Impact of bariatric surgery on glucose and lipid metabolism and liver and kidney function in food-induced obese diabetic rats

BACKGROUND Obesity usually causes diabetes mellitus(DM)and is a serious danger to human health.Type 2 DM(T2DM)mostly occurs along with obesity.Foodborne obesityinduced DM is caused by an excessive long-term diet and surplus energy.Bariatric surgery can improve the symptoms of T2DM in some obese patients.But different types of bariatric surgery may have different effects.AIM To investigate the effect of bariatric surgery on glucose and lipid metabolism and liver and kidney function in rats.METHODS Male Sprague-Dawley rats aged 6-8 wk underwent Roux-en-Y gastric bypass surgery(RYGB),sleeve gastrectomy(SG),or gastric banding(GB).Glucose and insulin tolerance tests,analyses of biochemical parameters,histological examination,western blot,and quantitative real-time polymerase chain reaction were conducted.RESULTS In comparison to the sham operation group,the RYGB,SG,and GB groups had decreased body weight and food intake,reduced glucose intolerance and insulin insensitivity,downregulated biochemical parameters,alleviated morphological changes in the liver and kidneys,and decreased levels of protein kinase Cβ/P66shc.The effect in the RYGB group was better than that in the SG and GB groups.CONCLUSION These results suggest that RYGB,SG and GB may be helpful for the treatment of foodborne obesity-induced DM.

Effects of Noise Pollution on Functions of the Liver and Kidney of Rats

To study the effects of noise pollution on the functions of the liver and kidney of rats, a total of 40 male SPF Wistar rats were randomly divided into a control group and three experimental groups. The rats in the experimental groups were respectively stimulated with 38, 55 and 70 dB noise for 15 days, and the levels of blood components were determined by an automatic biochemical analyzer. The results showed that in compari-son with the control group, the level of the blood glucose in the experimental groups increased by 23.53%, 52.94% and 88.24%, respectively, and the differences were statistically significant （P〈0.01）. The levels of triglyceride in the blood rose by 20.83%, 38.54% and 79.68%, respectively, and the differences were also statistically significant （P〈0.01）. The level of globulin in the blood increased by 16.49%, 21.13% and 51.78%, and the level of albumin in the blood rose by 9.51 %, 12.67% and 17.89%, respectively. The level of total bilirubin in the blood increased by 27.04%, 41.63% and 73.67%, respectively, and the differences were statistically significant （P〈0.01）. The level of creatinine in the blood rose by 9.72%, 10.21% and 20.99%, respectively. The level of amylase in the blood reduced by 6.6%, 13.05% and 23.89%, respectively. The level of creatine kinase in the blood decreased by 19.81%, 27.37% and 36.81 %, respectively, and the level of urea in the blood reduced by 11.19%, 12.77% and 19.26%, respectively. The results revealed that noise pollution could significantly affect the levels of blood components and the functions of the liver and kidney of rats.

Prognostic and diagnostic scoring models in acute alcoholassociated hepatitis:A review comparing the performance of different scoring systems

Alcohol-associated hepatitis(AAH)is a severe form of liver disease caused by alcohol consumption.In the absence of confounding factors,clinical features and laboratory markers are sufficient to diagnose AAH,rule out alternative causes of liver injury and assess disease severity.Due to the elevated mortality of AAH,assessing the prognosis is a radical step in management.The Maddrey discriminant function(MDF)is the first established clinical prognostic score for AAH and was commonly used in the earliest AAH clinical trials.A MDF>32 indicates a poor prognosis and a potential benefit of initiating corticosteroids.The model for end stage liver disease(MELD)score has been studied for AAH prognostication and new evidence suggests MELD may predict mortality more accurately than MDF.The Lille score is usually combined to MDF or MELD score after corticosteroid initiation and offers the advantage of assessing response to treatment a 4-7 d into the course.Other commonly used scores include the Glasgow Alcoholic Hepatitis Score and the Age Bilirubin international normalized ratio Creatinine model.Clinical AAH correlate adequately with histologic severity scores and leave little indication for liver biopsy in assessing AAH prognosis.AAH presenting as acute on chronic liver failure(ACLF)is so far prognosticated with ACLF-specific scoring systems.New artificial intelligence-generated prognostic models have emerged and are being studied for use in AAH.Acute kidney injury(AKI)is one possible complication of AAH and is significantly associated with increased AAH mortality.Predicting AKI and alcohol relapse are important steps in the management of AAH.The aim of this review is to discuss the performance and limitations of different scoring models for AAH mortality,emphasize the most useful tools in prognostication and review predictors of recurrence.

MRI monitoring of lesions created at temperature below the boiling point and of lesions created above the boiling point using high intensity focused ultrasound

Magnetic Resonance Imaging (MRI) was utilized to monitor lesions created at temperature below the boiling point and lesions created at temperature above the boiling point using High Intensity Focused Ultrasound (HIFU) in freshly excised kidney, liver and brain and in vivo rabbit kidney and brain. T2-weighted fast spin echo (FSE) was proven as an excellent MRI sequence that can detect lesions with temperature above the boiling point in kidney. This advantage is attributed to the significant difference in signal intensity between the cavity and the thermal lesion. In liver the MRI sequence of Proton Density is recommended to detect lesions above boiling. In brain T1-W FSE was the optimum pulse sequence to detect lesions of either type. In order to monitor the temperature elevation during a HIFU exposure, T1-weighted fast spoiled gradient (FSPGR) was used. The shape of the focal temperature distribution was uniform with the absence of boiling, whereas with an exposure affected by boiling, the temperature distribution could be of irregular shape, demonstrating the drastic effects taking place during boiling. In order to confirm that boiling occurred, the temperature was estimated using the widely used method of Proton Resonance Frequency (PRF) shift.

Diabetes mellitus is a risk factor of acute kidney injury in liver transplantation patients

Background: Diabetes mellitus has become an increasing global health burden with rapid growing prevalence. Patients with diabetes have higher susceptibility to acute kidney injury(AKI). Liver transplantation(LT) predisposes the kidney to injury. However, the association between diabetes and AKI in LT patients remains unclear. Methods: We conducted a retrospective cohort study examining risk factors for AKI in patients undergone orthotopic LT. Potential risk factors including baseline estimated glomerular filtration rate(e GFR), the model for end-stage liver disease(MELD) score, diabetes, hypertension and intraoperative blood loss were screened. The primary endpoint was AKI occurrence. Multivariate logistic regression was used to analyze the association between potential risk factors and AKI. Results: A total of 291 patients undergone orthotopic LT were included in the present study. Among them, 102 patients(35.05%) developed AKI within 5 days after LT. Diabetes was identified as an independent risk factor for AKI. Patients who developed AKI had worse graft function recovery and higher mortality within 14 days after LT compared to those who did not develop AKI. AKI patients with diabetes had a significant decline of e GFR within the first postoperative year, compared with patients who did not develop AKI and who developed AKI but without diabetes. Conclusions: Diabetes is an independent risk factor for AKI after orthotopic LT. AKI is associated with delayed graft function recovery and higher mortality in short-term postoperative period. Diabetic patients who developed AKI after LT experience a faster decline of e GFR within the first year after surgery.

Enhanced recovery after surgery program in the patients undergoing hepatectomy for benign liver lesions

Background:Enhanced recovery after surgery(ERAS)has shown effectiveness in terms of reducing the hospital stay and cost.However,the benefit of ERAS in patients undergoing hepatectomy for benign liver lesions is still unclear.Methods:ERAS was implemented in our center since March 1st,2018.From September 2016 to Febru-ary 2018,109 patients were enrolled into the control group,and from March 2018 to June 2019,124 patients were enrolled into the ERAS group.All the indicators related to operation,liver functions,and postoperative outcomes were included in the analysis.Results:The clinicopathologic baselines were similar in these two groups.A significantly higher propor-tion of patients underwent laparoscopic surgery in the ERAS group.On the whole,intraoperative blood loss(100.00 mL vs.200.00 mL,P<0.001),blood transfusion(3.23%vs.10.09%,P=0.033),total bilirubin(17.10μmol/L vs.21.00μmol/L,P=0.041),D-dimer(2.08μg/mL vs.2.57μg/mL,P=0.031),postoperative hospital stay(5.00 d vs.6.00 d,P<0.001),and postoperative morbidity(16.13%vs.32.11%,P=0.008)were significantly shorter or less in the ERAS group than those in the control group.After stratified by operation methods,ERAS group showed significantly shorter postoperative hospital stay in both open and laparoscopic operation(both P<0.001).In patients underwent open surgery,ERAS group demonstrated significantly shorter operative duration(131.76±8.75 min vs.160.73±7.23 min,P=0.016),less intra-operative blood loss(200.00 mL vs.450.00 mL,P=0.008)and less postoperative morbidity(16.00%vs.44.44%,P=0.040).Conclusions:ERAS program may be safe and effective for the patients underwent hepatectomy,especially open surgery,for benign liver lesions.

Studies on Preclinical Toxicology of a New Tumor Photolocalizing and Photochemotherapeutic Agent, Photocarcinorin(PsD-007)

Photocarcinorin was prepared in our Lab and its composition was differentfrom that of any other hematoporphyrin photosensitizers by TLC and HPLC analyses.The 95% fiducial limits of iv LD in mice were 176-236 mg·kg-1.The iv MLD indogs was 171 mg·kg-1.The acute and subacutc toxic tests in 37 dogs showed that theintoxicated manifestations were characterized by a complex syndrome always seen inporphyrias.The biological,laboratory and histopathologic findings revealed that theliver,kidney and erythroeytic series were the target organs.The damages were dose-related and reversible within 2 wk.he phototoxicity was determined in mice with UV ra-diation and compared with that of HpD.The extent of its phototoxic reactions waslower than that of HpD’s.

Changes of serum pancreatic stone protein and cholinesterase contents in children with sepsis and their correlation with systemic inflammatory response and target organ damage

Objective: To study the changes of serum pancreatic stone protein (PSP) and cholinesterase (ChE) contents in children with sepsis and their correlation with systemic inflammatory response and target organ damage. Methods: A total of 64 children with sepsis who were treated in the hospital between January 2015 and January 2017 were selected as observation group, and 50 healthy children who received vaccination in the hospital during the same period were selected as normal control group. The contents of PSP, ChE, inflammatory factors as well as liver and kidney function indexes in the two groups were detected. Pearson test was used to assess the correlation of serum PSP and ChE contents with systemic inflammatory response and target organ damage in children with sepsis. Results: Serum PSP content of observation group was higher than that of control group while ChE content was lower than that of control group;serum inflammatory factors PCT, CRP, IL-1, IL-6 and IL-10 contents of observation group were higher than those of normal control group;liver function indexes TBIL, ALT and AST contents were higher than those of normal control group;kidney function indexes Scr and BUN contents were higher than those of normal control group. Pearson test showed that the serum PSP and ChE contents in children with sepsis were directly correlated with the systemic inflammatory response as well as liver and renal function injury. Conclusion: Serum PSP content significantly increases while ChE content significantly decreases in children with sepsis and the specific change is directly correlated with the overall disease severity.

Dynamic monitoring of serum liver function indexes in patients with COVID-19

BACKGROUND Some patients with the novel 2019 coronavirus disease(COVID-19)display elevated liver enzymes.Some antiviral drugs that can be used against COVID-19 are associated with a risk of hepatotoxicity.AIM To analyze the clinical significance of the dynamic monitoring of the liver function of patients with COVID-19.METHODS This was a retrospective study of patients diagnosed with COVID-19 in January and February 2020 at the Department of Infection,Shantou Central Hospital.The exclusion criteria for all patients were:(1)History of chronic liver disease;(2)History of kidney disease;(3)History of coronary heart disease;(4)History of malignancy;or(5)History of diabetes.The serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyltransferase,and total bilirubin of patients with COVID-19 were measured on days 1,3,7 and 14 after admission,and compared to non-COVID-19 patents.RESULTS Twelve patients with COVID-19(seven men and five women)and twelve controls(eight men and four women)were included.There were one,two,and nine patients with severe,mild,and moderate COVID-19,respectively.There were no differences in age and sex between the two groups(both P>0.05).No significant differences were found in albumin,ALT,AST,γ-glutamyltransferase,or total bilirubin between the controls and the patients with COVID-19 on day 1 of hospitalization(all P>0.05).Serum albumin showed a decreasing trend from days 0 to 7 of hospitalization,reaching the lowest level on day 7.Total bilirubin was higher on day 3 than on day 7.ALT,AST,andγ-glutamyltransferase did not change significantly over time.The severe patient was observed to have ALT levels of 67 U/L and AST levels of 75 U/L on day 7,ALT of 71 U/L and AST of 35 U/L on day 14,and ALT of 210 U/L and AST of 123 U/L on day 21.CONCLUSION Changes in serum liver function indicators are not obvious in the early stage of COVID-19,but clinically significant changes might be observed in severe COVID-19.

Evaluation of Anti-Oxidant Status and Radioprotective Activity of a Novel Anti-Cancer Drug in Mice

Various approaches have been developed for diminishing the effects of radiation on normal tissues or enhancing tumor cell killing by ionizing radiation. Recently, there has been an increase in the interest in research on synthetic and/or natural radioprotective agents. An important potential use for these agents is to modify and improve the outcome of radiation therapy. The aim of this study was to examine the potential radioprotective role and antioxidant potency of the novel synthetic anticancer agent, quinoline sulfonamide (PIQSA) against tissue injury and oxidative stress induced by the exposure to gamma radiation and/or incidence of cancer in experimental animals. Mice (normal and bearing solid tumors) administered PIQSA (0.350 mg/kg body weight ip. three times a week for 21 days. At the last week of 30 days experimental period, an animal group was subjected to three successive doses of γ-radiation each of 2 Gy;another group was treated with combined administration of PIQSA 20 minutes before γ-irradiation. Some biochemical parameters (LPx, GSH, SOD, and CAT in liver homogenates, also plasma lipid profile (total lipids, total cholesterol, total triglycerides (TG), HDLc and LDLc were measured. To examine any adverse effect which could be attained by chemical treatment, liver enzymes (AST, ALT), and kidney function (creatinine and urea) were estimated in blood plasma, in addition to examination of some haematological indexes. The results indicated that the deleterious effects due to exposure to γ-radiation, and/or incidence of cancer on most of the estimated parameters could be controlled to a certain extent by administration of PIQSA to animals prior to irradiation. The results also confirmed that there were no significant adverse effects on mice due to the treatment with this chemical compound.

Value of serum PCT content for evaluating inflammatory factor release and organ function injury in neonatal septicemia

Objective: To explore the value of serum PCT content for evaluating inflammatory factor release and organ function injury in neonatal septicemia. Methods: 48 children who were diagnosed with neonatal septicemia in our hospital between March 2015 and May 2018 were selected as the septicemia group, and 50 healthy neonates delivered in our hospital during the same period were selected as the normal control group. The differences in PCT and inflammatory factor contents in serum as well as liver and kidney function index levels in peripheral blood were compared between the two groups. Pearson test was used to evaluate the correlation of serum PCT content with inflammatory factor release as well as liver and kidney function injury in children with neonatal septicemia. Results: The serum PCT content of septicemia group was significantly higher than that of normal control group;serum hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-8 (IL-8) and soluble intercellular adhesion molecule-1 (sICAM-1) contents were higher than those of normal control group;peripheral blood aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γ-GGT) and alkaline phosphatase (ALP) levels were higher than those of normal control group;peripheral blood blood urea nitrogen (BUN), serum creatinine (Scr) and serum β2-microglobulin (β2-M) levels were higher than those of normal control group (P<0.05). Correlation analysis showed that serum PCT content in children with neonatal septicemia was directly correlated with the degree of inflammatory response as well as the degree of liver and kidney function injury (P<0.05). Conclusion: The serum PCT content abnormally increases in children with neonatal septicemia, and the specific content is consistent with the disease severity and has certain clinical value for the judgment of children's condition.

Serum RAAS molecules and their relationship with the systemic inflammatory response and target organ function in patients with severe acute pancreatitis

Objective:To explore the relationship of renin-angiotensin-aldosterone system (RAAS) activity with the systemic inflammatory response and target organ function in patients with severe acute pancreatitis.Methods: A total of 78 patients with severe acute pancreatitis who were treated in our hospital between August 2012 and March 2016 were selected as the observation group, and 50 healthy people who underwent physical examination in our hospital during the same period were selected as the normal control group. The differences in the contents of RAAS indexes, inflammation indexes as well as liver and kidney function indexes were compared between the two groups, and Pearson test was used to evaluate the correlation between RAAS activity and illness in patients with severe acute pancreatitis. Results: Serum RAAS indexes E, Ang-Ⅱ and ALD levels of observation group were higher than those of normal control group;serum inflammation indexes IL-6, IL-8, IL-10 and CRP levels were higher than those of normal control group;serum liver function indexes ALP,γ-GT and AST levels were higher than those of normal control group;serum kidney function indexes Scr, BUN and UA levels were higher than those of normal control group. The RAAS activity of patients with severe acute pancreatitis was directly correlated with serum levels of inflammation indexes as well as liver and kidney function indexes.Conclusion: The RAAS activity increases in patients with severe acute pancreatitis, and the specific increase extent is consistent with systemic inflammatory response as well as liver and kidney function damage.

Effect of mixing lard with soybean oil in cooking on hepatic antioxidative ability and renal metabolic activity

A simulate daily oriental dietary pattern(a blend of lard and soybean oil)was performed in this research to investigate influence on liver and kidney function.Sixty mice were randomly divided into 6 groups with diets of different fat added oils respectively for 12 weeks.Malondialdehyde and uric acid contents in mice fed with blended oil were significantly lower than in those fed only with soybean oil and lard due to the improved activities of antioxidant enzymes.Daily use of a blend of lard with soybean oil significantly increased antioxidant capacity,reduced lipid peroxidation of liver and serum uric acid production,thus protected liver and renal function.It also suggests that the oriental dietary pattern might reduce the risk of gout.

Biochemical,Enzymatic,and Immunological Study on Antimutagenic Achillea millefolium Methanolic Extract in vivo

Traditionally medicinal plants are used for its potential chemotherapeutic action and for safety upon the continued use of these plants.Achillea millefolium(AM)is an ancient herb which is used to treat wounds,headaches,disorder in gastrointestinal and hepatobiliary,pain,and inflammation.This study was aimed to investigate the biochemical parameter of antimutagenic methanolic extract for AM in vivo.Plant extract together with MTX decreased the damage caused by the drug on the concentrations of total cholesterol and triglycerides(160.3±2.26 and 108.7±2.71),significant increase in total protein concentration(8.51±0.17,9.46±0.19 and 10.8±2.71 g\dL)for 100 and 200 mg\kg was observed.Also plant extracts counteract the damage caused by drug through the reduction for both creatinin and albumin concentrations to 1.57±0.03 mg\dL and 4.56±0.09 g\dL,respectively.On enzymatic level,the results of interactions indicated the ability of plant to modulating harmful effects of the drug(57.1±1.3,130±3.1 and 111.1±2.1 U\L)for GOT,GPT and ALP,respectively.On the other hand,the plant possesses the ability to enhance the concentrations of all immunoglobulin(IgM,IgA and IgG)in the two doses tested.Therefore,the results of this study indicate the antimutagenic potential of AM extract and encouraging its consumption with MTX as one of the promising therapies.

Effects of hemoperfusion combined with hemodialysis on target organ damage in patients with acute paraquat poisoning

Objective: To investigate the effects of hemoperfusion combined with hemodialysis on target organ damage in patients with acute paraquat poisoning. Methods: A total of 42 patients with acute paraquat poisoning who were admitted and treated in our hospital between December 2013 and October 2017 were selected as the research subjects, and their therapies were reviewed and used to divide them into the control group (n=20) who received hemoperfusion alone and the combined treatment group (n=22) who received hemoperfusion combined with hemodialysis. The differences in the levels of liver and kidney function indexes in peripheral blood as well as lung function indexes in arterial blood were compared between the two groups of patients immediately after admission, after 1 d of treatment and after 3 d of treatment. Results: Immediately after admission, the differences in the levels of liver and kidney function indexes in peripheral blood as well as lung function indexes in arterial blood were not statistically significant between the two groups. After 1d of treatment and after 3 d of treatment, kidney function indexes Scr, BUN and β2-MG levels in peripheral blood of combined treatment group were lower than those of control group at corresponding time points respectively;liver function indexes ALT, AST, TB and ALP levels in peripheral blood were lower than those of control group at corresponding time points respectively;lung function indexes PaO2, BE and PCO3- levels in arterial blood were higher than those of control group at corresponding time points respectively whereas PaCO2 levels were lower than those of control group at corresponding time points respectively. Conclusion: Compared with hemoperfusion alone, hemoperfusion combined with hemodialysis is more advantageous in protecting the functions of liver, kidney, lungs and other target organs of patients with acute paraquat poisoning.

肝功异常川崎病患儿发生冠状动脉损伤直接危险因素分析

目的探讨肝功异常川崎病患儿发生冠状动脉损伤(CAL)的直接危险因素。方法选择2020年9月至2022年8月在青岛市妇女儿童医院就诊的96例川崎病患儿作为实验组,根据谷丙转氨酶(ALT,ALT>50U/L为肝功异常)分为肝功正常组50例和肝功异常组46例;选择58例同期同年龄段呼吸科肺炎患儿作为对照组。对3组患儿均进行C-反应蛋白(CRP)、D-二聚体(D-D)、高密度脂蛋白胆固醇(HDL-C)、N端脑钠肽前体(NT-proBNP)的检测;同时对实验组进行超声心动图检查,比较川崎病两组之间CAL发生的比率。结果实验组患儿CRP、D-D、NT-proBNP的水平均明显高于对照组,HDL-C明显低于对照组(Z/t=603.00、588.00、48.00、6.65,均P<0.05);肝功异常组患儿CRP、D-D、NT-proBNP的水平均明显高于肝功正常组,HDL-C明显低于肝功正常组(Z/t=682.50、408.00、487.00、3.13,均P<0.05);超声心动图结果显示肝功异常组CAL发生率明显高于肝功正常组(χ2=5.16,P<0.05)。CRP、D-D、NT-proBNP及HDL-C水平预测肝功异常川崎病患儿并发CAL的ROC曲线结果显示,AUC分别为0.70、0.71、0.72、0.73;最佳临界值分别为64.88mg/L、2.05mg/L、1148.62pg/mL、0.66mmol/L;灵敏度分别为0.54、0.70、0.63、0.74;特异性分别为0.88、0.82、0.80、0.72;4个指标联合检测的AUC为0.84,灵敏度为0.89,特异性为0.63。结论CRP、D-D、NT-proBNP升高,HDL-C降低与川崎病发生密切相关;上述4个指标的变化可作为预测肝功异常川崎病患儿并发CAL的直接危险因素,且联合检测可提高诊断及预测价值。

Two cases of combined liver-kidney transplantation

To report the clinical experiences of simultaneous hepatorenal transplantation Methods We performed simultaneous hepatorenal transplantation in one patient with liver cirrhosis of hepatitis B and uremia of chronic nephritis on February 1, 1999 and one patient with liver cirrhosis of hepatitis B complicated by hepatorenal syndrome on March 12,1999 The donors were heart arrest cases Rapid multiple organ harvesting techniques and UW solution infusion in situ were used Liver and kidney transplantation were orthotopic and ordinary methods, respectively Immunosuppressive drugs consisted of cyclosporine, Cellcept, ALG and cortstco steroids Lamividine was used on day 50 and day 40 postoperation, respectively Results Both transplanted organs rapidly achieved normal function postoperation and the patients recovered well but suffered mild kidney rejection day 110 postoperation in No 1 patient In No 2 patient, acute renal function failure, mental symptoms, muscle spasm, cerebral artery thrombosis, inhalation pneumonia and chronic liver graft rejection ensured sequentially but were controlled The patients have survived for more than nine and eight months, respectively, with normal life quality Conclusions Combined hepatorenal transplant is a radical treatment method for liver and kidney function failure and requires more comprehensive techniques than isolated single organ transplantation Preventing the recurrence of hepatitis B by oral lamividine may be a key to long term survival

生化检验项目在肝硬化疾病诊断中的临床价值研究

目的 研究肝硬化疾病诊断中应用生化检验项目的价值。方法 选取2021年1月-2022年12月常熟市第五人民医院60例确诊为肝硬化疾病的患者(肝硬化组)与60例非肝硬化疾病患者(非肝硬化组)为研究对象,分别作为肝硬化组和非肝硬化组,比较两组肝功能指标、纤维病变情况及肝硬化分级患者纤维病变情况。结果肝硬化组胆碱酯酶(2 235.12±69.14)U/L、总蛋白(12.54±1.32)g/L低于非肝硬化组(8 320.12±87.15)U/L、(85.02±5.12)g/L,差异有统计学意义(t=423.697、106.181,P<0.05)。肝硬化组总胆红素、γ-谷氨酰转肽酶、天冬氨酸氨基转移酶、丙氨酸氨基转移酶水平高于非肝硬化组,差异有统计学意义(P<0.05)。肝硬化组Ⅲ型前胶原、层粘连蛋白、透明质酸水平均高于非肝硬化组,差异有统计学意义(P<0.05)。A级患者Ⅲ型前胶原、层黏连蛋白水平高于B级患者,且B级患者高于C级患者,差异有统计学意义(P<0.05)。A级患者透明质酸水平低于B级患者,且B级患者低于C级患者,差异有统计学意义(P<0.05)。结论 肝硬化疾病诊断中应用生化检验项目能够区分患者与非患者的肝功能状况,了解肝组织纤维病变状况,并可以将肝硬化患者精准分级,为肝硬化疾病诊断及治疗提供重要的检验支持。

水飞蓟宾胶囊联合常规治疗对酒精性肝病伴早期肝纤维化病变患者血清氧化损伤和肝功能的影响

目的:探讨水飞蓟宾胶囊联合常规治疗对酒精性肝病(ALD)伴早期肝纤维化病变患者血清氧化损伤和肝功能的影响。方法:选取2013年4月-2015年1月到我院就诊的ALD伴早期肝纤维化病变患者,按随机数字表法分为对照组和研究组,每组38例。对照组予以常规对症治疗措施[戒酒、口服肌苷片(0.4 g/次,每日2次)、补充维生素和微量元素等];研究组在对照组治疗基础上口服水飞蓟宾胶囊(70 mg/次,每日2次),持续治疗48周。比较两组患者临床疗效及不良反应发生率差异,记录治疗前、后血清氧化损伤指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]、肝纤维化指标[层粘连蛋白(LN)、透明质酸(HA)、Ⅳ型胶原(Ⅳ-C)、Ⅲ型前胶原(PCⅢ)]及肝功能指标[血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)]变化情况。结果:治疗前两组患者基线资料比较差异无统计学意义(P>0.05)。治疗后,研究组患者总有效率明显高于对照组(P<0.05),两组患者不良反应发生率差异无统计学意义(P>0.05)。与治疗前比较,两组患者血清MDA水平、肝纤维化指标和肝功能指标水平均明显降低(P<0.05),SOD水平明显升高(P<0.05),其中研究组改善效果较对照组更明显(P<0.05)。结论:水飞蓟宾胶囊联合常规治疗可增强ALD伴早期肝纤维化病变患者的临床疗效,主要表现为改善氧化应激、调节肝功能、抑制肝纤维化病变进程。

肝硬化门脉高压性胃病血清胃蛋白酶原的变化及意义

目的测定肝硬化者血清PG的水平,探讨肝硬化发生胃粘膜病变时胃粘膜的功能状态。方法胃镜观察已确诊的51例肝硬化患者胃粘膜病变,快速尿素酶实验或碳13呼气实验明确幽门螺杆菌感染情况,肝功能进行Child-Pugh分级,乳胶增强免疫比浊法检测血清PG(PGⅠ、PGⅡ)浓度,得出PGⅠ/PGⅡ值(PGR),数据进行统计学分析。结果血清PGⅠ水平比较,肝硬化PHG组明显低于无PHG组及对照组,差异有统计学意义,PGⅡ、PGR差异无统计学意义。肝硬化幽门螺杆菌感染与无幽门螺杆菌感染两组间比较PGⅡ、PGR比较有差异。肝硬化肝功能分级组间及酒精性肝硬化与乙肝肝硬化比较血清PG水平均无明显差异。结论肝硬化合并PHG时血清PGⅠ水平明显降低,胃粘膜损伤可达固有层,分泌功能降低;幽门螺杆菌可以影响PGⅡ水平;血清PG水平与肝功能无明显关系;血清PG水平尤其PGⅠ在一定程度上可以反映肝硬化胃粘膜功能状态。