保肝方治疗慢性乙型重型肝炎病45例

目的:观察保肝扶正退黄类中药配合西药治疗慢性乙型重型肝炎病的临床效果。方法:选取到我院进行治疗的慢性乙型重型肝炎病患者90例,按治疗方法的不同将其分为两组。治疗组采用保肝方(决明子、当归、麦冬、丹参、川芎、白芍、南沙参、赤芍、大黄、金钱草、黄芪、茵陈蒿)治疗,对照组采用常规西医治疗。比较并观察两组患者的治疗效果、不良反应及随访半年后患者的复发情况。结果:治疗组总有效率(97.78%)明显高于对照组总有效率(71.11%),统计学上有意义(P<0.05)。且治疗组凝血酶原活动度、血清总胆红素水平明显优于对照组,统计学上有意义(P<0.05)。结论:保肝方治疗慢性乙型重型肝炎病的疗效比常规西医治疗的疗效好,清热祛瘀,健脾和胃,可促进肝细胞的修复。

Science Letters:A novel way of liver preservation improves rat liver viability upon reperfusion

Background/aim： Currently, the liver is cold-preserved at 0-4 ℃ for experimental and clinical purposes. Here, we investigated whether milder hypothermia during the initial phase of the preservation period was beneficial for liver viability upon reperfusion. Methods： In the first set of experiments, rat livers were preserved either conventionally in clinically used histidine-trypthopan-ketoglutarate （HTK） solution （Group A： 45 min and Group B： 24 h） or by slow cooling HTK solution （from 13 ℃ to 3 ℃） during the initial 45 min of preservation （Group C： 24 h）. In the second set of experiments, additional groups of livers were evaluated： Group BB-preservation according to Group B and Group CC-preservation according to Group C. Further, some livers were preserved at 13 ℃ for 24 h. Livers were then reperfused using a blood-free perfusion model. Results： Bile production was approximately 2-fold greater in Group C compared to Group B. Alanine transaminase （ALT） and aspartate transaminase （AST） release into perfusate were 2-3-fold higher in Group B compared to Group C. No significant differences were found in ALT and AST release between Group C and Group A. Livers in Group CC compared to Group BB exhibited significantly lower portal resistance, greater oxygen consumption and bromosulfophthalein excretion into bile and lower lactate dehydrogenase （LDH） release into perfusate. Histological evaluation of tissue sections in Group BB showed parenchymal dystrophy of hepatocytes, while dystrophy ofhepatocytes was absent in Group CC. Livers preserved at 13 ℃ for 24 h exhibited severe ischemic injury Conclusion： These results suggest that the conventional way of liver preservation is not suitable at least for rat livers and that slow cooling of HTK solution during the initial phase of cold storage can improve liver viability during reperfusion.

Preservation of non-heart-beating donor livers in extracorporeal liver perfusion and histidine-trytophan-ketoglutarate solution

AIM: To compare the preservation of non-heart- beating donor (NHBD) livers in cold histidine-trytophan- ketoglutarate (HTK) solution and extracorporeal liver perfusion (ECLP). METHODS: Livers harvested from health pigs were stored for 10 h in cold HTK solution (group A, n = 4) or perfused with oxygenated autologous blood at body temperature (group B, n = 4). Both groups were then tested on the circuit for 4 h. Bile production, hemodynamic parameters, hepatocyte markers and reperfusion injury of extracorporeal livers were tested in each group. Liver tissues from each group were examined at the end of reperfusion. RESULTS: At 1, 2, 3 and 4 h after reperfusion, bile production, hemodynamic parameters, hepatocyte markers and reperfusion injury of livers in group A were statistically different from those in group B (P < 0.05 or P < 0.01). CONCLUSION: ECLP is better than HTK solution to preserve NHBD livers. ECLP can assess the graft viabilitybefore liver transplantation.

Occult hepatitis C virus infection is more common than hepatitis B infection in maintenance hemodialysis patients

Patients of end stage renal disease on maintenance hemodialysis were enrolled to study the prevalence of occult and dual hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and non-occult hepatitis B and C virus infection. One hundred and two patients were enrolled. Thirty patients had HCV infection, three of them were positive in anti-HCV. So, 27 (90%) of HCV-positive patients had occult HCV infection. Eleven (11%) patients had HBV infection. Five patients were positive in anti-HBc or HBV-DNA, but negative in HBsAg (occult HBV infection). Three (3%) patients had dual HBV and HCV infection. None of the patients showed changes in viral markers during the follow-up of 8 mo on average (1-12 mo).

Conserved balance of hepatocyte nuclear DNA content in mononuclear and binuclear hepatocyte populations during the course of chronic viral hepatitis

AIM： TO analyze the percentages of hepatocytes with increased nuclear DNA content, i.e., tetraploid （4n） and octoploid （Sn） nuclei, and then compared mononuclear and binuclear hepatocyte populations： METHODS： The percentages of mononuclear diploid （2n）, 4n, and 8n hepatocytes and those of binuclear 2 × 2n, 2 × 4n, and 2 × 8n hepatocytes were determined with a method that can simultaneously measure hepatocyte nuclear DNA content and binuclearity in 62 patients with chronic hepatitis B or C. The percentage of 4n and 8n hepatocytes in the mononuclear hepatocyte population was compared with the percentage of 2 × 4n and 2 × 8n hepatocytes in the binuclear hepatocyte population. RESULTS： The percentages of 4n and 8n hepatocytes in mononuclear hepatocytes and 2 ×4n and 2 × 8n hepatocytes in binuclear hepatocytes were similar, regardless of the activity or fibrosis grade of chronic hepatitis and regardless of the infecting virus. CONCLUSION： The distribution of nuclear DNA content within mononuclear and binuclear hepatocyte populations was conserved during the course of chronic viral hepatitis.