各型肝病患者外周血转化生长因子α(TGF-α)含量测定

目的探讨各型肝病患者外周血TGF-α水平及其临床意义。方法取130例肝病患者(包括急性黄疸型肝炎20例,轻型慢性乙型肝炎29例,慢性重型肝炎22例,肝炎肝硬化32例及原发性肝癌27例)入院时血清(-30℃下保存)以RIA法作TGF-α检测。结果急性黄疸型肝炎为17.61±7.90pg/ml,轻型慢性乙型肝炎为12.66±4.43pg/ml,慢性重型肝炎为10.754.80pg/ml,肝炎肝硬化为11.45±7.07pg/ml原发性肝癌为19.42±19.12pg/ml。均明显高于对照组6.46±2.15pg/ml。而原发性肝癌组明显高于肝炎肝硬化组。急性黄疸肝炎组明显高于慢性乙型肝炎组;原发性肝癌与急性黄疸型肝炎两组间无显著性差异。慢性乙型肝炎,肝炎肝硬化及慢性重型肝炎三组间比较无显著性差异。结论血清TGF-α在肝细胞急性炎症过程及肝细胞癌的形成中明显表达,并在肝硬化向原发化性肝癌转化的过程中,TGF-α有可能成为临床监测指标之一。     

各型肝病患者外周血转化生长因子α（TNF—α）含量测定

目的：探讨各型肝病患者外周血TNF-α水平及其临床意义。方法：取130例肝病患者（包括急性黄疸型肝炎20例,轻型慢性乙型肝炎29例,慢性重型肝炎22例,肝炎肝硬化32例及原发性肝癌27例）入院时血清（－30℃下保存）以RIA法作TNF-α检测。结果：急性黄疸型肝炎为17．61&;#177;7.90pg/ml,轻型慢性乙型肝炎为12．66&;#177;4.43/ml,慢性重型肝炎为10.754.80pg/ml,肝炎肝硬化为11.45&;#177;7.07pg/ml原发性肝癌为19.42&;#177;19.12pg/ml。均明显高于对照组6.48&;#177;2.15pg/ml。而原发性肝癌组明显高于肝炎肝硬化组。急性黄疸肝炎组明显高于慢性乙型肝炎组;原当性肝癌与急性黄疸型肝炎两组间无显著性差异。慢性乙型肝炎,肝炎肝硬化及慢性重型肝炎三组间比较无显著性差异。结论：血清TNF-α在肝细胞急性炎症过程及肝细胞癌的形成中明显表达,并在 肝硬化向原发化性肝癌转化的过程中,TNF-α有可能成为临床监测指标之一。     

肝病患者血清和腹水CA125水平变化

目的　探讨肝炎、肝硬化代偿期、肝硬化失代偿期、肝癌患者血清肿瘤抗原 12 5 (CA12 5 )水平与肝损害的关系。方法　采用放射免疫分析法检测 2 0例正常对照、3 0例肝炎患者、2 0例肝硬化代偿期患者、3 0例肝硬化失代偿期患者、2 5例肝癌患者血清CA12 5水平 ,并比较 2 5例肝硬化患者腹水CA12 5值与血清CA12 5值的相关性。结果　肝炎组、肝硬化代偿期组、肝硬化失代偿期组、肝癌组患者血清CA12 5值均显著高于对照组 (P <0 .0 5 ) ;肝硬化失代偿期组患者血清CA12 5值显著高于肝硬化代偿期组 (P <0 .0 1) ,肝癌组患者血清CA12 5值明显高于肝硬化失代偿期组 (P <0 .0 1)。 2 5例肝硬化患者腹水CA12 5值显著高于血清CA12 5值 ,二者之间呈线性相关 (r =0 .766,P <0 .0 0 1)。结论　肝硬化患者血清CA12 5水平升高及升高程度与肝病严重程度密切相关 ,血清CA12 5水平可作为反映肝病患者肝损害程度的指标之一 ,同时血清CA12 5水平可能成为监测肝硬化患者腹水消长的一项有用指标。     

各种肝病患者内皮素水平的检测与分析

目的探讨各种肝病患者血浆内皮素-l(ET-1)水平的临床意义.方法用放射免疫法检测急、慢性肝炎、重症肝炎、肝硬化和肝癌患者血清ET-l的含量.结果血浆ET-l水平在急性肝炎为(87.3士41.5)pg/ml,慢性肝炎组为(115.4士48.6)pg/ml,重症肝炎组为(63.4士40.4)pg/ml,肝硬化组为(78.8士45.0)pg/ml,肝癌患者血为(81.5±46.0)pg/ml,均明显高于对照组(34.32±19.38)pg/ml,P均＜0.01.结论血浆ET-1水平升高在各型肝病发生以及肝病的病理、生理改变过程有重要的作用.     

血清α1酸性糖蛋白检测在肝病中的意义

目的 :检测各型肝病患者血清α1 酸性糖蛋白 (α1 AGP)、谷丙转氨酶 (ALT)和谷草转氨酶 (AST)、白蛋白(ALB)含量的变化 ,观察在肝病中的临床意义 ,同时与非肝病患者和正常健康者作对照。方法 ::用罗氏生化 (α1 AGP)诊断试剂盒测定血清α1 AGP的含量。结果 :发现急性肝炎时 ,血清α1 AGP含量降低 ,ALT、AST升高 ,ALB无明显变化 ,尤其肝硬化 (失代偿 )、重症肝炎和重度慢性肝炎时 ,血清α1 AGP含量降低极为显著 (P <0 0 0 1) ,随病情好转 ,血清α1 AGP含量有所上升 ;肝癌时 ,血清α1 AGP含量却明显升高 (P <0 0 0 1) ,对肝细胞癌、肝硬化和肝炎的鉴别诊断有一定价值。结论 :①α1 酸性糖蛋白水平和肝脏病变的范围和损害程度明显相关 ,动态观察可作为病情预后观察的一项生化指标 ;②α1 酸性糖蛋白的检测对肝炎、肝硬化和肝癌的鉴别诊断有一定的辅助意义     

转化生长因子β1和肿瘤坏死因子α在门静脉高压症发病中的意义

目的　研究转化生长因子 β1 (TGFβ1 )和肿瘤坏死因子 α(TNFα)在门静脉高压症 (门脉高压 )发病中的作用。　方法　应用酶联免疫分析方法对 5 0例门脉高压患者 (其中 2 0例伴腹水形成 )、5 0例正常对照者进行TGFβ1 和 TNFα的检测。　结果　对照组血清 TGFβ1 和 TNFα为 12 .32± 3.2 9ng/ml,94.74± 49.30 pg/ml,门脉高压组分别为 19.2 1± 5 .87ng/ml,140 .85± 5 3.47pg/ml(P<0 .0 5 ) ;门脉高压伴腹水者为 18.44± 5 .89ng/m l,16 7.34± 38.6 2 pg/ml,不伴腹水者为 2 0 .6 8± 6 .73ng/ml,10 1.5 4± 2 8.2 4pg/m l,两者比较 TGFβ1 差异无显著性 ,而有腹水者 TNFα高于无腹水者 (P<0 .0 5 )。　结论　 TGFβ1 和 TNFα水平升高在肝硬化门脉高压发病的病理生理机制中起作用。     

肝病患者血清糖类抗原CA199化学发光法检测的临床意义

目的 :观察肝病患者 (包括肝癌 ,肝硬化及轻度乙肝患者 )血清糖类抗原CAl99含量变化并探讨化学发光法检测血清糖类抗原CAl99的临床价值。方法 :3 0例正常人和 60例肝病患者 (其中 2 0例肝癌 ,2 0例肝硬化和 2 0例轻度乙肝患者 )用化学发光法检测其血清糖类抗原CA199含量 ,将所得值进行t检验。结果 :正常人血清CA199值 3 .75± 2 .89U/ml,轻度乙肝组略升高CA199值 5 .79± 3 .5 7U/ml(P <0 .0 5 ) ;肝硬化组较正常升高 14.67± 8.98U/ml(P <0 .0 1) ;肝癌组升高明显 85 .18± 60 .79U/ml(P <0 .0 0 1)。结论 :化学发光法测定肝病患者血清CA199对临床诊断肝癌有重要价值     

血清前清蛋白在肝病检测中的临床意义

目的探讨血清前清蛋白（PA）在肝病病情检测及治疗中的临床价值。方法采用免疫散射比浊法测定186例肝病患者血清前清蛋白（PA）,同时采用溴甲酚绿比色法测定患者清蛋白（ALB）,对照健康人体的PA及ALB含量。结果PA含量在各类肝病患者中各有不同,且随着肝病病情的严重程度增加PA含量越低,而ALB含量（除重症肝炎、肝硬化失代偿期、肝癌）下降不明显。结论血清PA含量检测对肝细胞损伤诊断及治疗具有重要意义,特别是对于重症肝炎的早期诊治及监测,同时也是判断肝硬化失代偿期及代偿期的重要指标。     

肝硬化组织转化生长因子β1 的分布研究及临床意义

目的研究转化生长因子β1(TGFβ1)、胶原纤维和网状纤维在肝硬化组织中的分布、意义及肝细胞癌变对其分布的影响.方法采用免疫组织化学SP法检测30例肝硬化组织和1例大致正常肝组织TGFβ1的表达情况.用Masson染色显示胶原纤维,Gordon-Sweet染色显示网状纤维.CMIAS-8彩色图像分析系统对阳性目标进行分析处理.结果 (1)TGFβ1主要位于肝非实质细胞胞浆内,这些细胞主要分布在汇管区、纤维间隔、炎症区;纤维组织中有少量TGFβ1存在;少数肝细胞胞浆内也表达TGFβ1,总阳性率为20%,肝炎肝硬化组TGFβ1阳性表达率与肝炎肝硬化合并原发性肝细胞癌组比较无显著性差异(P>0.05);(2)肝炎肝硬化组TGFβ1的IOD为395.3±291.3,胶原纤维的AD为(6.3±3.8)%,网状纤维的AD为(5.4±2.3)%.TGFβ1的IOD与胶原纤维的AD呈正相关(r=0.8991,P<0.01),与网状纤维的AD呈正相关(r=0.8317,P<0.01);肝炎肝硬化合并原发性肝细胞癌组TGFβ1 的IOD为840.7±449.6,胶原纤维的AD为(12.5±4.9)%,网状纤维的AD为(9.2±3.2)%.TGFβ1的IOD与胶原纤维的AD呈正相关(r=0.8025,P<0.01),与网状纤维的AD无相关(r=0.4314,P>0. 05).肝炎肝硬化组TGFβ1的表达、胶原纤维和网状纤维分布与肝炎肝硬化合并原发性肝细胞癌组比较均有显著性差异(P均<0.01);(3)胶原纤维主要分布在汇管区、纤维隔,炎症区,肝窦旁也可见少量存在;网状纤维主要分布在汇管区、纤维隔、炎症区、肝窦旁、实质细胞周围;原发性肝癌及外周肝硬化组织Gordon-Sweet染色显示肝癌细胞区网状纤维不显色.结论 TGFβ1与肝纤维化肝硬化的发生发展密切相关.在肝炎肝硬化,TGFβ1表达增强,当合并原发性肝细胞癌时,TGFβ1有极强表达;TGFβ1可作为原发性肝细胞癌的血清学辅助诊断,Gordon-Sweet染色可作为原发性肝细胞癌的病理学辅助诊断.     

慢性乙型肝炎患者血清TGF-β_1水平与肝功能关系临床分析

目的 :探讨慢性乙型肝炎患者血清转化生长因子 β1 (TGF -β1 )的变化与肝功能损害的关系。方法 :采用双抗体夹心ELISA法测定 80例慢性乙型肝炎患者血清TGF -β1 含量 ;测定各项反映肝功能主要生化指标 :ALT、ALB、SB、PTA。结果 :TGF -β1 含量 ( x±s)分别为 :慢性乙型肝炎轻度 ( 18.2 5± 3.71)ng ml,中度 ( 5 4.32± 19.13)ng ml,重度 ( 10 8.15± 47.2 3)ng ml。重型 ( 2 41.73± 45 .48)ng ml均高于对照组 ( 7.1± 6.6)ng ml(P <0 .0 5 ) ,且随着肝损害加重 ,TGF -β1水平逐渐升高。结论 :TGF -β1 含量可反映肝损害程度 ,血清TGF -β1 的测定对慢性乙型肝炎病情及预后判断有重要意义。     

Liver

Alleviation of ischemia-reperfusion injury in rat liver donors by induction of exogenous hTERT gene;Effects of surgical technique on acute renal failure after orthotopic liver transplantation in patients with end-stage liver disease at high risk： a report of 90 eases;Timing for liver transplantation for chronic severe hepatitis;Analysis of bacterial variance and drug resistance after orthotopic liver transplantation;The influence of splenectomy on orthotopic liver transplantation and its management     

Liver

<正>209461 Intraoperative ligation of recipient’s portasystemic shunt in liver transplantation/Chen Litian(,Organ Transplant Center,Tianjin 1st Centr Hosp Tianjin 300192)…∥Chin J Gen Surg.-2009,25(4).-489～491Objective To investigate the clinical significance of ligating the portasystemic shunt confirmed by preoperative CT evaluation during orthotopic liver transplantation.Methods From January 2007 to August 2008,35 patients in Tianjin First Central Hospital underwent preoperative three-dimensional CT scan,among them 23 patients had spontaneous major portasystemic shunts,the other 12 patients did not have portasystemic shunts.16 out of the 23 cases with significant shunts underwent shunt ligation based on portal blood flow volume measured by intraoperative portal vein flowmetry.The shunt of the other 7 patients were left untreated.Results The portal blood flow in the 12 patients without portasystemic shunt judged by preoperative CT scanning were(1 101±70)ml/min.The shunts in 7 patients with portal blood flow greater than 1 000 ml/min were not ligated,that of the 16 patients with portal blood flow volume lower than 1 000 ml/min were ligated.The portal blood flow volume in those 16 patients before and after ligating the shunt were(657±112)ml/min and(1 136±161)ml/min,respectively(P<0.05).Postoperatively 2 patients suffered from portal vein thrombosis,among them 1 patients suffered from intermittent disturbance of consciousness,2 patients died within 3 months,with one died of respiratory failure from pulmonary aspergillus infection,one died of hepatic failure in 2 months after operation because of graft dysfunction.The other 19 patients with normal blood flow and well-functioning graft were alive.Conclusion The ligation of portasytemic shunt is mandatory in patients when pretransplant CT evaluation showing a major porto-systemic shunts and portal blood flow volume was less than 1 000 ml/min.5 refs,2 figs.     

Liver

<正>209293 Probing into indication of living-related Liver Transplantation for Wilson’s disease/Cheng Feng(Liver Transplant Center,1st Hosp Nanjing Med Univ,Key Lab Living Donor Liver Transplant,Minist Public Health,Nangjing 210029)…∥Chin J Surg.-2009,47(6).-437~440Objective To probe into indication of living-related liver transplantation(LRLT)for Wilson’s Disease.Methods From January 2001 to February 2007,thirty-seven living-related liver transplants were performed.A retrospective analysis was carried on outcome of those patients.The indications for LRLT were acute hepatic failure in 3 patients and chronic advanced liver disease in 32 patients including 13 patients with Wilsonian neurological manifestations.Two patients presented with severe Wilsoian neurological manifestations even though their liver functions were stable.According to the scoring system for evaluation of the neurological impairment in Wilsion disease based on neurological signs and functions(total score was 30),the pre-transplantation score of those patients with neurological manifestations was 15.9±4.3(n=15).Results Thirty-seven patients were followed up for 20-93 months.The survival rates of post-transplant patients and grafts at 1,3,and 5 year were 91.9%,83.8%,75.7%,and 86.5%,78.4%,75.7%,respectivly.Postoperative surgical complications occurred in 2 donors with bile leakage required drainage,in 2 recipients with hepatic thormbosis underwent retransplantation of cadeveric liver and in 1 recipient with hepatic stenosis required balloon dilatation.Neurological function was improved in all recipients and the score of posttransplantation at 6,12,18,24,and 30 months was 17.5±3.7(n=13);21.0±4.3(n=12);23.9±3.9(n=10);26.6±2.2(n=10)and 28.1±1.9(n=7)respectively.Conclusion Patients with acute hepatic failure or patients with severe liver disease unresponsive to chelation tratment should be treated with LRLT.Early transplantation in patients with an unsatisfactory response medical tratment may prevent irreversible neurologica     

Liver

<正>209604 The suppressive effect of CD8+ CD28-regulatory T cells from spontaneous tolerance models on the acute rejection responses in rat liver transplantation/Chen Ning(陈宁,Dept Gastroenterol,Peking Univ Peop Hosp,Beijing 100044)…∥Chin J Organ Trans-plant. -2009,30(9). -524 ～526     

Liver

<正>209087 Clinical analysis of outcome of invasive fungal infection after kidney transplantation/Chen Guodong(陈国栋,Dept Transplant Surg,1st Hosp,Sun Yat sen Univ, Guangzhou 510080)…∥Chin J Organ Transplant. -2009, 30(10). -616～619 Objective To explore the outcome of invasive fungal infection in kidney transplantation and the influencing factors.     

探讨脂肪肝供肝在肝脏移植中的价值

目的探讨应用不同脂肪沉着程度供肝对肝移植患者预后的影响。方法选取64例进行肝移植术患者,依据供肝浸润程度,随机分为轻度脂肪肝组、中度脂肪肝组、重度脂肪肝组、无脂肪肝组共四组,每组各16例,比较四组患者肝功能(主要观察ALT、AST指标)、入住ICU的平均时间、1年移植物成活率、移植物原发无功发生率。结果轻度脂肪肝组入住ICU的平均时间、ALT和AST水平、移植物原发无功发生率与无脂肪肝组接近;中度脂肪肝组入住ICU平均时间、ALT和AST水平均较轻度组和无脂肪肝组明显增高,P0.05;重度脂肪肝组入住ICU平均时间、ALT和AST水平、移植物原发无功发生率明显较前三组为高,P0.05。结论轻、中度肝脏脂肪浸入可作为肝移植供肝,重度脂肪肝不能作为供肝的选择目标。     

Liver

Prevention and treatment of artery complication after liver transplantation by HBO , Clincal feature of cytomegabvirus pneumonia in orthtopic liver-transplantation and treatments, Risk factors of diabetes mellitus following orthotopic liver transplantation , Re-infection of hepatitis B virus after liver transplantation , Diagnosis and treatment of fungal infection after orthotopic liver transplantation , Two successful adult-to-adult living donor liver transplantation using dual grafts     

Microenvironment of Liver Regeneration in Liver Cancer

The occurrence and development of liver cancer are essentially the most serious outcomes of uncontrolled liver regeneration. The progression of liver cancer is inevitably related to the abnormal microenvironment of liver regeneration. The deterioration observed in the microenvironment of liver regeneration is a necessary condition for the occurrence, development and metastasis of cancer. Therefore, the use of a technique to prevent and treat liver cancer via changes in the microenvironment of liver regeneration is a novel strategy. This strategy would be an effective way to delay, prevent or even reverse cancer occurrence, development and metastasis through an improvement in the liver regeneration microenvironment along with the integrated regulation of multiple components, targets, levels, channels and time sequences. In addition, the treatment of "tonifying Shen (Kidney) to regulate liver regeneration and repair by affecting stem cells and their microenvironment" can regulate "the dynamic imbalance between the normal liver regeneration and the abnormal liver regeneration"; this would improve the microenvironment of liver regeneration, which is also a mechanism by which liver cancer may be prevented or treated.     

化肝汤1号治疗酒精性肝纤维化症状及肝功能改变

目的观察活血化瘀、软坚散结药配伍治疗肝纤维化时对患者主、次症状改变及肝功能的影响。方法将确诊为酒精性肝纤维化患者90例,随机分为三组,治疗组采用自制方剂化肝汤1号(醋鳖甲、黄芩、柴胡、赤芍等),对照组1采用凯西莱治疗,对照组2采用化肝汤1号和凯西莱联合治疗,疗程3个月。观察三组患者治疗前后主、次症状改善情况,血清天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、γ谷氨酰转肽酶(γ-GT)变化。结果三组治疗后的临床疗效比较差异无统计学意义(H=2.5897,P>0.05)。三组治疗后肝功能指标均有改善,与治疗前比较,差异有统计学意义(P<0.05)。结论化肝汤1号可有效地降低肝细胞的损害程度,促进受损细胞修复,从而改善肝功能。