肝纤维化相关细胞因子的血清学检测对慢性乙型肝炎肝纤维化进程的诊断价值

目的:检测慢性乙型肝炎患者血清中相关细胞因子的水平,为慢性乙型肝炎肝纤维化的分期提供诊断依据。方法:选择175例在我院接受治疗的慢性乙型肝炎患者作为研究对象,采用ELISA方法检测患者血清中基质金属蛋白酶抑制剂(TIMP-1,TIMP-2)、脂连素及其受体(AdipoQ)、瘦素(Leptin)、生长因子(PDGF)、骨桥蛋白(OPN)6项指标的含量,并利用ROC曲线对各指标与肝纤维化分期之间的关系进行相关性分析。结果:TIMP-1、TIMP-2、Leptin在不同纤维化组中呈差异性表达,且AUROC高于其他指标(P0.05);其余指标无统计学意义(P0.05)。结论:TIMP-1、TIMP-2、Leptin这3项指标对慢性乙型肝炎肝纤维化分期具有一定的辅助诊断价值,与其他指标相结合可获得更好的诊断效能。     

旋磁场对健康人和矽肺病人血清铜蓝蛋白活力的影响

目的 :为了解旋磁场对健康人、矽肺患者血清铜蓝蛋白 (Cp)活力的影响。方法 :Cp采用联大茴香胺法进行测定。结果 :在旋磁场中曝磁 30分钟后 ,健康曝磁组血清Cp( 1 0 1 .1 2± 39.35 )与健康对照组血清Cp( 73.0 9± 36.72 )相比活力显著增加 (p <0 .0 5 ) ;矽肺曝磁组血清Cp( 1 63.36± 32 .64)与矽肺对照组血清Cp( 1 2 3.80± 2 8.2 5 )相比活力显著增加 (p <0 .0 1 )。结论 :旋磁场影响健康人和矽肺患者血清铜蓝蛋白的活力。     

核酸适配体在肝纤维化诊断和治疗中的应用

肝纤维化(hepatic fibrosis,HF)是细胞外基质过度沉积引起的慢性肝脏疾病,如不及早发现、治疗,后期会发展成肝硬化甚至肝癌.目前,HF的各种诊断方法都有其不足之处,并且对HF的治疗也尚未有特异有效的药物.适配体是短单链DNA或RNA寡核苷酸序列,可以特异性地识别分子靶点并调节其生物活性,从而对疾病进行诊断...     

血清C反应蛋白在急性脑膜炎鉴别诊断中的应用

血清Ｃ反应蛋白（Ｓ－ＣＲＰ）是一种非特异性的急性炎症产物，不同的刺激因子诱导产生的Ｓ－ＣＲＰ浓度存在差异，故可将Ｓ－ＣＲＰ应用于鉴别细菌性和病毒性疾病。本文就Ｓ－ＣＲＰ测定在细菌性和病毒性脑膜炎鉴别诊断中的应用现状及影响因素作一简要概述。     

大鼠肝纤维化病理分期与肝纤维化血清标志物相关性研究

目的：研究肝纤维化病理组织学分期与血清纤维化标志物门冬氨酸氨基转移酶（AST）与血小板（PLT）比值指数（APRI）、透明质酸（HA）及基质金属蛋白酶抑制物（TIMP-1）的相关性,以探讨非创伤性检测血清蛋白和联合分析血清纤维化标志物的诊断价值。方法：将75只成年健康的SD大鼠采用改良式复合因素法构建大鼠肝纤维化模型,分别在5、6个周后,进行大鼠肝脏穿刺活检病理学组织检查,HE、Masson染色后进行病理组织学分期,同时检测大鼠血清门冬氨酸氨基转移酶（AST）与血小板（PLT）比值指数（APRI）、透明质酸（HA）及基质金属蛋白酶抑制物（TIMP-1）水平。结果：肝脏组织病理学检查发现肝纤维化的分期与炎症活动程度呈明显的正相关（P〈0.05）。而对于区分显著肝纤维化（≥S2）血清标志物指标诊断纤维化的ROC曲线分析发现,HA、TIMP-1、APRI曲线下面积分别为0.921、0.732、0.905。HA＋APRI联合诊断灵敏度为84.1%,特异度为91.2%。TIMP-1＋APRI联合诊断灵敏度为83.2%,特异度为91.7%。结论：利用检测血清纤维化标志物这种对患者无创的检测方法虽不能完全取代病理学活检,但预测肝纤维具有一定的诊断价值,当联合分析两种血清纤维化标志物时,灵敏度和特异度都比单独分析一种标志物要高。     

乙肝患者肝纤维化血清标志物表达水平及其临床意义

目的探讨乙肝患者肝纤维化血清标志物表达水平及其与病情、病程的关系。方法用R IA方法对135例乙肝患者进行血清透明质酸酶(HA)、层粘连蛋白(LN)、Ⅲ型胶原前体(PⅢC)、Ⅳ型胶原(ⅣC)检测。结果乙肝患者血清中HA、LN、PⅢC和ⅣC水平分别为(338.7±122.6)、(226.2±43.3)、(152.8±33.7)和(132.6±41.1)μg/L。其中,急性黄疸肝炎、慢性肝炎轻度、慢性肝炎中度、慢性肝炎重度、肝硬变代偿期、肝硬变失代偿期、肝癌和肝硬变+肝癌患者HA、LN、PⅢC和ⅣC水平分别为(134.2±101.4)、(185.1±104.5)、(373.5±147.1)、(445.5±123.6)、(477.3±186.0)、(653.7±98.5)、(597.5±91.3)和(723.6±110.4)μg/L;(106.7±31.3)、(179.5±28.5)、(234.6±66.1)、(287.3±57.0)、(294.8±66.4)、(345.6±61.2)、(322.1±71.0)和(357.8±88.3)μg/L;(103.5±19.2)、(108.6±21.4)、(145.3±37.3)、(194.5±41.7)、(188.8±39.5)、(247.6±48.0)、(251.3±37.3)和(286.7±35.8)μg/L;(49.6±14.7)、(83.4±15.3)、(134.5±50.5)、(178.7±61.4)、(183.2±61.3)、(256.8±72.4)、(217.7±64.5)和(281.1±57.0)μg/L。结论肝癌、肝硬化、肝硬变+肝癌和慢性肝炎重度患者存在明显的肝纤维化征象,急性黄疸肝炎、慢性肝炎轻度患者肝纤维化程度较轻,在一定范围内肝纤维化程度与肝病的病情、病程关系密切。     

腹部超声联合血清甲胎蛋白、高尔基体蛋白73、γ-谷氨酰转肽酶/血小板比值对慢性乙型肝炎患者肝纤维化的诊断价值研究

摘要 目的：探讨腹部超声联合血清甲胎蛋白（AFP）、高尔基体蛋白73（GP73）、γ-谷氨酰转肽酶/血小板比值（GPR）对慢性乙型肝炎患者肝纤维化的诊断价值。方法：选择新疆维吾尔自治区中医医院2020年3月～2022年2月期间收治的慢性乙型肝炎患者148例,根据肝脏活检病理诊断结果分为无肝纤维化组39例、轻度肝纤维化组33例、中度肝纤维化组51例、重度肝纤维化组25例。比较各组患者入院后腹部超声检查结果及血清AFP、GP73、GPR,应用受试者工作特征（ROC）曲线分析腹部超声联合AFP、GP73、GPR对慢性乙型肝炎患者肝纤维化的诊断价值。结果：随着肝纤维化程度地增加,患者肝脏轮廓逐渐不清晰、表面不光滑、肝脏回声逐渐增粗增强、有结节感、肝内胆管走形逐渐模糊,脂肪肝和腹水比例逐渐增加,脾脏厚度、脾脏长度、门静脉内径、脾静脉内径逐渐增加,经单因素方差分析显示各组超声指标比较差异有统计学意义（P<0.05）。腹部超声对慢性乙型肝炎患者肝纤维化诊断的灵敏度为79.82%、特异度为76.92%、准确度为79.05%。随着肝纤维化程度的增加,患者血清AFP、GP73及GPR逐渐增加,差异均有统计学意义（P<0.05）。ROC曲线分析结果显示,血清AFP、GP73、GPR对慢性乙型肝炎患者肝纤维化诊断具有较高的曲线下面积（AUC）,分别为0.701、0.664、0.779,腹部超声联合血清AFP、GP73、GPR对慢性乙型肝炎患者肝纤维化诊断的AUC最高（AUC为0.819）。结论：慢性乙型肝炎肝纤维化患者血清AFP、GP73、GPR升高,腹部超声联合血清AFP、GP73、GPR对慢性乙型肝炎患者肝纤维化具有较高的诊断价值。     

异种血清诱发肝纤维化模型中ECM变化的研究

为了观察异种血清诱发肝纤维化过程中细胞外基质（ECM）及其生成细胞的变化规律,经腹腔注射猪血清建立大鼠肝纤维化模型,以免疫组织化学方法显示肝内胶原（Col）Ⅰ、Ⅲ、Ⅳ、Ⅴ型和纤连蛋白（Fn）及其生成细胞。结果：①Fn最早在汇管区、小叶间隔内沉积,ColⅢ、Ⅳ、Ⅴ随之增多,停止血清注射后它们都明显减弱或消失;ColⅠ沉积出现最迟,但阳性迅速增强,停止注射后仍较强;②结蛋白（Dm）阳性的肝星状细胞（HSC,原称Ito细胞）其分布和数量变化与Fn和ColⅡ基本同步,而位于汇管区及细胞间隔的原始间叶细胞（PMC）Dm（-）。提示ECM生成细胞可能来自细胞骨架表型不同的PMC和HSC,本模型由于能清晰地显示ECM及其生成细胞而更适用于肝纤维化机制及防治的研究。     

内质网应激信号通路在肝纤维化中的研究进展

肝纤维化是各种因素导致的胶原大量沉积和炎症过度反应的病理过程,严重威胁人类的健康。寻求有效的肝纤维化治疗策略是全球性的医学难题。内质网损伤导致内质网应激,激活未折叠蛋白应答,介导三种跨膜蛋白(PERK、IRE1、ATF6)途径来维持内质网稳态,恢复内质网功能,而长期或过强的应激状态将诱导细胞相关凋亡信号表达和自噬,促进细胞死亡。目前研究发现内质网应激在肝纤维化的发生发展和逆转中起着重要作用。本文就内质网应激信号通路在肝纤维化中的作用进行综述。     

注射用丹酚酸A防治肝纤维化的实验研究

目的：探讨注射用丹酚酸A抗肝纤维化的作用,为丹酚酸A的临床应用提供理论依据。方法采用CCl4体外诱导肝细胞损伤,观察丹酚酸A对肝细胞活性及其细胞培养上清液ALT、AST、LDH水平和细胞裂解液中SOD活性和MDA含量的变化;另采用皮下注射CCl4诱导大鼠肝纤维化模型,观察丹酚酸A对肝纤维化大鼠血清LN、HA、SOD和MDA含量的影响以及肝脏组织病理改变情况。结果与模型对照组比,丹酚酸A高、低剂量组和Vit E组的细胞存活率显著提高（P ＜0.01）,丹酚酸A高剂量组ALT、AST和LDH活性显著降低（P ＜0.01）,丹酚酸A高剂量组和Vit E组SOD活性明显升高（P ＜0.05）,MDA含量显著降低（P ＜0.05）;体内试验发现,与模型对照组比,丹酚酸A高剂量组纤维化大鼠的血清LN和HA水平显著降低（P ＜0.05）,高、低剂量组SOD活性显著升高（P ＜0.05, P ＜0.01）,MDA含量显著降低（P ＜0.01, P ＜0.05）,并能改善肝脏病理形态。结论注射用丹酚酸A可通过抗脂质过氧化作用,起到保护肝细胞,减轻肝纤维化的作用。     

Alpha-lipoic acid inhibits hepatic PAI-1 expression and fibrosis by inhibiting the TGF-β signaling pathway

Accumulating evidence suggests that plasminogen activator inhibitor (PAI)-1 plays an important role in the development of hepatic fibrosis via its involvement in extracellular matrix remodeling. We previously reported that alpha-lipoic acid (ALA), a naturally occurring thiol antioxidant, prevents hepatic steatosis by inhibiting the expression of sterol regulatory element binding protein-1c. The aim of the present study was to determine whether ALA prevents hepatic PAI-1 expression and fibrosis through the inhibition of multiple TGF-β-mediated molecular mediators. We investigated whether ALA inhibited the development of hepatic fibrosis in mice following bile duct ligation (BDL), an established animal model of liver fibrosis. We found that ALA markedly inhibited BDL-induced hepatic fibrosis and PAI-1 expression. We also found that ALA attenuated TGF-β-stimulated PAI-1 mRNA expression, and inhibited PAI-1 promoter activity in liver cells; this effect was mediated by Smads and the JNK and ERK pathways. The results of the present study indicate that ALA inhibits hepatic PAI-1 expression through inhibition of TGF-β-mediated molecular mediators, including Smad3, AP1, and Sp1, and prevents the development of BDL-induced hepatic fibrosis. These findings suggest that ALA may have a clinical application in preventing the development and progression of hepatic fibrosis.     

Relationship between anti-fibrotic effect of Panax notoginseng saponins and serum cytokines in rat hepatic fibrosis

The aim of this study was to investigate the relationship between anti-fibrotic effect of Panax notoginseng saponins (PNS) and serum cytokines in rat hepatic fibrosis. Hepatic fibrosis induced by carbon tetrachloride (CCl₄) was studied in animal models using SD rats. Liver index, serum alanine amino transferase (ALT), aspartate amino transferase (AST), transforming growth factor-β1 (TGF-β1), tumour necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured, respectively. Liver index and the degree of liver fibrosis were also determined. Our results showed that the levels of ALT, AST and liver index in PNS-treated group were markedly lower than those in model group. PNS therapy also significantly attenuated the degree of hepatic fibrosis, collagen area and collagen area percent in liver tissue. Furthermore, the levels of serum TGF-β1, TNF-α and IL-6 were strikingly reduced in PNS-treated group compared with model group while the production of IL-10 was up-regulated. These findings demonstrate that PNS has certain therapeutic effects on hepatic fibrosis probably by immunoregulating the imbalance between pro-fibrotic and anti-fibrotic cytokines.     

Performance of the main downstream operations on hyaluronic acid purification

Hyaluronic acid (HA), or hyaluronan, is a natural polyelectrolyte, ubiquitous in human tissues. Exogenous HA has been a valuable material due to its wide range of medical applications, such as in osteoarthritis treatment, ophthalmic surgery, adhesion prevention after surgeries and wound healing, as well as cosmetic applications. However, to ensure the physicochemical and biological properties, a purity near to 99 % is a primary requirement, aiming clinical applications. To achieve this goal, various downstream operations have been used, aiming HA concentration, separation and purification. Precipitation with organic solvents has been a common operation in most purification processes, combined with other downstream operations such as precipitation with quaternary salts, filtration, adsorption and ion exchange. This work presents an updated review of HA purification, emphasizing the performance of the main downstream operations used to achieve highly purified HA, in the period from 1970 to 2019. We conclude that, in the majority of the published works, there is a lack of studies regarding the operational conditions, as well as an absence of the purification percentage development during the processes.     

Articular cartilage regeneration with microfracture and hyaluronic acid

Microfracture used to treat articular cartilage injuries can facilitate access to stem cells in the bone marrow and stimulate cartilage regeneration. However, the regenerated cartilage is fibrocartilage as opposed to hyaline articular cartilage and is thinner than native cartilage. Following microfracture in rabbit knee cartilage defects, application of hyaluronic acid gel resulted in regeneration of a thicker, more hyaline-like cartilage. The addition of transforming growth factor-β3, an inducer of chondrogenic differentiation in mesenchymal stem cells, to the treatment with microfracture and hyaluronic acid did not significantly benefit cartilage regeneration.     

Synthesis of a C-linked hyaluronic acid disaccharide mimetic

The synthesis of a C-disaccharide that is designed as a mimetic for the repeating unit disaccharide of hyaluronic acid is described. The target compound was obtained via the SmI2-promoted coupling reaction of the sulfone, 2-acetamido-4,6-O-benzylidene-3-O-tert-butyldimethylsilyl-1,2-dideoxy-1-pyridinylsulfonyl-beta-D-glucopyranose (6), and the aldehyde, p-methoxyphenyl 2,3-di-O-benzyl-4-deoxy-4-C-formyl-6-O-p-methoxybenzyl-beta-D-glucopyranoside (14).     

益生菌高活菌酸奶联合肠内营养对肝纤维化患者的辅助治疗效果观察

比较观察两种微生态制剂联合肠内营养(EN)对肝纤维化患者的营养效果及肝功能的改善情况。

选择104例通过瞬时弹性成像技术(TE)排除肝硬化的慢性肝病患者, 并且营养风险筛查2002评分(NRS2002)≥3分, 按入院顺序随机数字表法分成观察组(益生菌高活菌数酸奶+EN)54例和对照组(金双歧+EN)50例。两组患者入院后24 h内开始启动肠内营养治疗, 观察组每日补充高活菌益生菌酸奶, 对照组给予肠内营养液加金双歧口服。对比3周后两组患者胃肠道情况、炎性指标、肝功能各项指标、肝纤维化改善程度及营养状况。

观察组与对照组患者在使用益生菌制剂3周后, 胃肠道症状均有改善, 其中观察组恶心、呕吐、腹胀的改善较对照组恢复程度更好(P < 0.05), 腹泻、便秘的缓解两组差异不大(P > 0.05)。通过血浆炎性指标分析, 观察组IL-1β、TNF-α下降较对照组明显(P < 0.05), 血清ALT、AST、GGT、ALP较治疗前降低明显, 与对照组相比血清ALT、GGT、ALP的改善较好, 差异均具有统计学意义(P < 0.05)。在治疗3周后, 肝纤维化指标结果显示, 观察组与对照组血清LN、Ⅳ-C水平均有下降, 观察组下降更为显著(P < 0.05), 但两组患者HA、PC-Ⅲ水平治疗前后均改变不明显, 与入院前相比差异无统计学意义(P > 0.05)。随着肝功能的纠正和肠内营养治疗, 肝脏合成蛋白的能力增强, 两组患者营养不良均有改善, 治疗3周后, 其中观察组血清ALB的提高较对照组显著, 差异有统计学意义(P < 0.05)。

长期服用益生菌酸奶有助于改善慢性肝病患者肠道微生态环境, 对早期肝脏纤维化有一定改善, 但是否有逆转肝纤维化的作用仍需大样本研究。

     

Preparation of photo-crosslinkable cinnamate modified hyaluronic acid for immobilization of horseradish peroxidase

In this work, a photo-responsive hydrogel membrane based on cinnamate-modified hyaluronic acid (HA-CM) was developed and safely cross-linked under UV light curing. The obtained material was effectively utilized for immobilization of horseradish peroxidase (HRP) enzyme via encapsulation and entrapment strategy with efficiency above 95%. The prepared HA-CM biopolymer was investigated before the UV curing using instrumental and spectral techniques including Fourier transform infrared (FTIR) and nuclear magnetic resonance (NMR). During the UV irradiation, the progress of the cross-linking reaction was monitored by the UV–vis light spectroscopy. In addition, when the photo-induced cross-linking had accomplished, the morphological appearance of the hydrogel membrane was recorded using a scanning electron microscope (SEM). The HRP immobilized in HA-CM membranes displayed remarkable stability against the environmental pH changes especially under alkaline media and shift the optimum pH to 8 compared to the free HRP, which exhibited the highest activity at pH 7. Also, the entrapped enzyme was able to preserve above 85% of its catalytic activity at higher temperature values where the free enzyme had deactivated by approximately 50%. Moreover, HA-CM-HRP maintained 87% of its activity after 10 sequential reuse cycles, which indicate the economic value of the employed immobilization strategy.