AIM:To study the clinical efficacy of traditional Chinese medicine(TCM)intervention"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"("TTK...AIM:To study the clinical efficacy of traditional Chinese medicine(TCM)intervention"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"("TTK")for treating liver failure due to chronic hepatitis B.METHODS:We designed the study as a randomized controlled clinical trial.Registration number of Chinese Clinical Trial Registry is Chi CTR-TRC-12002961.A total of 144 patients with liver failure due to infection with chronic hepatitis B virus were enrolled in this randomized controlled clinical study.Participants were randomly assigned to the following three groups:(1)a modern medicine control group(MMC group,36patients);(2)a"tonifying qi and detoxification"("TQD")group(72 patients);and(3)a"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"("TTK")group(36patients).Patients in the MMC group received general internal medicine treatment;patients in the"TQD"group were given a TCM formula"tonifying qi and detoxification"and general internal medicine treatment;patients in the"TTK"group were given a TCM formula of"TTK"and general internal medicine treatment.All participants were treated for 8 wk and then followed at 48 wk following their final treatment.The primaryefficacy end point was the patient fatality rate in each group.Measurements of various virological and biochemical indicators served as secondary endpoints.The one-way analysis of variance and the t-test were used to compare patient outcomes in the different treatment groups.RESULTS:At the 48-wk post-treatment time point,the patient fatality rates in the MMC,"TQD",and"TTK"groups were 51.61%,35.38%,and 16.67%,respectively,and the differences between groups were statistically significant(P<0.05).However,there were no significant differences in the levels of hepatitis B virus DNA or prothrombin activity among the three groups(P>0.05).Patients in the"TTK"group had significantly higher levels of serum total bilirubin compared to MMC subjects(339.40μmol/L±270.09μmol/L vs 176.13μmol/L±185.70μmol/L,P=0.014).Serum albumin levels were significantly increased in both the"TQD"group and"TTK"group as compared with the MMC group(31.30 g/L±4.77g/L,30.72 g/L±2.89 g/L vs 28.57 g/L±4.56 g/L,P<0.05).There were no significant differences in levels of alanine transaminase among the three groups(P>0.05).Safety data showed that there was one case of stomachache in the"TQD"group and one case of gastrointestinal side effect in the"TTK"group.CONCLUSION:Treatment with"TTK"improved the survival rates of patients with liver failure due to chronic hepatitis B.Additionally,liver tissue was regenerated and liver function was restored.展开更多
目的:研究脐血间充质干细胞(UCMSC)对全身X线受照小鼠的肝组织辐射损伤后的防护作用,为相关放射性肝疾病的治疗提供理论依据。方法:选取清洁级SD小鼠进行全身辐射,建立小鼠辐射损伤模型,观察辐射前后小鼠的一般状态;给小鼠注射UCMSC悬浮...目的:研究脐血间充质干细胞(UCMSC)对全身X线受照小鼠的肝组织辐射损伤后的防护作用,为相关放射性肝疾病的治疗提供理论依据。方法:选取清洁级SD小鼠进行全身辐射,建立小鼠辐射损伤模型,观察辐射前后小鼠的一般状态;给小鼠注射UCMSC悬浮液1 m L和等体积生理盐水,分别于处理后第1、2、7、14 d取小鼠肝脏,用苏木精-伊红染色,观察辐射后肝组织病理形态学的变化;取肝脏组织匀浆检测丙二醛(MDA)含量和超氧化物歧化酶(SOD)的活性。结果:辐射组小鼠与正常组小鼠相比活动明显减少,治疗后的小鼠状况有所恢复;肝组织石蜡切片染色显示,按组织学标准评价后各组肝组织比较有显著性差异;辐射组与正常组比较,肝细胞内MDA含量显著升高,SOD活性显著降低,差异有统计学意义;普通组与辐射组比较,肝细胞内MDA含量有所降低,SOD活性有所升高有明显改善作用;加强组与普通组比较,MDA含量降低,SOD活性有所升高。结论:脐血间充质干细胞移植具有清除自由基、减轻肝损伤及修复再生损伤肝细胞的作用,能够有效改善肝脏损伤。展开更多
基金Supported by National Science and Technology Key Projects on"Major Infectious Diseases such as HIV/AIDS,Viral Hepatitis Prevention and Treatment",No.2008ZX10005-007Research Projects of Key Disease of National Traditional Chinese Medicine(Hepatopathy)Clinical Research Center(Hubei Province),No.JDZX2012054+3 种基金National Natural Science Foundation of China,No.81373513,No.90709041,No.30672590,No.30271562,No.30371787,No.81102531 and No.81274147Key Projects of Natural Science Foundation of Hubei Province,No.2011CDB463Specialized Research Fund for the Doctoral Programs in Institution of Higher Education,No.20124230110001Key Subjects of Department of Science and Technology of Wuhan City,No.201260523199
文摘AIM:To study the clinical efficacy of traditional Chinese medicine(TCM)intervention"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"("TTK")for treating liver failure due to chronic hepatitis B.METHODS:We designed the study as a randomized controlled clinical trial.Registration number of Chinese Clinical Trial Registry is Chi CTR-TRC-12002961.A total of 144 patients with liver failure due to infection with chronic hepatitis B virus were enrolled in this randomized controlled clinical study.Participants were randomly assigned to the following three groups:(1)a modern medicine control group(MMC group,36patients);(2)a"tonifying qi and detoxification"("TQD")group(72 patients);and(3)a"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"("TTK")group(36patients).Patients in the MMC group received general internal medicine treatment;patients in the"TQD"group were given a TCM formula"tonifying qi and detoxification"and general internal medicine treatment;patients in the"TTK"group were given a TCM formula of"TTK"and general internal medicine treatment.All participants were treated for 8 wk and then followed at 48 wk following their final treatment.The primaryefficacy end point was the patient fatality rate in each group.Measurements of various virological and biochemical indicators served as secondary endpoints.The one-way analysis of variance and the t-test were used to compare patient outcomes in the different treatment groups.RESULTS:At the 48-wk post-treatment time point,the patient fatality rates in the MMC,"TQD",and"TTK"groups were 51.61%,35.38%,and 16.67%,respectively,and the differences between groups were statistically significant(P<0.05).However,there were no significant differences in the levels of hepatitis B virus DNA or prothrombin activity among the three groups(P>0.05).Patients in the"TTK"group had significantly higher levels of serum total bilirubin compared to MMC subjects(339.40μmol/L±270.09μmol/L vs 176.13μmol/L±185.70μmol/L,P=0.014).Serum albumin levels were significantly increased in both the"TQD"group and"TTK"group as compared with the MMC group(31.30 g/L±4.77g/L,30.72 g/L±2.89 g/L vs 28.57 g/L±4.56 g/L,P<0.05).There were no significant differences in levels of alanine transaminase among the three groups(P>0.05).Safety data showed that there was one case of stomachache in the"TQD"group and one case of gastrointestinal side effect in the"TTK"group.CONCLUSION:Treatment with"TTK"improved the survival rates of patients with liver failure due to chronic hepatitis B.Additionally,liver tissue was regenerated and liver function was restored.
文摘目的有研究表明人羊膜间充质干细胞(human amniotic mesenchymal stem cells,h AMSCs)具有多种分化和增殖功能,其可以诱导分化成肝样细胞,从而对肝损伤有一定的修复作用。方法体外复苏培养人羊膜间充质干细胞,66只健康雌性Wistar大鼠,随机取22只,不做任何处理为正常对照组,余44只采用白酒灌胃30 d的方式建立大鼠慢性酒精性肝损伤模型,建模后将其随机分为模型组(尾静脉注射1 m L PBS),h AMSCs组(经尾静脉注入1 m L h AMSCs(2×106个),每组各22只。于移植后4周,采用全自动生化分析仪分别检测各组大鼠血清丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、血清总胆红素(TBIL)、血清白蛋白(ALB)、血清总蛋白(Tp);同时检测检测各组大鼠肝脏超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)、过氧化氢酶(CAT)、以及丙二醛(MDA)、IL-4含量变化;免疫荧光显微镜观察PKH-26标记的h AMSCs分布情况,TUNEL法检测各组肝细胞凋亡情况。结果各组大鼠血生化检测结果显示,与正常对照组比较,模型组中ALT、AST、TBIL、Tp含量均显著升高,而与模型组比较,h AMSCs移植组中ALT、AST、TBIL、Tp含量均显著下降(P<0.05),与正常对照组比较,模型组中ALB含量明显下降,而与模型组比较,h AMSCs移植组中ALB含量明显升高(P<0.05);与模型组比较,h AMSCs移植组SOD、GSH-PX、CAT含量均显著增高,MDA、IL-4含量均显著下降,与正常对照组比较,h AMSCs移植组SOD、GSH-PX、CAT含量均降低,MDA、IL-4含量均升高(P<0.05);移植组可见移植的PKH-26标记阳性的h AMSCs细胞分布于肝脏组织内,其余各组未见此类细胞分布(P<0.05);TUNEL法检测各组肝细胞凋亡可见凋亡细胞数,模型组最多(34.27±5.71),h AMSCs移植组次之(18.42±3.95),正常对照组未见凋亡细胞。结论人羊膜间充质干细胞移植能够改善大鼠肝硬化的血生化指标水平,h AMSCs移植后可以减轻慢性酒精性肝损伤大鼠的肝脏细胞凋亡。
文摘目的:研究脐血间充质干细胞(UCMSC)对全身X线受照小鼠的肝组织辐射损伤后的防护作用,为相关放射性肝疾病的治疗提供理论依据。方法:选取清洁级SD小鼠进行全身辐射,建立小鼠辐射损伤模型,观察辐射前后小鼠的一般状态;给小鼠注射UCMSC悬浮液1 m L和等体积生理盐水,分别于处理后第1、2、7、14 d取小鼠肝脏,用苏木精-伊红染色,观察辐射后肝组织病理形态学的变化;取肝脏组织匀浆检测丙二醛(MDA)含量和超氧化物歧化酶(SOD)的活性。结果:辐射组小鼠与正常组小鼠相比活动明显减少,治疗后的小鼠状况有所恢复;肝组织石蜡切片染色显示,按组织学标准评价后各组肝组织比较有显著性差异;辐射组与正常组比较,肝细胞内MDA含量显著升高,SOD活性显著降低,差异有统计学意义;普通组与辐射组比较,肝细胞内MDA含量有所降低,SOD活性有所升高有明显改善作用;加强组与普通组比较,MDA含量降低,SOD活性有所升高。结论:脐血间充质干细胞移植具有清除自由基、减轻肝损伤及修复再生损伤肝细胞的作用,能够有效改善肝脏损伤。
