隐匿性肝癌自发破裂出血的螺旋CT诊断

目的探讨隐匿性肝癌自发破裂出血的螺旋CT诊断价值。方法对6例经手术病理证实的隐匿性肝癌破裂出血病人的CT资料进行回顾性分析。结果平扫肝内呈混杂密度影,边界欠清晰,5例肝、脾周见液体密度影;增强扫描动脉期边缘可见不均匀强化,1例肿瘤可见包膜及裂口,5例密度不均匀,内可见多条裂隙;静脉期2例可见门静脉癌栓;造影剂渗漏均不明显。结论CT诊断隐匿性肝癌自发破裂出血有较高的价值,可作为首选检查方法;三期增强扫描十分必要,对于肝癌破裂的诊断具有较高的临床应用价值。     

原发性肝癌三维适形放疗114例疗效评价

观察三维适形放射治疗（three-dimensional conformal radiotherapy,3DCRT）原发性肝癌的临床疗效.对114 例原发性肝癌患者在CT 定位下以3～5 mm层厚连续扫描,静脉双期碘造影剂增强扫描,精确定位治疗靶区并制定3DCRT计划,使90%等剂量曲线包绕计划靶体积（planning target volume,PTV）.以Varian 2100C 直线加速器实施放疗计划照射剂量1.8～2 Gy/次,5次/周,总剂量50～66 Gy,总疗程5～7周.治疗后1个月33例部分缓解,3个月42例部分缓解,6个月53例部分缓解.1、2和3年生存率分别为52.6%、35.1%和 28.9%.初步研究结果提示,3DCRT是原发性肝癌的有效无创治疗手段.     

全肝介入化疗加立体定向放疗治疗中晚期原发性肝癌效果分析

为探讨介入化疗加立体定向放射治疗对中晚期原发性肝癌的临床疗效,对32例患者行全肝化疗后,行立体定向放射治疗,对于病灶集中者设一个适形野,80%等剂量线包绕;对于多个病灶而病灶相距较远者行X刀旋转照射,80%等剂量线包绕。中心最大剂量(3～4)Gy/次,隔日治疗1次,共10～12次。治疗期间使用保肝药物和疏肝理气中药。经以上治疗后患者CR6例(18.8%),PR24例(75.0%),(SD PD)4例(6.2%)。初步研究结果提示,全肝介入化疗加局部立体定向放疗是治疗中晚期肝癌的有效方法,疏肝理气中药和保肝药物的应用可保护肝脏功能和降低放射线对肝脏的损害。     

抗GPC3/CD3双特异性重链抗体的制备及其抗肝癌作用评价

目的:设计并制备抗GPC3/CD3双特异性重链抗体(BiHcAb),分析其与双特异性T细胞衔接子(BiTE)在体内外抗肿瘤活性的差异.方法:通过全基因合成抗GPC3和抗CD3单域抗体(sdAb)序列,克隆至携带IgG4 Fc段的表达载体中,同时利用KIH技术形成稳定的双特异性重链抗体.2种质粒共转染HEK-293F细胞...     

Liver Damage Is Related to the Degree of Being Underweight in Anorexia Nervosa and Improves Rapidly with Weight Gain

Background: The present study investigates the relationship between hypertransaminasemia and malnutrition on the basis of a very large number of patients. We assume that the level of transaminases not only reflects the extent of underlying liver cell damage but also provides information about the metabolic situation under conditions of energy deficiency. Methods: We present an observational study in two different samples. The first sample consists of 3755 patients (mean age 22.7 years, Range 12–73 years; mean BMI 15.4 kg/m², range 8.1–25.7) out of a total of 4212 patients with anorexia nervosa treated in the Roseneck Clinic within five years for whom a complete admission laboratory was available. The second sample was obtained from a special ward for medically at-risk patients with eating disorders. During the period in question, four hundred and ten patients with anorexia nervosa were treated. One hundred and forty-two female patients (mean age 26.4 years, Range 18–63 years; mean BMI 11.5 kg/m², range 8.4–13) had a BMI of thirteen or less and a complete data set was obtained at admission and weekly in the following four weeks after admission. Results: The increase in liver transaminases shows a very high correlation with weight in sample one (N = 3755). The analysis of variance shows highly significant (<0.001) correlations with an F-value of 55 for GOT/AST and 63 for GPT/ALT. Nevertheless, the variance within the groups with the same BMI is quite high. With re-nutrition in sample two, GOT/AST decreased on average from 71 U/L to 26 U/L (MANOVA F 10.7, p < 0.001) and GPT/ALT from 88 to 41 U/L (F = 9.9, p < 0.001) within four weeks. Discussion: Below a BMI of about 13, the nutritional status of the patients becomes so critical that the energy supply of the patient is increasingly dependent on the autophagy of the liver, which can be seen in the very strong increase in transaminases here. Refeeding leads very quickly to the normalisation of the transaminases and, thus, a stabilisation of the metabolism leading also to a decrease in autophagy.     

Very Low Alcohol Consumption Is Associated with Lower Prevalence of Cirrhosis and Hepatocellular Carcinoma in Patients with Non-Alcoholic Fatty Liver Disease

The role of moderate alcohol consumption in the evolution of NAFLD is still debated. The aim of this study is to evaluate the impact of current and lifelong alcohol consumption in patients with NAFLD. From 2015 to 2020, we enrolled 276 consecutive patients fulfilling criteria of NAFLD (alcohol consumption up to 140 g/week for women and 210 g/week for men). According to their current alcohol intake per week, patients were divided in: abstainers, very low consumers (C1: <70 g/week) and moderate consumers (C2). We created a new tool, called LACU (Lifetime Alcohol Consuming Unit) to estimate the alcohol exposure across lifetime: 1 LACU was defined as 7 alcohol units per week for 1 drinking year. Patients were divided into lifelong abstainers and consumers and the latter furtherly divided into quartiles: Q1-Q4. Stratification according to alcohol intake, both current and cumulative as estimated by LACU, showed that very low consumers (C1 and Q1-Q3) displayed lower frequency of cirrhosis and hepatocellular carcinoma compared to abstainers and moderate consumers (C2 and Q4). We can speculate that up to one glass of wine daily in the context of a Mediterranean diet may be a long-term useful approach in selected NAFLD patients.     

肠道益生菌补充对酒精高糖高脂致肝损伤大鼠肝功能和肠道菌群的影响

目的 探究肠道益生菌补充对酒精、高糖、高脂致肝损伤大鼠肝功能和肠道菌群的影响.方法 高糖高脂饮食联合白酒灌胃处理制备酒精、高糖、高脂致肝损伤大鼠模型,并分为空白对照组、模型组、低剂量肠道益生菌组(20×108 CFU/kg)和高剂量肠道益生菌组(40×108 CFU/kg).灌服白酒7周后,算大鼠脏体比、血清乙醇体积分...     

疏肝中药内服配合灌肠治疗慢性盆腔疼痛症

目的:通过与单纯灌肠疗法的近期及半年、一年复发情况的对比观察,证实内服疏肝中药在该病治疗中的有效性、重要性。方法:将70例患者随机分为两组,内服外灌组36例,以疏肝中药内服每日3次,配合每日一次中药灌肠;单纯灌肠组34例,每日中药灌肠一次。两组均以3周为一疗程,治疗二疗程。结果:内服外灌组愈显率86.1%,明显高于单纯灌肠组之52.9%。痊愈病例半年、一年后复发率内服外灌组分别为0、10%,低于单纯灌肠组10%、30%。经统计学处理,两组疗效有显著差异(P<0.05)。结论:疏肝法配合灌肠治疗慢性盆腔疼痛症的疗效良好,可有效降低复发率。     

中医学关于非酒精性脂肪肝研究

随着生活品质的提高,非酒精性脂肪肝患者的患病率日益增加,现代医学尚无针对性用药,文章搜集了近五年中医药关于非酒精性脂肪肝的相关报道,总结了脂肪肝的中西医发病机制,论述了中医内外治法.中医学通过调节肝脾肾三脏,疏通经络气血运行,减少痰瘀化生,同时拮抗炎症损伤、抑制氧化应激,进而保护肝细胞,提高临床疗效.