The development of liver cirrhosis and portal hypertension(PH), one of its major complications, are structural and functional alterations of the liver, occurring in many patients with chronic liver diseases(CLD). Actu...The development of liver cirrhosis and portal hypertension(PH), one of its major complications, are structural and functional alterations of the liver, occurring in many patients with chronic liver diseases(CLD). Actually the progressive deposition of hepatic fibrosis has a key role in the prognosis of CLD patients. The subsequent development of PH leads to its major complications, such as ascites, hepatic encephalopathy, variceal bleeding and decompensation. Liver biopsy is still considered the reference standard for the assessment of hepatic fibrosis, whereas the measurement of hepatic vein pressure gradient is the standard to ascertain the presence of PH and upper endoscopy is the method of choice to detect the presence of oesophageal varices. However, several non-invasive tests, including elastographic techniques, are currently used to evaluate the severity of liver disease and predict its prognosis. More recently, the measurement of the spleen stiffness has become particularly attractive to assess, considering the relevant role accomplished by the spleen in splanchnic circulation in the course of liver cirrhosis and in the PH. Moreover, spleen stiffness as compared with liver stiffness better represents the dynamic changes occurring in the advanced stages of cirrhosis and shows higher diagnostic performance in detecting esophageal varices. The aim of this review is to provide an exhaustive overview of the actual role of spleen stiffness measurement as assessed by several elastographic techniques in evaluating both liver disease severity and the development of cirrhosis complications, such as PH and to highlight its potential and possible limitations.展开更多
AIM To explore the relationship of liver and spleen shear wave velocity in patients with liver cirrhosis combined with portal hypertension,and assess the value of liver and spleen shear wave velocity in predicting the...AIM To explore the relationship of liver and spleen shear wave velocity in patients with liver cirrhosis combined with portal hypertension,and assess the value of liver and spleen shear wave velocity in predicting the prognosis of patients with portal hypertension.METHODS All 67 patients with liver cirrhosis diagnosed as portal hypertension by hepatic venous pressure gradient in our hospital from June 2014 to December 2014 were enrolled into this study. The baseline information of these patients was recorded. Furthermore,67 patients were followed-up at 20 mo after treatment,and liver and spleen shear wave velocity were measured by acoustic radiation force impulse at the 1^(st) week,3^(rd) month and 9^(th) month after treatment. Patients with favorable prognosis were assigned into the favorable prognosis group,while patients with unfavorable prognosis were assigned into the unfavorable prognosis group. The variation and difference in liver and spleen shear wave velocity in these two groups were analyzed by repeated measurement analysis of variance. Meanwhile,in order to evaluate the effect of liver and spleen shear wave velocity on the prognosis of patients with portal hypertension,Cox's proportional hazard regression model analysis was applied. The ability of those factors in predicting the prognosis of patients with portal hypertension was calculated through receiver operating characteristic(ROC) curves.RESULTS The liver and spleen shear wave velocity in the favorable prognosis group revealed a clear decline,while those in the unfavorable prognosis group revealed an increasing tendency at different time points. Furthermore,liver and spleen shear wave velocity was higher in the unfavorable prognosis group,compared with the favorable prognosis group; the differences were statistically significant(P < 0.05). The prognosis of patients with portal hypertension was significantly affected by spleen hardness at the 3^(rd) month after treatment [relative risk(RR) = 3.481]. At the 9^(th) month after treatment,the prognosis was affected by liver hardness(RR = 5.241) and spleen hardness(RR = 7.829). The differences between these two groups were statistically significant(P < 0.05). The ROC analysis revealed that the area under the curve(AUC) of spleen hardness at the 3^(rd) month after treatment was 0.644,while the AUCs of liver and spleen hardness at the 9^(th) month were 0.579 and 0.776,respectively. These might predict the prognosis of patients with portal hypertension.CONCLUSION Spleen hardness at the 3^(rd) month and liver and spleen shear wave velocity at the 9^(th) month may be used to assess the prognosis of patients with portal hypertension. This is hoped to be used as an indicator of predicting the prognosis of patients with portal hypertension.展开更多
Objective:The aim of the study was to investigate the adaptive response of low-dose radiation-induced apoptosis in mouse spleen cells and its related proteins control mechanism. Methods: Kunming male mice were randoml...Objective:The aim of the study was to investigate the adaptive response of low-dose radiation-induced apoptosis in mouse spleen cells and its related proteins control mechanism. Methods: Kunming male mice were randomly divided into sham-irradiation group, attacking dose irradiation group (D2) and low-dose radiation + attacking dose irradiation group (D1+D2). After a week the D1+D2 group was given low-dose radiation (doses were 25,50,75 and 100 mGy, dose rate of 12.5 mGy/min), after 6 hours the D2 group and the D1+D2 group were given attacking dose of radiation (Dose of 1.5 Gy, dose rate of 287 mGy/min). After 18 hours all mice were killed. The spleen cell apoptosis and Caspase-3 expression's changes were detected by flow cytometry (FCM) analysis, and the changes of apoptosis-related proteins Bcl-2 and Bax were detected by immunohistochemical staining semi-quantitative method. Results: The rate of apoptosis, the fluorescence intensity of Caspase-3, and the semi-quantitative results of apoptosis-related proteins Bcl-2 and Bax in every group were significantly different. Of all groups, the apoptosis rate and Caspase-3 fluorescence intensity of D2 group were the highest. Compared with the sham-irradiated group, Bcl-2 protein level of D2 group decreased significantly, and Bax protein level of D2 group increased significantly. But compared with D2 group, the apoptosis rates, the fluorescence intensities of Caspase-3 expression and the Bax protein levels in D1+D2 group were lower in different doses, and the Bcl-2 protein levels in D1+D2 group were higher in different doses. Conclusion: 25-75 mGy low-dose radiation can induce the adaptive response of mouse spleen cells' apoptosis, the expression of Caspase-3, and the apoptosis-related protein Bcl-2 expression increased, Bax reduced, and it leads to the apoptosis of the spleen cells decreased.展开更多
Objective： To observe the clinical effect of tuina for spleen deficiency infantile diarrhea. Methods： A total of 60 cases were randomized into a treatment group and a control group （30 in each group）. Tuina manip...Objective： To observe the clinical effect of tuina for spleen deficiency infantile diarrhea. Methods： A total of 60 cases were randomized into a treatment group and a control group （30 in each group）. Tuina manipulations were employed in the treatment group, whereas medication was administered in the control group. The between-group clinical effects were compared after one course of treatment. Results： The recovery rate was 20.0% in the treatment group, versus 3.3% in the control group, showing a statistical significance （P〈0.05）. After treatment, there were between-group statistical differences （P〈0.05） in infants＇ main accompanying symptoms such as complexion, spirit, vomiting, and abdominal pain. Conclusion： Tuina is effective for infantile diarrhea due to spleen dficiencv.展开更多
Objective： To observe the effect of moxibustion on intestinal propulsion rate, content of serum D-xylose, content of adenosine triphosphate （ATP） and activities of adenosine triphosphatases （ATPase） in jejunum ti...Objective： To observe the effect of moxibustion on intestinal propulsion rate, content of serum D-xylose, content of adenosine triphosphate （ATP） and activities of adenosine triphosphatases （ATPase） in jejunum tissues of spleen-deficiency rats, and to explore the effect of moxibustion on the production of ATP and activities of membrane proteins, for analyzing the mechanism of moxibustion in reinforcing the spleen-stomach. Methods： Forty healthy Sprague Dawley rats were randomly divided into four groups, namely group A （blank control group）, group B （model control group）, group C （moxibustion group） and group D （herbs group）. The animal model of spleen-deficiency was established by intragastric administration with Da Huang （Radix et Rhizoma Rhei） infusion. The rats in group C received moxibustion at Zusanli （ST 36）, Zhongwan （CV 124 Guanyuan （CV 4）, Pishu （BL 20） and Weishu （BL 21）. The rats in group D received intragastric administration with 5i Jun Zi decoction. The intestinal propulsion was measured by toner method, and the content of D-xylose in serum was detected by phloroglucinol method. Colorimetry method was used to detect the content of ATP and activities of Na^＋-K^＋-ATPase and Ca^2＋-Mg^2＋-ATPase in jejunum tissues. Results： Compared with group A, the intestinal propulsion rate, content of D-xylose in serum, content of ATP, activities of Na^＋-K^＋-ATPase and Ca^2＋-Mg^2＋-ATP in jejunum tissues decreased significantly in group B （P〈0.05 or P〈O.O1）. Compared with group B, the intestinal propulsion rate, content of D-xylose in serum, content of ATP, activities of Na^＋-K^＋-ATPase and Ca^2＋-Mg^2＋-ATPase in jejunum tissues increased significantly in group C and D （P〈0.05 or P〈0.01）, while there were no significant differences between group C and group D. Conclusion： Moxibustion can increase the intestinal propulsion rate, content of D-xylose in serum and ATP in jejunum tissues, as well as the activities of Na^-K＋-ATPase and Ca^2＋-Mg^2＋-ATPase of spleen-deficiency rats, which suggests that moxibustion can enhance the motility and absorption functions of small intestine by promoting the production of ATP in intestinal epithelial cells, increasing the content of membrane proteins, and improving transmembrane transport.展开更多
文摘The development of liver cirrhosis and portal hypertension(PH), one of its major complications, are structural and functional alterations of the liver, occurring in many patients with chronic liver diseases(CLD). Actually the progressive deposition of hepatic fibrosis has a key role in the prognosis of CLD patients. The subsequent development of PH leads to its major complications, such as ascites, hepatic encephalopathy, variceal bleeding and decompensation. Liver biopsy is still considered the reference standard for the assessment of hepatic fibrosis, whereas the measurement of hepatic vein pressure gradient is the standard to ascertain the presence of PH and upper endoscopy is the method of choice to detect the presence of oesophageal varices. However, several non-invasive tests, including elastographic techniques, are currently used to evaluate the severity of liver disease and predict its prognosis. More recently, the measurement of the spleen stiffness has become particularly attractive to assess, considering the relevant role accomplished by the spleen in splanchnic circulation in the course of liver cirrhosis and in the PH. Moreover, spleen stiffness as compared with liver stiffness better represents the dynamic changes occurring in the advanced stages of cirrhosis and shows higher diagnostic performance in detecting esophageal varices. The aim of this review is to provide an exhaustive overview of the actual role of spleen stiffness measurement as assessed by several elastographic techniques in evaluating both liver disease severity and the development of cirrhosis complications, such as PH and to highlight its potential and possible limitations.
基金Supported by Medical and Health Science and Technology Program of Zhejiang Province,2017,No.2017KY590
文摘AIM To explore the relationship of liver and spleen shear wave velocity in patients with liver cirrhosis combined with portal hypertension,and assess the value of liver and spleen shear wave velocity in predicting the prognosis of patients with portal hypertension.METHODS All 67 patients with liver cirrhosis diagnosed as portal hypertension by hepatic venous pressure gradient in our hospital from June 2014 to December 2014 were enrolled into this study. The baseline information of these patients was recorded. Furthermore,67 patients were followed-up at 20 mo after treatment,and liver and spleen shear wave velocity were measured by acoustic radiation force impulse at the 1^(st) week,3^(rd) month and 9^(th) month after treatment. Patients with favorable prognosis were assigned into the favorable prognosis group,while patients with unfavorable prognosis were assigned into the unfavorable prognosis group. The variation and difference in liver and spleen shear wave velocity in these two groups were analyzed by repeated measurement analysis of variance. Meanwhile,in order to evaluate the effect of liver and spleen shear wave velocity on the prognosis of patients with portal hypertension,Cox's proportional hazard regression model analysis was applied. The ability of those factors in predicting the prognosis of patients with portal hypertension was calculated through receiver operating characteristic(ROC) curves.RESULTS The liver and spleen shear wave velocity in the favorable prognosis group revealed a clear decline,while those in the unfavorable prognosis group revealed an increasing tendency at different time points. Furthermore,liver and spleen shear wave velocity was higher in the unfavorable prognosis group,compared with the favorable prognosis group; the differences were statistically significant(P < 0.05). The prognosis of patients with portal hypertension was significantly affected by spleen hardness at the 3^(rd) month after treatment [relative risk(RR) = 3.481]. At the 9^(th) month after treatment,the prognosis was affected by liver hardness(RR = 5.241) and spleen hardness(RR = 7.829). The differences between these two groups were statistically significant(P < 0.05). The ROC analysis revealed that the area under the curve(AUC) of spleen hardness at the 3^(rd) month after treatment was 0.644,while the AUCs of liver and spleen hardness at the 9^(th) month were 0.579 and 0.776,respectively. These might predict the prognosis of patients with portal hypertension.CONCLUSION Spleen hardness at the 3^(rd) month and liver and spleen shear wave velocity at the 9^(th) month may be used to assess the prognosis of patients with portal hypertension. This is hoped to be used as an indicator of predicting the prognosis of patients with portal hypertension.
文摘Objective:The aim of the study was to investigate the adaptive response of low-dose radiation-induced apoptosis in mouse spleen cells and its related proteins control mechanism. Methods: Kunming male mice were randomly divided into sham-irradiation group, attacking dose irradiation group (D2) and low-dose radiation + attacking dose irradiation group (D1+D2). After a week the D1+D2 group was given low-dose radiation (doses were 25,50,75 and 100 mGy, dose rate of 12.5 mGy/min), after 6 hours the D2 group and the D1+D2 group were given attacking dose of radiation (Dose of 1.5 Gy, dose rate of 287 mGy/min). After 18 hours all mice were killed. The spleen cell apoptosis and Caspase-3 expression's changes were detected by flow cytometry (FCM) analysis, and the changes of apoptosis-related proteins Bcl-2 and Bax were detected by immunohistochemical staining semi-quantitative method. Results: The rate of apoptosis, the fluorescence intensity of Caspase-3, and the semi-quantitative results of apoptosis-related proteins Bcl-2 and Bax in every group were significantly different. Of all groups, the apoptosis rate and Caspase-3 fluorescence intensity of D2 group were the highest. Compared with the sham-irradiated group, Bcl-2 protein level of D2 group decreased significantly, and Bax protein level of D2 group increased significantly. But compared with D2 group, the apoptosis rates, the fluorescence intensities of Caspase-3 expression and the Bax protein levels in D1+D2 group were lower in different doses, and the Bcl-2 protein levels in D1+D2 group were higher in different doses. Conclusion: 25-75 mGy low-dose radiation can induce the adaptive response of mouse spleen cells' apoptosis, the expression of Caspase-3, and the apoptosis-related protein Bcl-2 expression increased, Bax reduced, and it leads to the apoptosis of the spleen cells decreased.
基金supported by the Budding Talent Training Program of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese MedicineShanghai Science & Technology Development Foundation
文摘Objective： To observe the clinical effect of tuina for spleen deficiency infantile diarrhea. Methods： A total of 60 cases were randomized into a treatment group and a control group （30 in each group）. Tuina manipulations were employed in the treatment group, whereas medication was administered in the control group. The between-group clinical effects were compared after one course of treatment. Results： The recovery rate was 20.0% in the treatment group, versus 3.3% in the control group, showing a statistical significance （P〈0.05）. After treatment, there were between-group statistical differences （P〈0.05） in infants＇ main accompanying symptoms such as complexion, spirit, vomiting, and abdominal pain. Conclusion： Tuina is effective for infantile diarrhea due to spleen dficiencv.
基金supported by the Priority Academic Program Development of Jiangsu Higher Education Institutionsthe Open Project Program of Traditional Chinese Medicine Department of Nanjing University of Chinese Medicine(No.YS2012ZYX414)+1 种基金Subject of Hunan Education Department(No.11C0965)Hunan University Innovation Fund Project Open Platform(No.12K088)
文摘Objective： To observe the effect of moxibustion on intestinal propulsion rate, content of serum D-xylose, content of adenosine triphosphate （ATP） and activities of adenosine triphosphatases （ATPase） in jejunum tissues of spleen-deficiency rats, and to explore the effect of moxibustion on the production of ATP and activities of membrane proteins, for analyzing the mechanism of moxibustion in reinforcing the spleen-stomach. Methods： Forty healthy Sprague Dawley rats were randomly divided into four groups, namely group A （blank control group）, group B （model control group）, group C （moxibustion group） and group D （herbs group）. The animal model of spleen-deficiency was established by intragastric administration with Da Huang （Radix et Rhizoma Rhei） infusion. The rats in group C received moxibustion at Zusanli （ST 36）, Zhongwan （CV 124 Guanyuan （CV 4）, Pishu （BL 20） and Weishu （BL 21）. The rats in group D received intragastric administration with 5i Jun Zi decoction. The intestinal propulsion was measured by toner method, and the content of D-xylose in serum was detected by phloroglucinol method. Colorimetry method was used to detect the content of ATP and activities of Na^＋-K^＋-ATPase and Ca^2＋-Mg^2＋-ATPase in jejunum tissues. Results： Compared with group A, the intestinal propulsion rate, content of D-xylose in serum, content of ATP, activities of Na^＋-K^＋-ATPase and Ca^2＋-Mg^2＋-ATP in jejunum tissues decreased significantly in group B （P〈0.05 or P〈O.O1）. Compared with group B, the intestinal propulsion rate, content of D-xylose in serum, content of ATP, activities of Na^＋-K^＋-ATPase and Ca^2＋-Mg^2＋-ATPase in jejunum tissues increased significantly in group C and D （P〈0.05 or P〈0.01）, while there were no significant differences between group C and group D. Conclusion： Moxibustion can increase the intestinal propulsion rate, content of D-xylose in serum and ATP in jejunum tissues, as well as the activities of Na^-K＋-ATPase and Ca^2＋-Mg^2＋-ATPase of spleen-deficiency rats, which suggests that moxibustion can enhance the motility and absorption functions of small intestine by promoting the production of ATP in intestinal epithelial cells, increasing the content of membrane proteins, and improving transmembrane transport.
