原发性肝癌术后超声引导下经皮经肝门静脉穿刺化疗安全性分析

目的 研究原发性肝癌术后超声引导下经皮经肝门静脉穿刺化疗安全性.方法 总结2004年1～10月实施的原发性肝癌术后行超声引导下经皮经肝门静脉穿刺化疗病例,分析其术后常见并发症及其预防及处理措施.结果 共有524例原发性肝癌病人在肝切除手术后接受了超声引导下经皮经肝门静脉穿刺化疗,累及实施1865例次.共发生穿刺操作相关性并发症149例次,并发症发生率为79.89‰(149/1865),其中包括术后穿刺点疼痛118例次(118/1865,63.27％0),肝包膜下出血3例次(3/1865,1.61‰),腹腔出血2例次(2/1865,1.07‰),胆汁漏6例次(6/1865,2.54‰),门静脉血栓形成8例次(8/1865,4.29％0),导管相关性感染4例次(4/1865,2.14‰),气胸3例次(3/1865,1.61％0),导管脱落5例次(5/1865,2.68‰).化疗相关并发症587例次(587/1865,31.47％),其中包括胃肠道不良反应385例次(385/1865,20.64％),白细胞减少121例次(385/1865,20.64％),转氨酶升高62例次(62/1865,3.32％),皮疹11例次(11/1865,5.90％),其他8例次(8/1865,4.29％).所有并发症经保守治疗后均痊愈,未有致死性并发症.结论 肝癌术后超声引导下经皮经肝门静脉穿刺化疗操作简单、安全,术后并发症发生率在可接受范围.     

胆汁酸在梗阻性黄疸小鼠肝部分切除术后肝再生中作用的研究

目的：探讨胆汁酸（CA）在梗阻性黄疸（OJ）小鼠肝部分切除术后肝再生中的作用及机制。 方法：180只健康雄性小鼠随机均分为6组,分别行假手术（对照组）、胆总管结扎（OJ组）、胆总管结扎并于7 d加行外引流（ED组）、胆总管结扎+0.2%CA灌胃并7 d后加行外引流（ED+0.2%CA组）、胆总管结扎+1%CA灌胃并于7 d后加行外引流（ED+1%CA组）、胆总管结扎并于7 d后加行内引流（ID组）,各组分别于实验第14天行70%肝切除,且各外引流组改行内引流。检测各组肝切除术后不同时间点肝再生率与肝组织增殖细胞核抗原Ki-67表达、叉状头盒M1b基因（Foxm1b）mRNA相对表达、成纤维细胞生长因子受体4（FGFR4）蛋白表达,并观察部分组肝细胞原位凋亡情况。 结果：除对照组外,肝再生率、肝组织Ki-67阳性表达率、Foxm1b mRNA及FGFR4蛋白表达在其余各组均由高到低依次为：ID组>ED+0.2%CA组>ED组>OJ组>ED+1%CA组,组间差异均有统计学意义（均P<0.05）;ID组与对照组间各指标差异均无统计学意义（均P>0.05）;肝细胞凋亡率由高到低依次为：ED+1%C组>ED组>ED+0.2%CA组>对照组,组间差异均有统计学意义（均P<0.05）。 结论：内引流通过减少内源性CA的丢失有利于肝切除后肝再生;外源性低浓度CA可以恢复外引流引起的肝再生障碍,可能与其上调Foxm1b与FGFR4的表达从而促进肝再生有关。     

超声造影定量分析评价结直肠癌肝转移化疗的早期疗效

目的：探讨超声造影（CEUS）定量分析在结直肠癌肝转移辅以贝伐单抗联合细胞毒性化疗及仅细胞毒性化疗早期疗效评价中的应用价值。 方法：将28例结直肠癌肝转移患者分成贝伐单抗联合mFOLFOX6治疗组与mFOLFOX6治疗组,每组各14例。于第1~4次化疗前1 d行常规超声及CEUS,采用动态造影定量分析软件,记录患者肝脏病灶的各项定量参数,根据实体瘤疗效评价标准（RECIST）最终结果,分别比较两治疗组中有效患者与无效患者第1次化疗前1 d与第2次化疗前1 d病灶定量参数变化百分数的差异。 结果：贝伐单抗联合mFOLFOX6治疗组有效患者与无效患者病灶定量参数峰值强度（PI）变化百分数差异有统计学意义（P=0.03）,余参数差异无统计学意义（均P>0.05）;mFOLFOX6治疗组有效患者与无效患者病灶各参数变化百分数比较差异均无统计学意义（均P>0.05）。 结论：CEUS定量参数PI对于结直肠癌肝转移贝伐单抗联合细胞毒性化疗早期疗效评价有一定应用价值。     

A quantitative real-time RT-PCR assay for salmon IGF-I mRNA, and its application in the study of GH regulation of IGF-I gene expression in primary culture of salmon hepatocytes

The hormone insulin-like growth factor-I (IGF-I) regulates vertebrate growth. The liver produces most circulating IGF-I, under the control of pituitary growth hormone (GH) and nutritional status. To study the regulation of liver IGF-I production in salmon, we established a primary hepatocyte culture system and developed a TaqMan quantitative real-time RT-PCR assay for salmon IGF-I gene expression. A portion of the coho salmon acidic ribosomal phosphoprotein P0 (ARP) cDNA was sequenced for use as a reference gene. A systematic bias across the 96 well PCR plate was discovered in an initial IGF-I assay, which was corrected when the assay was redesigned. IGF-I mRNA levels measured with the validated assay correlated well with levels measured with an RNase protection assay, and were highest in liver compared with other tissues. We examined the time course of hepatocyte IGF-I gene expression over 48 h in culture, the response to a range of GH concentrations in hepatocytes from fed and fasted fish, and potential effects of variation in IGF-I in the medium. IGF-I gene expression decreased over time in culture in hepatocytes in plain medium, and in cells treated with 5 nM GH with or without a combination of metabolic hormones (1 microM insulin, 100 nM triiodothyronine, and 0.1 nM dexamethasone). GH stimulated IGF-I gene expression at all time points. In cells treated with GH plus metabolic hormones, IGF-I gene expression was intermediate between the controls and GH alone. Increasing concentrations of GH resulted in biphasic IGF-I gene expression response curves in cells from fed and fasted fish, with the threshold for stimulation from 0.5 to 2.5 nM GH, maximal response from 5 to 50 nM, and a reduced response at 500 nM. Medium IGF-I (5 nM) did not affect basal or GH stimulated IGF-I gene expression. This study shows that primary hepatocyte culture and the TaqMan IGF-I assay can be used to study the regulation of hepatic IGF-I gene expression in salmon, and provides the first evidence of a biphasic response to GH concentration in fish hepatocyte culture.     

Expression of SOCS-1 in the liver tissues of chronic hepatitis B and its clinical significance

AIM： To study the expression of suppressor of cytokine signaling-1 （SOCS-1） in the liver tissues of chronic hepatitis 13 （CHB） and the clinical significance of this expression. METHODS： The expression of SOCS-1 in liver tissues of 45 cases of CHB was investigated by immunohistochemical staining, and its correlations with inflammation grades and fibrosis stage were analyzed by SPSS statistics software. RESULTS： The result showed SOCS-1 expressing could be observed in the liver tissue of CriB. The expression of SOCS-1 was mainly distributed near the portal area in the liver tissue of mild inflammation CriB group, and was diffusely distributed in the liver tissue of moderate and severe inflammation groups. SOCS-1 positive stains mainly appear in the hepatocytes, only a few of liver interstitial cells were involved. Inside the hepatocyte, SOCS-1 positive stains are mainly distributed in the plasma. Some of the staining was observed on the membrane. The inclusion bodies in the plasma of hepatocytes were observed occasionally. There were both obvious correlations between the expression of SOCS-1 and the inflammatory grade, and that between the expression of SOCS-1 and the fibrosis stage, CONCLUSION： The distribution of SOCS-1 in the liver tissue of CriB is variable. This expression was correlated with the inflammation grade and fibrosis stage.     

Increase of microsomal glucose-6-phosphatase activity after chronic ethanol administration

To study the effect of chronic ethanol administration on the activity of hepatic microsomal glucose-6-phosphatase, female rats were pair-fed liquid diets with 36% of total calories either as ethanol or isocaloric carbohydrate (controls). The remainder of the diet contained 35% of total calories as fat, 18% as protein, and 11% as additional carbohydrate. Six weeks of ethanol feeding as isocaloric substitution for carbohydrate increased significantly the activity of glucose-6-phosphatase (expressed per mg microsomal protein) both in fed (38%; p < 0.001) and fasted 18%; p < 0.02) rats. When expressed per unit of body weight, the enzyme activity was increased even further both in fed (66%; p < 0.01) and fasted (43%; p < 0.01) rats. Another group of rats received diets containing 36% of calories either as ethanol or isocaloric fat. The remainder of the diet contained 11% of total calories as carbohydrate, 18% as protein, and 35% as additional fat. Six weeks of this ethanol feeding as isocaloric substitution for fat again increased glucose-6-phosphatase activity significantly. Ultracentrifugation in a Cs⁺-containing sucrose gradient to separate rough and smooth microsomes revealed that the increase in glucose-6-phosphatase activity after ethanol feeding occurred mainly in the smooth microsomal membranes.     

α-Fetoprotein,tissue polypeptide antigen and ferritin in diagnosing primary hepatocellular carcinoma in patients with liver cirrhosis

Summary This study was undertaken in order to compare the usefulness of three indices of tumour proliferation in detecting primary hepatocellular carcinoma (HCC) and in differentiating this neoplasm from liver cirrhosis. In 10 patients with HCC and in 63 with liver cirrhosis serum -fetoprotein (AFP), tissue polypeptide antigen (TPA) and ferritin were assayed. Increased levels of AFP but not of TPA and ferritin were observed in HCC as compared to liver cirrhosis. The receiver-operating characteristic curves demonstrated that AFP is more discriminating between HCC and liver cirrhosis than the other two markers. Correlations between liver function tests and serum markers were observed in liver cirrhosis but not in HCC. We can conclude that AFP is more useful than TPA and ferritin in detecting HCC in patients with liver cirrhosis, owing to the high frequency of false positive results of the latter two indices in liver cirrhosis. Liver dysfunction is probably involved in increasing all these markers of malignancy, thus reducing the specificity of these tests.Abbreviations AFP -tetoprotein - TPA tissue polypeptide antigen - HCC primary hepatocellular carcinoma Partially supported by a grant of the Italian National Research Council, Special Project Oncology, contract 87.01.541.04. Under the auspices of the R. Farini association for gastroenterological research     

Biomarkers for the Prediction and Diagnosis of Fibrostenosing Crohn’s Disease: A Systematic Review

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Prediction,identification and progression of histopathological liver disease activity in children with intestinal failure

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Pharmacoangiographic diagnosis of venous invasion of carcinoma of the colon with reference to liver metastases

Angiography using prostaglandin E1 was performed on 34 patients with carcinoma of the colon in order to define the degree of venous invasion. Venous findings on angiogram (occlusion and/or encasement) were classified into three groups: AG-V2, above-mentioned venous findings up to marginal vein; AG-V1, these findings up to the vasa recta; AG-V0, no distinct findings on the vein. These venous findings were compared with histologic subserosal venous invasion that was diagnosed with both hematoxylin and eosin and elastica van Gieson's staining. When angiographic findings were compared with histologic subserosal venous invasion, the results of AG-V2, AG-V1, and AG-V0 showed a positive correlation of 92.3 percent, 46.7 percent, and 16.7 percent, respectively. The angiographic findings were also correlated with the degree of fibrosis around the carcinoma of the colon. The incidence rate of liver metastasis in a group of AG-V2 was 46.2 percent. In AG-V1 it was 26.7 percent and in AG-V0 0 percent. In the course of the postoperative follow-up, liver metastases appeared in two cases of AG-V2 and AG-V1, respectively. This finding may suggest the presence of liver micrometastases at the time of surgery.