丽珠肠乐（回春生）对肝硬化的疗效观察

丽珠肠乐（回春生）为双歧杆菌活菌制剂,给７３例肝硬化失代期病人口服２２～６７天。治疗前后分别检测血内毒素含量及肝功能,观察其疗效。结果表明本制剂对肝硬化的疗效明显,总有效率为７９．４５％,其中内毒素水平治疗后明显下降,与治疗前比较,Ｐ＜０．０１,有效率为８７．６７％。肝功能各指标有不同程度的改善,有效率７８．０８％。说明回春生是当代最新的微生态调节剂。     

微生态制剂治疗肝硬化肠功能紊乱患者的临床观察

目的探讨微生态制剂治疗肝硬化肠功能紊乱患者的疗效。方法选择80例肝硬化肠功能紊乱患者,随机分成治疗组和对照组。治疗组:常规保肝治疗加金双歧(4粒/次,2次/d);对照组:常规保肝治疗。疗程均为4周。结果治疗组和对照组相比,腹胀、腹泻、腹部不适症状明显改善,血氨水平降低,血浆内毒素水平下降,2组相比差异有显著性(P<0.05)。结论微生态制剂对于改善肝硬化患者临床症状有肯定的价值,并可降低血氨及血浆内毒素水平,有利于肝功能的改善。     

苍牛防己黄芪汤联合西医疗法治疗乙肝肝硬化腹水的临床疗效

为探究苍牛防己黄芪汤联合西医疗法对乙肝肝硬化腹水患者的临床疗效,本研究以2016年5~10月期间我院收治的64例乙肝肝硬化腹水患者为研究对象,随机分成两组,每组32例,对照组使用常规西医疗法,治疗组在西医疗法的基础上再配合苍牛防己黄芪汤治疗。观察并比较两组患者连续治疗1个月后的中医症候疗效、腹水复发率临床疗效差异。结果显示,治疗组的中医症候积分均明显低于对照组,治疗组的中医症候疗效和临床综合疗效明显优于对照组,治疗组的腹水复发率明显低于对照组。这表明,苍牛防己黄芪汤辅助西医基础治疗可有效改善乙肝肝硬化腹水患者中医症候症状,提升治疗效果,降低治疗后腹水复发率,为乙肝肝硬化腹水患者临床治疗提供参考。     

微生态制剂在肝硬化肠功能紊乱患者的治疗作用

目的 研究肠道微生态制剂对肝硬化肠功能紊乱患者的治疗作用。方法 选择100例肝硬化肠功能紊乱患者,随机分成治疗组和对照组,治疗组予培菲康、乳果糖口服28d。观察2组患者治疗前后临床症状,检测治疗前后血氨和血浆内毒素。结果 与对照组相比,治疗组临床症状有明显改善,血氨水平降低,血浆内毒素水平下降,与对照组差异均有显著性（P〈0．05）。结论 肝硬化肠功能紊乱患者存在肠道菌群失调,微生态制剂可有效改善肝硬化肠功能紊乱患者临床症状,并降低血氨及血浆内毒素,减少并发症发生率。     

枯草杆菌二联活菌预防肝硬化上消化道出血后并发症的临床疗效研究

目的:探讨枯草杆菌二联活菌预防肝硬化上消化道出血后自发性细菌性腹膜炎(SBP)和肝性脑病(HE)等并发症的疗效。方法:将60例确诊为肝硬化合并上消化道出血患者随机分为对照组和治疗组(各30例),对照组采用常规综合治疗,治疗组在常规综合治疗基础上加用枯草杆菌二联活菌制剂,连续治疗2周后观察两组疗效及肝功能指标治疗前后的变化情况。结果:治疗组和对照组预防SBP的有效率分别为83.3%和56.7%,差异有统计学意义(P0.05);预防肝性脑病的有效率分别为83.3%和80%,差异无统计学意义(P0.05)。两组治疗后ALT、AST和ALB水平均明显改善,且治疗组改善较对照组更为显著,差异有统计学意义(P0.05)。结论:在基础治疗前提下,枯草杆菌二联活菌可预防肝硬化上消化道出血后SBP的发生,且有利于肝功能的改善。     

肠道菌群调整对肝硬化病人临床症状及实验室指标的观察

目的研究肝硬化与肠道菌群的关系。方法应用常规保肝治疗和加用回春胶囊两组共６８例进行观察。结果治疗组与对照组在临床症状、生化指标及肠道菌群方面相比较均有明显改善。结论双歧杆菌活菌制剂有利于维护肝硬化患者的肠道微生态平衡,减少内毒素的产生、吸收,使病情稳定并向好的趋势转化。     

应用回春生制剂对肝硬化,各型肝炎治疗效果的观察

取从一健康成人分出的青春型双歧杆菌制成活菌制剂,观察其对肝硬化和各型肝炎的疗效。实验组患者除接受与对照组同样的常规治疗外,加服回春生。检测实验组和对照组麝香草酚浊度试验(TTT)并进行比较,结果表明,用回春生治疗后,肝硬化组34例(P<0.05),慢性活动性肝炎组39例(P<0.01),急性黄疸性肝炎组21例(P<0.05)TTT 比值均明显低于对照组相应为21,32,19例,提示:回春生影响患者肝脏内促进改善蛋白代谢具有较好的调节作用。     

复合益生菌活菌制剂对肝硬化患者肠道菌群的影响

目的:观察肝硬化患者口服三联活菌后肠道菌群、血氧及血浆内毒素的变化.方法:选择肠道菌群中具有代表性的细菌进行培养和计数.42例肝硬化患者给予三联活菌治疗21 d.测定治疗前后肠道菌群菌落计数、血氨(干片法)、血浆内毒素(改良鲎试验法).结果:与正常对照组相比,肝硬化组患者存在不同程度的肠道菌群失调,主要表现为双歧杆菌减少(10.12±0.71比9.27±1.25,P＜0.05).治疗后,双歧杆菌由9.27±1.25增至10.43±1.25,差异有显著性(P＜0.01).且血氨水平降低,并可降低肝硬化患者血浆内毒素水平[(109.21±12.23)pg/ml比(71.46±9.12)pg/ml,P＜0.05].结论:肝硬化患者存在肠道菌群失调.益生菌制剂可有效改善肝硬化患者肠道菌群失调,并降低血氨及血浆内毒素.     

微生态制剂对预防肝硬化自发性腹膜炎再发的疗效观察及护理体会

目的探讨常规保肝基础上联合微生态制剂对肝硬化自发性腹膜炎再发的疗效及护理措施。方法选取选取2011年10月至2013年6月来我院治疗的肝硬化自发性腹膜炎患者48例,随机分为微生态治疗组及对照组,微生态治疗组行常规保肝治疗并加用微生态制剂,对照组仅行常规保肝治疗,比较1年内两组患者自发性腹膜炎的再发情况及再发时各症状缓解时间的变化,并总结护理措施。结果微生态治疗组再发率明显低于与对照组再发率,差异有统计学意义(P0.05);微生态治疗组的各项症状的缓解时间也明显少于对照组,差异有统计学意义(P0.05)。结论在常规保肝基础上加服微生态制剂可以有效地预防肝硬化患者自发性腹膜炎再发,并能显著缩短再发时各症状的缓解时间。同时,护理人员的正确护理是保证治疗顺利进行,并改善患者预后的关键。     

三株口服液对门脉高压症术后的疗效观察

三株口服液双歧杆菌是复合制剂,经６９例门脉高压症术后（断流术）病人口服１５ｄ－２８ｄ。治疗前后分别检测血内毒素含量及肝功能并观察其临床症状的改变。结果表明：本制剂对门脉高压病术后的疗效明显。总有效率为７９．８％,其中内毒素水平治疗后明显下降,与治疗前比较,Ｐ＜０．０５,有效率为８６．９５％。肝功能各项指标有不同程度的改善,有效率为７８．２６％,腹胀亦明显改善。     

回春生治疗肝硬化双盲法临床疗效观察

回春生是大连医学院微生态学研究室研制的活菌制剂。给肝硬化患者口服,进行临床双盲观察。结果表明,对实验组(20例)和对照组(20例)进行比较,LLT(p<0.005),A/G(p<0.05),TTT(p<0.005)两组具有显著性差异。提示双歧杆菌制剂对肝硬化患者具有辅助治疗作用。     

The Limulus Lysate Endotoxin Assay as a Test of Microbial Quality of Ground Beef

The Limulus lysate test (LLT) for endotoxin assay has been found to be an excellent, simple and rapid test of microbial quality of refrigerated ground beef. In fresh ground beef held at 5°C for 7–12 d, LLT titres increased from 10²–10⁵ and correlated very highly with extract-release volume (ERV) data and total viable Gram negative counts at both 5° and 30°C. The LLT was negative for fresh beef containing low numbers of bacteria and on aged beef in the absence of increasing numbers of Gram negative bacteria. Of 14 Gram negative meat isolates, all gave a positive LLT while none of eight miscellaneous Gram positive bacteria did. The use of this test provides objective information on the microbial quality of fresh refrigerated ground meats in 1 h. Based upon this study, it is suggested that a 0·1 ml inoculum from a 10³ dilution of good quality ground beef should produce a negative lysate test and thus serve as an additional rapid screening test of meat microbial quality.     

回春生治疗急性肝炎双盲法临床疗效观察

回春生是双歧杆菌的活菌制剂,给急性肝炎患者口服,进行临床双盲观察试验。结果表明,在200例实验组和20例对照组中,LLT,GPT,A/G比值均有显著性差异(P<0.005,P<0.001,P<0.01))。提示双歧杆菌制剂对肝炎,尤其是伴有内毒素血症的肝炎患者有较好的辅助治疗作用。     

超声随访在肝硬化结节恶变筛查及诊断中的价值研究

目的:研究超声随访在肝硬化结节恶变筛查及诊断中的价值。方法:选取我院收治的乙肝后肝硬化患者83例,均采取超声检查,观察超声随访在肝硬化结节恶变筛查及诊断中的应用价值。结果:本组83例随访发现,出现肝硬化伴增生性结节患者演变小肝癌21例。增生性结节患者的增生性结节直径与小肝癌患者肿块直径比较,差异无统计学意义(P0.05)。增生性结节患者的回声情况与小肝癌患者比较,差异有统计学意义(P0.05)。超声随访发现,结节由112个增加至126个,结节数量增加。肝硬化结节14例,在超声引导下行肝穿刺活检,成功13例,失败1例,病理诊断肝硬化结节患者9例,肝癌患者3例,与超声的检查结果相同。结论:超声随访在肝硬化结节恶变的筛查诊断中具有较高的临床价值,可在早期提供较为准确的检查结果,帮助医师做出诊断,及早治疗以改善预后。     

Advanced oxidation protein products and inflammatory markers in liver cirrhosis: a comparison between alcohol-related and HCV-related cirrhosis

Advanced oxidation protein products (AOPPs) are protein markers of oxidative stress with pro-inflammatory properties that accumulated in liver cirrhosis. In the present study, we investigated the association between chronic inflammatory response triggered by AOPPs and the severity of liver disease as assessed by the Child-Pugh score. Plasma concentrations of AOPPs and inflammatory markers such as C-reactive protein, tumor necrosis factor-α, and interleukin-6 were measured in 41 patients with HCV-related cirrhosis, 43 patients with alcohol-related liver cirrhosis (ALC), and in 30 age and sex matched controls. In comparison with controls, AOPPs were increased in HCV-related compensated (Child-Pugh A) and decompensated (Child-Pugh B-C) cirrhosis and in alcohol-related compensated cirrhosis. AOPPs level positively correlated with Child-Pugh score in alcohol-related cirrhosis but not in HCV-related cirrhosis and the correlation with the indices of chronic inflammation was stronger in ALC. In turn, AOPPs in HCV-related cirrhosis was related to inflammation to a lesser extent, but a significant correlation with antioxidant defense could be noted. In summary, liver cirrhosis was associated with increased formation of AOPPs, which differed between alcohol-related and HCV-related cirrhosis with respect to the relationship between AOPPs and antioxidant defense, stage of liver cirrhosis, and inflammatory response. The significant correlation between AOPPs accumulation and indices of chronic inflammation, more specifically TNF-α, suggests that oxidative stress may be a mediator of chronic inflammatory state in the early stage of alcohol-related cirrhosis.     

Cell-mediated Immune Responses in Chronic Liver Diseases

Studies of the cell-mediated response to liver antigens, using the leucocyte migration test, in 163 patients with various liver disorders showed that abnormal responses were almost confined to active chronic hepatitis (53% abnormal), primary biliary cirrhosis (64%), and cryptogenic cirrhosis (29%). The test was also abnormal in five out of seven patients with jaundice due to drug hypersensitivity and in one patient with acute infectious hepatitis at a time when mitochondrial antibodies were present in the serum. More of those with active chronic hepatitis on prednisone or azathioprine had normal tests than of those who were untreated, and in 8 out of 10 examined serially during therapy there was an accompanying improvement in leucocyte migration. Abnormal responses to salivary gland or kidney antigens were also found in nearly half of those with features of Sjögren''s syndrome or renal tubular acidosis as part of a multisystem involvement—this, though occurring in cryptogenic cirrhosis, was found with greater frequency in active chronic hepatitis and primary biliary cirrhosis. These cell-mediated immune responses, perhaps triggered by the initial damage to the liver from viral or other agents, may be responsible both for the perpetuation of the liver disease and, because of common surface antigens, for the damage to other organs.     

Nuclear matrix protein expressions in hepatocytes of normal and cirrhotic rat livers under normal and regenerating conditions

We explored the feasibility of studying nuclear matrix protein (NMP) expressions of the hepatocytes in normal and cirrhotic rat livers with liver regeneration after partial hepatectomy. Sixteen Wistar healthy rats were studied with experimental liver regeneration and/or liver cirrhosis. Two-dimensional (2-D) gel electrophoresis was used to generate these NMP compositions from these rat liver samples. Several antibodies against cytokeratin, vimentin, actin, B23, HNF4alpha, and heat shock protein 70 were used for identification by Western blot. Totally, 41 strongly stained protein spots were characterized on the 2-D gels. Thirty-four protein spots were detected in all of these rat livers, of which, cytokeratin, vimentin, actin, HNF4alpha, and heat shock protein 70 were identified. B23 was detected in the regenerated livers. Three protein spots (s33, s34, and s35) were detectable only in NMP preparation extracted from the regenerating rat livers after hepatectomy. Another three protein spots (s36, s37, and s38) were detectable only in NMP preparation extracted from thioacetamide-induced cirrhotic rat livers. Under these conditions including experimental liver regeneration and/or liver cirrhosis, Over thirty higher abundance NMPs of hepatocytes were consistently expressed and considered as common and basic NMPs. Some of the NMPs are specific for liver regeneration and may play a critical role in cell proliferation and cell cycle, and some are specific for liver cirrhosis.     

Hepatocyte growth factor in ascites from patients with cirrhosis.

Hepatocyte growth factor (HGF) stimulating DNA synthesis of adult rat hepatocytes in primary culture was found in the ascites and plasma from patients with liver cirrhosis, but not in those from patients without cirrhosis. HGF was purified about 400-fold in 10% yield from cirrhotic ascites by ultrafiltration, cation-exchange chromatography on a S-Sepharose column, and affinity chromatography on a heparin-Sepharose CL-6B column. The partially purified factor was a heat- and acid-labile cationic protein with a molecular weight of 100,000-150,000. Its effect was half-maximal at 3.8 micrograms/ml, and was additive with those of insulin and epidermal growth factor. HGF in ascites from patients with cirrhosis had the same properties as HGF purified and characterized from rat platelets. These findings suggest that HGF is secreted into the ascites from the plasma or liver of patients with cirrhosis and may increase in the plasma with the development of hepatic impairment and act in repair of the damaged liver of patients with chronic liver disease.