均无显著差别．如采用控速缓慢输注法，则经肝血管较经外周静脉在提高肝脏浓度方面具有显著效果，心脏内浓度也有一定程度降低。如在肝血管内输注时与血液净化联合应用，则更能提高上述要求。以上结果将为临床抗癌药介入治疗应用方法的开展提供依据和参考价值。     

Sarcoidosis and primary biliary cirrhosis

Summary An unusual case of a woman with primary biliary cirrhosis and cutaneous sarcoidosis is described. The factors that allow a specific diagnosis of each condition are presented and the literature pertaining to such complex and unusual cases is presented.This work was supported in part by a grant from the Gastroenterology Medical Research Foundation of Southwestern Pennsylvania.     

ERK信号传导通路调控乙醛刺激的肝星状细胞Na+/Ca2+泵mRNA表达的研究

目的 :探讨Erk信号传导通路调控乙醛刺激的肝星状细胞 (HSC)Na /Ca2 泵mRNA表达的影响。方法 :用链霉蛋白酶和胶原酶原位灌流 ,Metrizamide密度梯度离心分离大鼠肝星状细胞 ,采用RT PCR测定PD980 5 9阻断乙醛激活的肝星状细胞Erk活性后Na /Ca2 泵mRNA表达。结果 :乙醛刺激后 ,HSC后明显促进Na /Ca2 泵mRNA表达 (P<0 0 1) ,不同剂量PD980 5 9对肝星状细胞Na /Ca2 泵mRNA表达的影响无统计学意义。结论 :Erk信号传导通路可能对乙醛刺激的肝星状细胞激活状态的启动无明显影响     

枳鳖胶囊抗大鼠肝纤维化形态学及肝组织Ⅲ型胶原mRNA表达的实验研究

目的:观察枳鳖胶囊抗肝纤维化形态学和Ⅲ型胶原mRNA表达的变化。方法:选择66只健康清洁级SD大鼠,雌雄各半,随机分为:正常对照组,模型组,秋水仙碱组,枳鳖胶囊大、中、小剂量组。以40%四氯化碳花生油皮下注射结合高脂饲料、酒水饮料复合因素诱导大鼠肝纤维化模型。造模结束后,除正常组不予处理外,其他组分别以蒸馏水,秋水仙碱混悬液,高、中、低浓度枳鳖胶囊溶液灌胃,疗程36d。疗程结束后,观察大鼠新鲜肝脏的表面情况、色泽、质地等大体形态,测定肝组织Ⅲ型胶原mRNA的表达,光镜观察肝组织HE染色和网状纤维染色的病理形态学改变。结果:模型组大鼠肝细胞损害、肝脏脂肪变性和胶原纤维增生的程度最显著,Ⅲ型胶原mRNA的表达最强。枳鳖胶囊组上述改变明显减轻,且可抑制Ⅲ型胶原mRNA的表达,疗效优于秋水仙碱组。结论:枳鳖胶囊可较好地保护肝细胞,并能阻止肝纤维化进程甚或逆转肝纤维化病理改变,抑制胶原基因表达,抑制胶原基因表达可能是其抗肝纤维化的作用机理之一。     

Liver pathology associated with the use of anabolic-androgenic steroids

Abstract: This review examines the liver-damaging side effects of anabolic-androgenic steroids (AAS). It seems that AAS can cause development of peliosis hepatis, subcellular changes of hepatocytes, hepatocellular hyperplasia and hepatocellular adenomas. On the other hand, it has not been convincingly proved that AAS can cause development of hepatocellular carcinomas when used in the usual therapeutic doses. Tumours reported as hepatocellular carcinomas caused by AAS seem to be hyperplastic lesions of a benign nature able to regress with withdrawal of the putative agent. The effects of untraditional combinations and high-dose AAS are not yet known, leaving the possibility of a carcinogenic effect in those cases.     

全植入式药泵行肝血管灌注治疗晚期肝癌

对２４例不能切除的晚期肝癌采用完全植入式药泵行肝动脉和门静脉双灌注化疗。结果：部分缓解（ＰＲ）１５例（６２．５％），稳定（Ｓ）８例（３３．３％），进展（Ｐ）１例。平均生存期为９．１７月，半年生存率为６６．７％，１年为２５％。在ＡＦＰ＞４００μｇ／Ｌ的１０例中，５例下降。     

Axial tissue diffusion can account for the disparity between current models of hepatic elimination for lipophilic drugs

An assumption of previous models of hepatic elimination is that there is negligible axial diffusion in the liver. We show, by construction of a stochastic model and analysis of published data, that compounds which are readily diffusible and partitioned into hepatocytes may undergo axial tissue diffusion. The compounds most likely to be affected by axial tissue diffusion are the lipophilic drugs for which the cell membranes provide little resistance and which are highly extracted, thereby creating steep concentration gradients along the sinusoid at steady state. This phenomenon greatly modifies the availability of the compound under conditions of altered hepatic blood flow and protein binding. For moderately diffusible compounds, these relationships are similar to those predicted by the simplistic venous-equilibrium model. Hence, the paradoxical ability of the venous-equilibrium model to describe the steady-state kinetics of lipophilic drugs such as lidocaine, meperidine, and propranolol may be finally resolved. The effects of axial tissue diffusion and vascular dispersion on hepatic availability of drugs are compared. Vascular dispersion is of major importance to the availability of poorly diffusible compounds, whereas axial tissue diffusion becomes increasingly dominant for highly diffusive and partitioned substances.This study was supported by the National Health and Medical Research Council of Australia.