缬草提取物对类脂质代谢的影响与对胆囊结石治疗作用的关系

目的：研究缬草提取物对胆囊结石的治疗作用对血浆载脂蛋白、血清及胆汁类脂水平影响的关系。方法：大耳白种 家兔，手术植入人胆固醇为主的混合结石 。实验组灌喂缬草提取物，对照组灌喂等容、等渗盐水，8周后取出胆囊结石称重，取胆总管胆汁测胆固醇、磷脂、总胆汁酸浓度；取血清查载脂蛋白A1、B及胆固醇、磷脂、总胆汁酸水平。结果：实验组胆囊结石平均重量较对照组明显减轻（P＜0．01），结石消失率达75％；实验组血清胆固醇及总胆汁酸水平低于对照组（P＜0．05，P＜0．01），载脂蛋白A1高于对照组（P＜0．01），载脂蛋白B低于对照组（P＜0．01），胆总管胆汁酸实验组高于对照组（P＜0．05）。结论：缬草提取物对胆囊结石有明显治疗作用，其治疗作用与其对血清载脂蛋白及对血、胆汁内的类脂质水平改变有关。     

大鼠酒精性肝损害时血浆细胞因子TNF-α、IL-6水平的变化及其意义

目的 探索细胞因子在酒精性肝损害中的作用。方法 采用SD大鼠进行酒精灌胃制作酒精性肝损害的动物模型，对比检测模型组及正常对照组在外源性内毒素刺激前后血浆中谷丙型转氨酶（ALT），肿瘤坏死因子（TNF－α），白细胞介素6（IL－6）水平，同时光镜观察肝组织病理学变化。结果 模型组TNF－α，ALT高于对照组（0．01＜P＜0．05），LPS加强后差别更大（P＜0．01）；模型组IL－6与对照组比较，差别不显著（P＞0．05），采用LPS刺激后差别显著性明显加大（P＜0．01），所有检测数据同肝组织的病理学变化相一致。结论 酒精性肝损害时肝内Kupffer细胞活化，伴随着TNF－α，IL－6的分泌增加。     

冠心病与肿瘤坏死因子、白细胞介素-6浓度关系的研究

采用放射免疫法及酶联免疫吸附法检测35例冠心病患者（其中20例冠状动脉狭窄，15例心肌梗死）及20例健康者血清肿瘤坏死因子（TNF）、白细胞介素-6（IL－6）的浓度及血脂水平。结果显示：①冠心病组较对照组TNF浓度高（P＜0.01），而以心肌梗死组更为明显（P＜0.001）；②冠心病组TNF浓度与胆固醇、低密度脂蛋白-胆固醇、载脂蛋白B100呈正相关，而与高密度脂蛋白-胆固醇、载脂蛋白地呈负相关。③冠状动脉狭窄组与对照组比较IL－6浓度光显著性差异（P＞0．05），但心肌梗死组IL－6浓度显著增高（P＜0．001）。提示：TNF、IL－6与冠心病的发生发展有关，IL－6参与了急性心肌梗死的缺血损伤；内皮细胞受损，TNF、IL－6作用，脂质代谢的异常是冠心病发生的重要环节。     

L-型钙通道α-1c亚型mRNA在结石胆囊组织的表达

目的研究不同类别结石胆囊组织L-型钙通道（Car1．2）mRNA的表达,探讨胆囊结石形成的可能分子机制及意义。方法应用RT-PCR半定量法分析胆色素结石、胆固醇结石、胆囊息肉的胆囊组织Car1．2mRNA的表达量。结果Cav1．2mRNA的表达在胆色素结石组和胆囊息肉组明显高于胆固醇结石组（P〈0．05）,但在胆色素结石组和息肉胆囊组之间差异无统计学意义（P〉0．05）。结论Cav1．2mRNA在胆色素结石、胆固醇结石、胆囊息肉三组胆囊组织中均有表达,并且在不同组别中的表达存在明显的差异,这种差异可能是钙离子通道在各类胆囊上分布差异的分子基础,在胆囊结石形成过程中起着重要作用。     

肿瘤坏死因子拮抗剂对异丙肾上腺素诱导大鼠心力衰竭的治疗作用

目的：研究肿瘤坏死因子（TNF－α）拮抗剂（Enbrel,EB)对异丙肾上腺素（isoproterenol,ISO)诱导大鼠心功能不全和心室重构的治疗作用并探讨其机理。方法：将70只雄性Wistar大鼠随机分为3组。EB组（n=30);给予致心力衰竭剂量ISO后再给予EB治疗；ISO组（n=30)；给予ISO后不给予EB治疗；对照组（n=10);不给予任何处置。8周后，随机从各组选取存活大鼠8只，进行心脏超声检查和血流动力学测定，并测定血清及心肌组织中TNF－α、白细胞介素－1β（IL－1β）的含量。结果：（1）EB组与ISO组相比除左室后壁厚度、左室重量／体重比值无明显差别外，左室舒张末期直径、左室收缩末期直径、左室舒张末压、左室压力最大下降速率、左室等容舒张时间常数均有明显减少（P＜0．05），而左室短轴缩短率、左室收缩末压、左室压力最大上升速率明显高于ISO组（P＜0．01），但与对照组仍有明显差异。（2）EB组血清及心肌组织TNF－α与ISO组间无显差异（P＞0．1），但显高于对照组（P＜0．01）。对照组血清TNF－α水平未能测出。EB组心肌组织IL－1β显低于ISO组（P＜0．05），对照组心肌组织中及3组 动物血清中IL－1β均未能测出.结论：（1）EB能够明显改善ISO诱导的左室功能不全，这除了与其直接拮抗TNF－α的生物学作用有关外，可能部分地与心肌组织IL－1β表达水平下降有关。（2）EB具有减轻左室重构的作用，并且这种作用主要表现为对左室构型的影响。     

慢性肝病患者血清TNF—α、IL—8和血浆选择素水平的检测及其意义

目的：探讨TNF－α、IL－8和P-selectin与慢性肝病的关系。方法应用双抗体夹心酶联免疫吸附法（ELISA）测定124例慢性肝病患者血清TNF－α、IL－8和P－selectin的水平。结果：慢性肝病患者血清TNF－α、IL－8和P－selectin水平均明显高于对照组（P值均＜0．001，P－selectin组P＜0．01）。结论TNF－α、IL－8和P－selctin可能与慢性肝病免疫病理损伤过程。检测血清TNF－α、IL－8和P－selectin水平对判断患者病情和预后有临床实用价值。     

血脂、性激素水平与胆囊结石关系的研究

目的：探讨血脂、性激素水平与胆囊结石的关系。方法：选取212例确诊为胆囊结石的患者,测定其血脂TC、TG、LDL－ch,HDL-ch,LDL-ch/HDL-ch及T、E2、P、E2／P,并与72例正常对照组比较。结果：除HDL－ch外,血脂TC、TG、LDL－ch,LDL-ch/HDL-ch各项指标均值,胆囊结石组均高于健康对照组（P＜0．05－0．001）。血清T结石组与对照组比较无显著性差异（P＞0．05）。E2、P除育龄期结石组外,绝经期及男性结石组均高于对照组（P＜0．05－0．01）。育龄期结石组血清P高于对照组（P＜0．01）。血清E1虽有升高,但组间比较无显著性差异（P＞0．05）。E2／P结石组明显低于对照组（P＜0．01－0．001）。结论：脂类供谢及雌性激素代谢紊乱与胆囊结石的发生有明显关系。女性脂类代谢异常更是胆囊结石发生的重要原因之一。     

细胞因子在急性心肌梗塞中的作用

为探讨细胞因子在急性心肌梗塞（AMI）中的作用，测定了28例AMI患者血清肿瘤坏死因子α（TNFα）和白细胞介素1β（IL－β）水平，并选择13例不稳定型心绞痛（UA）患者和15例健康人作为对照。结果表明：AMI组血清TNFα水平明显高于UA组及正常组（P＜0．01），UA组血清TNFα水平明显高于正常组（P＜0．01）；血清IL－1β水平在严重的AMI患者（心功能KillipⅢ、Ⅳ级）明显高于正常组（P＜0．01）。提示血清TNFα和IL-1β水平与心肌缺血的严重程度有关。     

男性胆囊胆固醇结石患者血浆脂联素、性激素水平与体脂分布的关系

目的探讨男性胆囊胆固醇结石患者血浆脂联素、性激素水平与体脂分布的关系。方法对30名男性胆囊胆固醇结石患者与30名健康志愿者，分别测定其血浆脂联素、雌二醇（E2）、游离睾酮（FT）、总睾酮（TT）水平，同时监测血压、腰围（WC）、体重指数（BMI）、腰／臀比（WHR），并进行比较。结果（1）结石组血浆FT、TT、脂联素水平较对照组低（P〈0．05），控制BMI、WC、WHR后，结石组脂联素水平仍较对照组低（P〈0．05），而E2值差异无统计学意义（P〉0．05）。结石组WC、WHR、BMI较对照组高（P〈0．01），均具统计学意义。（2）男性胆囊胆固醇结石血浆脂联素水平与WC呈负相关，TT水平与BMI呈负相关，FT水平与BMI、WHR、WC呈负相关，（P〈0．05）。（3）多因素分析提示WHR、TT水平为男性胆囊胆固醇结石发病的危险因素。结论（1）男性胆囊胆固醇结石患者血浆脂联素、TT、FT水平同时降低，TT水平是男性胆囊胆网醇结石发病的危险因素。（2）男性胆囊胆固醇结石患者存在体脂分布异常，雄激素在男性胆囊胆固醇结石病人脂联素水平的降低中似乎未参与调节，脂联素、雄激素水平同时降低可能是由于体脂分布异常所致，体脂分布异常是男性胆囊胆固醇结石发病的危险因素。     

病毒性肝炎患者血清IL-6,IL-8水平及临床意义

了解病毒性肝炎患者血清IL－6、IL－8水平及临床意义。应用放射免疫法检测124例病毒性肝炎患者血清IL－6、IL－8水平并动态观察，其中35例慢性肝炎进行肝活检，并按肝组织病理进行分级和分期。①急性肝炎、慢性肝炎中重度、慢性重型肝炎IL－6和IL－8水平依次升高，明显高于正常对照（P＜0．01）；②IL－6、IL－8水平与肝 组织炎症坏死程度和肝纤维化程度呈正相关（P＜0．01，P＜0．01）；③IL－6、IL－8水平随急性肝炎恢复和慢性肝炎稳定而降低（P＜0．01，P＜0．05）。IL－6、IL－8水平可作为反映肝细胞坏死程度和纤维化轻重的指标。     

胆囊结石患者胆囊壁CCK-AR mRNA表达及血浆CCK-8水平与胆囊排空功能的关系

目的探讨胆囊结石患者胆囊收缩素(CCK)-A受体(AR)mRNA表达及血浆CCK-8水平与胆囊排空功能的关系。方法60例胆囊结石患者(结石组)和30例无胆囊结石而行上腹部手术者(对照组),术前用B超测定胆囊排空功能,RT-PCR技术检测胆囊壁CCK-ARmRNA,放射免疫法检测血浆CCK-8。结果结石组CCK-ARmRNA为0.59±0.11,与对照组的0.91±0.06相比,P<0.01;结石组中,胆囊收缩减弱者的CCK-ARmRNA为0.52±0.06,与收缩正常者的0.70±0.07相比,P<0.01;结石组血浆CCK-8为(42.91±2.88)pmol/L,与对照组的(31.50±1.62)pmol/L相比,P<0.05;结石组术前血浆CCK-8为(42.91±2.88)pmol/L,与术后的(34.21±2.56)pmol/L相比,P<0.05。结论CCK-AR、CCK-8在胆囊运动调节中发挥重要作用。     

Gallbladder Contractility in Liver Cirrhosis: Comparative Study in Patients with and Without Gallbladder Stones

An increased prevalence of gallstones was demonstrated in patients with liver cirhosis, higher in the advanced stages of the disease. Some studies have found impaired emptying of the gallbladder in cirrhotic patients. Our aim here was to investigate gallbladder emptying in cirrhotic patients with and without gallstones to find out whether emptying is further impaired in the presence of gallstones. The study group comprised 24 patients with liver cirrhosis and gallstones, 8 in each Child class. The controls were represented by 18 cirrhotic patients without gallstones, 6 in each Child class. Fasting gallbladder volume was calculated by ultrasound using the ellipsoid formula. Gallbladder emptying was evaluated for 90 min after ingestion of a solid-liquid meal (14 g fat, 425 kcal), by assessing minimal residual volume, gallbladder ejection fraction, and area under emptying curve at 15-min intervals. Statistical analysis was performed using the two-tailed Students' t test and Pearson's correlation coefficient. In controls, gallbladder fasting and residual volumes increased with the severity of cirrhosis, but gallbladder emptying did not change significantly. In cirrhotics with gallstones, gallbladder emptying decreased in Child C compared with Child A class patients and, also, compared to Child C controls. The number or size of gallstones, as well as the thickness of the gallbladder wall, did not correlate with gallbladder emptying parameters. Gallbladder contractility is impaired in patients with liver cirrhosis and gallstones. Hypomotility is proportional to the severity of liver disease. Gallbladder hypomotility might contribute to the increased gallstone formation in patients with advanced cirrhosis.     

老年糖尿病患者胆囊运动功能变化与血浆胃动素水平的关系

目的：研究老年糖尿病患者胆囊运动功能与血浆胃动素的关系。方法：４２例老年糖尿病患者和１４例健康对照者和在口服煎鸡蛋前后,用Ｂ超声波测量胆囊容积变化,用放免方法测量血浆胃动素水平变化。结果：无任何自主神经病变及轻度自主神经病变者,胆囊运动功能和血浆胃动素民正常对照组比较无显著差异。糖尿病伴有严重自主神经病变者,胆囊红缩功能减低,血浆胃动素水平升高。结论：老年糖尿病患者胆囊运动功能与血浆胃动素水平变化     

Gallbladder Contents and Fasting Gallbladder Volumes during and after Pregnancy

Background: A high risk of developing sludge or gallstones has been associated with pregnancy. The aim of this study was to relate the prevalence of sludge and gallstones during and shortly after pregnancy to fasting gallbladder volume as an indicator of gallbladder motility. Methods: The population included 114 apparently healthy pregnant women from the Outpatient Clinic of Obstetrics of a large regional hospital and from the practices of regional midwives. Ultrasonography of the gallbladder was performed at weeks 15, 25, and 35 of gestation and at week 3 and month 6 postpartum. Results: At gestational week 15, 3 women had gallstones and 10 had sludge (mean volume, 33.8 ml), and 99 women had a normal gallbladder (mean volume, 30.5 ml). At week 25, 1 woman with a normal gallbladder formed gallstones and underwent cholecystectomy shortly after, and 22 women had sludge, of whom 13 had a normal gallbladder at first examination (mean volume, 33.2 ml). In 88 women with normal gallbladders (of whom 2 had sludge at week 15) mean volume was 31.9 ml. At week 35, 2 women had gallstones, and 21 had sludge (mean volume, 30.5 ml). In the remaining 79 women the gallbladders were clear (mean volume, 29.5 ml). Eight women developed sludge and two women gallstones in normal gallbladders at week 25. Seven women with sludge at week 25 had a normal gallbladder at week 35. Three weeks postpartum only 10 of 100 women had sludge (mean volume, 29.1 ml). Of these 10, 9 women had a normal gallbladder at week 35. Twenty of 21 women with sludge at week 35 had normal gallbladders week 3 postpartum. Gallstones found at week 35 had disappeared. In the women with a normal gallbladder the mean volume was decreased to 19.7 ml (P &;lt; 0.0001). Six months postpartum, sludge was found in 6 (mean volume, 18.4 ml) of 93 women (mean volume, 20.3 ml), of whom 5 had a normal gallbladder at week 3 postpartum. Only 61 women showed a normal gallbladder at each examination of the study. No differences in patient characteristics were found between women with normal gallbladders and those with sludge or gallstones. Conclusions: Fasting gallbladder volume was increased in all pregnant women. This could not explain the formation of sludge or gallstones during gestation. Decrement of gallbladder volumes after delivery was faster in normal, clear gallbladders. More than a prerequisite, increased fasting gallbladder volume seemed to be a permissive factor of pregnancy-associated gallstone formation.     

Gallbladder emptying,plasma levels of estradiol and progesterone,and cholecystokinin secretion in liver cirrhosis

Defective gallbladder emptying has been proposed as a possible accessory pathogenetic factor to explain the increased prevalence of gallstones in liver cirrhosis. In this study we have evaluated the fasting volume and the meal-stimulated emptying of the gallbladder, the plasma levels of estradiol and progesterone, and the basal and postprandial secretion of cholecystokinin in Child A cirrhotic patients compared to normal subjects. Basal (42.2±27 vs 22.8±8.4 ml) (P<0.002) and residual (8.4±8.7 vs 4.6±3.8 ml) (P<0.05) gallbladder volumes were higher in cirrhotics but neither the integrated gallbladder response to meal nor the maximal percentage of emptying was significantly different. Circulating estradiol and progesterone was slightly increased in only 1/13 and 5/13 cirrhotics, respectively. In eight cirrhotics and seven normals taken from the overall populations, the secretion of cholecystokinin was also measured. The fasting plasma level of cholecystokinin was higher in the cirrhotics (6.71±5.08 vs 2.02±0.46 pmol/liter) (P<0.01). The meal-stimulated integrated plasma cholecystokinin response also was greater in cirrhotics (438.5±615 pmol/liter/270 min) than in normals (153±170.4 pmol/liter/270 min), but this difference was not significant because of the small study population. In spite of a normal kinetics of postprandial emptying, cirrhotic patients show increased fasting gallbladder volume and increased plasma levels of basal and postprandial cholecystokinin. Circulating estradiol and progesterone do not seem to be responsible for the large gallbladder volume found in liver cirrhosis.     

桑叶提取物对糖尿病小鼠心肌保护作用的研究

目的 基于氧化应激探究桑叶提取物(MLE)对糖尿病小鼠心肌保护作用及机制.方法 采用链脲佐菌素(STZ)及高糖脂饲料(HFD)诱导的糖尿病小鼠模型,以二甲双胍(Met,200 mg/kg)为阳性对照,分别给予100 mg/kg、200 mg/kg、400 mg/kg的桑叶提取物对糖尿病小鼠灌胃给药,干预12周后检测各组...     

老年急性心肌梗死患者肿瘤坏死因子-α和白细胞介素-10的变化及辛伐他汀的干预作用

目的　探讨老年人急性心肌梗死 (AMI)患者外周循环肿瘤坏死因子 α(TNF α)和白细胞介素 10 (IL 10 )的变化及辛伐他汀对TNF α和IL 10的作用。方法　测定 39例老年AMI患者 (AMI组 )、2 0例老年陈旧性心肌梗死 (OMI)患者 (OMI组 )及 2 0例正常老年人 (正常人组 )血清TNF α和IL 10浓度。 39例AMI患者入院后随机分为辛伐他汀组和对照组 ,治疗前、治疗后 1周和 6周测定血清TNF α和IL 10浓度。结果　AMI组TNF α、IL 10水平明显高于OMI组 ;OMI组TNF α水平明显高于正常人组 ;正常人组血清IL 10未检测到。辛伐他汀组和对照组经治疗后 1周、6周TNF α水平均显著下降 ,6周后辛伐他汀组TNF α水平显著低于对照组。辛伐他汀组和对照组IL 10水平 6周后均显著降低 ,但两组差异无显著性意义。结论　辛伐他汀具有降低AMI患者血清TNF α水平的作用 ,对IL 10水平无影响     

Evaluation of Gallbladder Motility in Patients with Liver Cirrhosis

To investigate the postprandial gallbladder motility, including emptying and refilling, in cirrhotic patients and to evaluate the relationship to the presence of gallstones and various humoral mediators, 82 patients with liver cirrhosis and 40 age- and sex-matched healthy subjects were enrolled into this study. Postprandial gallbladder volumes were measured with ultrasonography every 15 min for 2 hr. Plasma levels of estradiol, testosterone, substance P, and nitrate/nitrite were also measured. Cirrhotic patients showed a higher prevalence of gallstones than healthy subjects (41% vs 15%, P = 0.003), and the prevalence increased with the progression of liver cirrhosis (Child-Pugh class A: 26%, B: 44%, and C: 65%, P = 0.02). Plasma levels of estradiol, testosterone, and substance P, and nitrate/nitrite and estradiol/testosterone ratios were not different between cirrhotic patients with and without gallstones. However, postprandial refilling of the gallbladders was significantly impaired in patients with cirrhosis, especially in those combined with gallstones. There was no significant difference in the postprandial gallbladder motility between cirrhotic patients with and without elevated plasma levels of estradiol, testosterone, and substance P and nitrate/nitrite, and estradiol/testosterone ratios. Gallstones were common in patients with liver cirrhosis and the prevalence increased with the progression of liver diseases. Sex hormones, substance P, and nitrate/nitrite did not play major roles in the formation of gallstones in cirrhotic patients. Refilling of the gallbladder was significantly impaired in patients with liver cirrhosis, especially in those with gallstones, and may play an important role in the pathogenesis of gallstones.     

Ginkgo biloba extract reverses CCl4-induced liver fibrosis in rats

AIM: To study the reversing effect of Ginkgo biloba extract (GbE) on established liver fibrosis in rats. METHODS: Following confirmation of CCI4-induced liver fibrosis, GbE or saline was administrated to the rats for 4 weeks. The remaining rats received neither CCI 4 norGbE as normal control. The four groups were compared in terms of serum enzymes, tissue damage, expression of αSMA and tissue inhibitor-1 of metalloproteinase (TIMP-1) and metalloproteinase-1 (MMP-1). RESULTS: Compared with saline-treated group, liver fibrosis rats treated with GbE had decreased serum total bilirubin (P&lt;0.01) and aminotransferase levels (P&lt;0.01) and increased levels of serum albumin (P&lt;0.01). Microscopic studies revealed that the livers of rats receiving GbE showed allieviation in fibrosis (P&lt;0.05) as well as expression of αSMA (P&lt;0.01). The liver collagen and reticulum contents were lower in rats treated with GbE than saline-treated group (P&lt;0.01). RT-PCR revealed that the level of TIMP-1 decreased while the level of MMP-1 increased in GbE group. CONCLUSION: Administration of GbE improved CCI4-induced liver fibrosis. It is possibly attributed to its effect of inhibiting the expression of TIMP-1 and promoting the apoptosis of hepatic stellate cells.