先天性胆总管囊肿合并胆道及肝胰病变的影像学诊断

目的 探讨先天性胆总管囊肿(CCC)伴发胆道、肝脏及胰腺病变的影像学表现特征。 方法 回顾性分析经手术证实的47例CCC多普勒超声及CT表现,47例均行多普勒超声检查,CT扫描13例。 结果 CCC Ⅰ型29例,Ⅱ型3例,Ⅳ型9例,Ⅴ型6例;合并肝内外胆管结石13例,胆囊结石16例,胆囊炎18例,后位胆囊4例,囊肿穿孔3例,肝肿大18例,胰腺肿大17例。结论 CCC并发胆道系统结石、感染及肝胰损害机率较高,多普勒超声及CT检查不应仅满足于CCC的诊断,还应注意其合并病变。

注射硫代乙酰胺及饲喂不同油脂水平饲料建立草鱼肝损伤实验模型

目的通过注射硫代乙酰胺(TAA)及饲喂不同油脂水平饲料建立草鱼肝损伤实验模型。方法 实验草鱼分模型组和对照组,每组分别投喂2.8%油脂组、4.8%油脂组和6.8%油脂组,模型组腹腔注射TAA 300mg/kg,1次/日,注射1 d,共计6个实验组,饲养10周。养殖过程中,于2周、4周和6周对每组实验鱼采血,测定天门冬酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)和AST/ALT。结果①模型组特定生长率显著降低了30.5%(P<0.01),成活率平均为73.33%。模型组草鱼肌肉粗脂肪含量显著降低了17.6%,而肝胰脏粗脂肪含量显著增高了13.38%(P<0.01)。②模型组2周、4周和6周时,模型组血清AST/ALT分别为对照组的1.94倍、1.38倍和1.31倍。10周时,模型组草鱼血清AST/ALT增高了10.10%(P>0.05),而血清胆碱酯酶(CHE)降低了6.38%(P>0.05)。模型组草鱼血清超氧化物歧化酶(SOD)活力显著低于对照组8.56%(P<0.05)。③与对照组相比,模型组肝细胞肿胀且边界模糊,肝细胞部分脂肪病变,有部分炎症浸润,并均出现肝纤维化。结论注射TAA及饲喂不同油脂水平饲料可以诱导草鱼肝损伤实验模型,实验模型具备脂肪肝和肝纤维化病理特征。

Diabetes mellitus, insulin resistance and hepatitis C virus infection: A contemporary review

To summarise the literature data on hepatitis C virus (HCV)-infected patients concerning the prevalence of glucose abnormalities and associated risk.METHODSWe conducted a PubMed search and selected all studies found with the key words 'HCV' or 'hepatitis C virus' and 'diabetes' or 'insulin resistance'. We included only comparative studies written in English or in French, published from January 2000 to April 2015. We collected the literature data on HCV-infected patients concerning the prevalence of glucose abnormalities [diabetes mellitus (DM) and insulin resistance (IR)] and associated risk [i.e., severe liver fibrosis, response to antivirals, and the occurrence of hepatocellular carcinoma (HCC)].RESULTSHCV infection is significantly associated with DM/IR compared with healthy volunteers and patients with hepatitis B virus infection. Glucose abnormalities were associated with advanced liver fibrosis, lack of sustained virologic response to interferon alfa-based treatment and with a higher risk of HCC development. As new antiviral therapies may offer a cure for HCV infection, such data should be taken into account, from a therapeutic and preventive point of view, for liver and non-liver consequences of HCV disease. The efficacy of antidiabetic treatment in improving the response to antiviral treatment and in decreasing the risk of HCC has been reported by some studies but not by others. Thus, the effects of glucose abnormalities correction in reducing liver events need further studies.CONCLUSIONGlucose abnormalities are strongly associated with HCV infection and show a negative impact on the main liver related outcomes.