血清肝纤维化指标与慢性肝炎肝纤维化程度的相关性

目的:评价血清肝纤维化指标与慢性肝炎肝纤维化程度病理分期的关系.方法:采用放射免疫技术对113例慢性肝炎患者的血清进行肝纤维化指标检测,包括透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原蛋白(PCⅢ)、Ⅳ型胶原蛋白(Ⅳ-C).并按肝穿刺活检进行组织纤维化分期(S),对这些指标的诊断价值进行分析.结果:血清肝纤维化指标HA、PcⅢ、Ⅳ-C与肝组织纤维化程度相关(r=0.677,0.395,O.454,P<0.01或0.05).除LN外(r=0.053,P>0.05),HA、PCⅢ、Ⅳ-C均随着肝纤维化程度的加重而呈上升趋势.结论:血清肝纤维化指标对判断肝纤维化程度有一定指导意义,对于难以开展肝穿刺活检的单位可以帮助肝纤维化诊断.     

慢性肝炎的分度与血清肝纤维化指标的关系(摘要)——附2600例(280例肝活检)血清指标分析

目的:探讨慢性肝炎患者血清肝纤维化指标(HA、PCⅢ、Ⅳ-C、LN)的临床实用价值。方法:对2600例慢性肝炎轻、中、重度患者,进行血清HA、PCⅢ、Ⅳ-C、LN的检测,均用放射免疫法,并对其中的280例进行肝穿刺肝脏病理组织学检查,作肝组织炎症活动度分级、肝纤维化程度分期及慢性肝炎病理组织学诊断分轻、中、重度、探讨它们之间关系。结果:2600     

血清肝纤维化标志物水平与肝组织炎症活动度纤维化程度的相关性分析

研究血清纤维化指标透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)及Ⅳ型胶原(Ⅳ-C)水平与肝组织病理分级、分期的相关性。用放射免疫法(RIA)检测600例乙型肝炎和肝炎肝硬化患者血清HA、LN、CⅣ、PCⅢ水平,同时进行肝组织活检,对肝组织进行炎症分级和纤维化分期检测。血清学指标水平与慢性肝炎发展阶段性一致,与肝组织炎症活动度及纤维化程度呈正相关。其中HA、CⅣ在病理分期中,从S1～S4期均依次大幅度升高,与S0相比(P<0.01),对早期肝纤维化诊断优于LN。而PCⅢ在反映肝纤维化时与S2期呈依次明显升高,可作为肝纤维化中、晚期辅助诊断。血清纤维化指标HA、LN、CⅣ、PCⅢ水平,对肝纤维化不同阶段做出相对准确的诊断,是目前了解肝纤维化程度检测指标之一。     

血清透明质酸、层粘连蛋白、Ⅳ型胶原和Ⅲ型前胶原水平与肝纤维化的关系

目的:探讨4项血清肝纤维化指标的诊断价值。方法:采用放射免疫法对478例各型肝病患者血清透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)和Ⅲ型前胶原(PCⅢ)指标进行了联合检测。结果:HA、Ⅳ-C和PCⅢ3项指标在慢性肝炎轻度、急性肝炎、慢性肝炎中度、重度和重型肝炎之间依次升高,各组间均有显著性差异(P<0.01)。重型肝炎组HA、PCⅢ和Ⅳ-C显著高于原发性肝癌(HCC)组和肝炎肝硬变(HLC)组(P<0.05)。而LN在对照组、急性肝炎、慢性肝炎轻度、中度和重度间均无显著性差异(各组间P<0.05),在重型肝炎组、HLN组和HCC组LN水平则显著高于急性肝炎、慢性肝炎轻、中、重度组(P<0.01),说明LN可作为区分慢性肝炎和肝硬变的辅助指标之一。4项肝纤维化指标联合检测结果中,2项和3项以上阳性在慢性肝炎轻度、中度、重度和肝炎肝硬变、重型肝炎之间依次升高,各组间均有显著性差异(P<0.01或P<0.05)。结论;4项指标联合检测可极大增加肝纤维化临床诊断的准确性和可靠性。     

慢性肝病与肝纤维化指标的关系

目的:探讨肝纤维化指标包括透明质酸(HA),Ⅲ型前肢原(PCⅢ),层连蛋白(LN)及Ⅳ型胶原(Ⅳ-C)等与慢性肝病的关系。方法:应用放免法检潮103例慢性乙型肝炎,42例肝细胞癌和64例肝炎肝硬变患者及40例正常人的HA、PCⅢ、LN和Ⅳ-C的值。结果:慢性乙型肝炎轻、中、重度病人此4项血清学指标依次升高;慢性肝炎(重度)、肝硬变、肝细胞癌患者4项指标均有明显升高。结论:慢性乙型肝炎(重度)、肝炎肝硬变和肝细胞癌患者与肝纤维化有密切关系;联合检测HA、PCⅢ、LN和Ⅳ-C 4项指标,有助于慢性肝病肝纤维化的诊断。     

血清肝纤维化HA、Ⅳ-C、PCⅢ和LN联合检测在布加综合征导致的肝纤维化诊断中的价值

目的:探讨血清透明质酸(hyaluronic acid,HA)、Ⅳ型胶原(type Ⅳ collagen,Ⅳ-C)、Ⅲ型前胶原肽(type Ⅲ procollagen,PCⅢ)、层黏连蛋白(laminin,LN)检测在布加综合征(budd-chiari syndrome,BCS)导致肝纤维化诊断的价值.方法:应用化学发光法分别检测我院介入科2004-03/2012-06收治的61例BCS患者(研究组)及60例健康者(对照组)血清HA、Ⅳ-C、PCⅢ、LN含量,并进行统计学分析.结果:BCS患者血清HA、Ⅳ-C、PCⅢ、LN含量均高于对照组,差异具有统计学意义,分别为t=6.879,P<0.05;t=7.071,P<0.05;t=5.753,P<0.05;t=6.330,P<0.05.研究组进行组间比较,血清HA、Ⅳ-C、PCⅢ、LN含量差异无统计学意义(P>0.05).结论:血清HA、Ⅳ-C、PCⅢ、LN作为检测肝纤维化灵敏指标,联合检测对BCS导致肝纤维化的诊断和临床治疗具有重要意义.     

肝纤维化指标与疾病程度、病毒含量及病理的关系

目的探讨血清肝纤维化指标与肝炎疾病程度、血清病毒含量及肝脏病理的关系.方法选择190例肝炎患者进行血清HA,LN,Ⅳ-C,PCⅢ测定,其中急黄肝19例,慢肝轻度32例,中度79例,重度20例,肝硬变28例,慢重肝6例,携带者6例.其中乙肝145例,检测血清HBVDNA.有61例慢肝患者进行肝活组织学检查.对不同临床分型肝炎血清HA,LN,Ⅳ-C、PCⅢ进行比较,并分析HBVDNA含量及肝组织病理与之相对应关系.结果随着肝炎疾病程度的加重,血清HA,LN,Ⅳ-C,PCⅢ水平逐渐升高,以肝硬变及慢重肝为最高(P＜0.01,P＜0.01,为与携带组比较).145例乙肝中,HBV DNA(+)组与HBV DNA(-)组血清HA,LN,Ⅳ-C,PCⅢ比较无差异(P＞0.05).61例有肝脏病理的慢肝患者血清HA,LN,Ⅳ-C与病理炎症活动度成正相关(r=0.9783,r=0.9566,r=0.9745,r=0.8648),HA,LN,Ⅳ-C,PCⅢ与病理纤维化程度成正相关(r=0.9557,r=0.9455,r=0.9428,r=0.9435).HA,LN在G4期升高明显,而Ⅳ-C在肝硬变期才升高明显.PCⅢ在G1～4期无变化.PCⅢ在S2期明显升高.结论血清HA,LN,Ⅳ-C,PCⅢ可用于判断肝炎疾病的严重程度,与病毒复制强弱无关,HA,LN能较早反映肝炎炎症活动度,PCⅢ能较早反映肝炎纤维化程度.     

慢性乙型肝炎患者血清肝纤维化指标与病理的关系

目的探讨慢性乙型肝炎患者血清肝纤维化指标透明质酸（HA）、Ⅳ型胶原（IV—C）、层粘连蛋白（LN）及Ⅲ型前胶原（PCⅢ）与肝脏病理的关系。方法慢性乙肝患者40例,行肝穿刺,制片,HE染色及浸银染色后作病理学检查;取血,分离血清,应用放射免疫法检测HA、IV—C、LN及PCⅢ水平,对肝组织进行炎症活动度分级（G）及纤维化分期（s）。结果40例慢性乙肝患者血清HA、Ⅳ-C、LN及PCⅢ水平随肝脏炎症活动度升高而升高,随肝组织纤维化程度的加重而升高。结论血清HA、Ⅳ-C、LN及PCⅢ水平与肝组织纤维化程度呈正相关。检测上述指标有助于判断肝炎疾病的严重程度,并能反映肝组织纤维化程度。     

安络化纤丸治疗慢性乙型肝炎肝纤维化临床疗效观察

目的观察安络化纤丸对慢性乙型肝炎血清肝纤维化指标的影响。方法随机将60例慢性肝炎患者分为安络化纤丸治疗组(治疗组)和一般保肝治疗组(对照组),对比分析治疗前和治疗3个月后血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)水平的变化。结果治疗组在降低血清肝纤维化指标方面均优于对照组。结论安络化纤丸具有较好的抗肝纤维化作用,治疗期间未发现明显不良反应。     

慢性乙肝患者HBV-DNA、肝功能指标与肝纤维化的关系

[目的]探究慢性乙型病毒性肝炎患者乙肝病毒脱氧核糖核酸(HBV-DNA)、肝功能指标与肝纤维化的关系。[方法]入选65例慢性乙肝患者为患者组;同期选取肝功能合格的体检者65例作为对照组;检测2组肝纤维化指标[血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型胶原(PCⅢ)、Ⅳ型胶原(Ⅳ-C)],HBV-DNA,肝功能指标[总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆汁酸(TBA)、白蛋白(ALB)]和血小板计数(PLT);并通过SPSS 22.0对所得数据进行相关性分析。[结果]患者组的肝纤维化指标HA:(207.8±120.1)ng/ml、LN:(160.02±94.23)ng/ml、PCⅢ:(143.22±67.82)ng/ml、Ⅳ-C:(123.53±81.72)ng/ml、血清HBV-DNA(5.76±1.22)均显著高于对照组(P<0.05)。患者组中的重度乙肝患者肝纤维化指标与血清HBV-DNA均显著高于轻度及中度乙肝患者(P<0.05)。患者组HA、LN、PCⅢ水平在不同HBV-DNA载量水平(<10³ IU/ml、10³~10⁶ IU/ml、≥106 IU/ml)中比较差异有统计学意义(P<0.05)。经分析除TBIL外,患者组与对照组ALT、AST、TBA、ALB、PLT比较均差异有统计学意义(P<0.05)。患者组中的重度乙肝患者ALT、AST、TBIL、TBA均显著高于轻度及中度乙肝患者(P<0.05),ALB、PLT均显著低于轻度及中度乙肝患者(P<0.05)。血清HBV-DNA载量与LN之间呈正相关关系(r=0.293,P=0.011);血清HBV-DNA载量与HA、PCⅢ、Ⅳ-C之间相关性较弱。患者组肝纤维化与肝功能及PLT之间表现出部分或全部的相关性(P<0.05),其中与ALB、PLT呈负相关;肝纤维化HA相关性最强,其次依次为PCⅢ、LN和Ⅳ-C。[结论]慢性乙肝患者HBV-DNA水平与除LN外其余肝纤维化指标之间均无相关性;肝功能指标与肝纤维化、PLT之间相关性较强,HA相关性最为显著;因此,可综合考虑LN、HA、PLT以及肝功能指标对肝纤维化进行诊断。     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Serological survey of HIV and syphilis in pregnant women in Madagascar

Objectives Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow‐up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy. Methods Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow‐up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays. Results Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum. Conclusions Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.