胃癌肝转移术中射频消融治疗的临床意义

目的：评估胃癌根治术同时性射频消融治疗在治疗胃癌肝转移的临床意义。方法：收集2008年1月至2010年12月19例胃癌肝转移患者,合计转移灶33个,转移灶小于4厘米,且合计不超过4个转移灶。射频消融治疗在术中超声引导下完成。Kap-lan—Meier法分析无病生存期,无肝转移生存期及总生存期。对临床病理学因子及肝转移相关因子采用Log-rank法Cox风险比例模型解析。结果：中位无病生存、无肝转移生存及总生存期为355,394及488天。有3例患者获得长期的无复发生存。单因素分析显示,较早的T分期、N分期,较少的转移灶数量,较小的转移灶直径与良好的预后相关。多因素分析提示,病灶数量与病灶直径为独立预后因子。结论：肝转移射频消融治疗安全性好,对单发的小于4cm转移灶,以及多发病灶合计直径小于4cm者射频消融治疗较为适用,可有显著生存获益。部分患者可迭临床治愈。对于胃癌肝转移的合适病例,射频消融治疗值得推广。     

四氯化碳诱导大鼠肝性脑病模型的制备

目的建立肝性脑病（HE）动物模型。方法应用四氯化碳联合酒精自饮法制作慢性肝功能衰竭引起HE发生的模型,进行迷宫试验、脑电图、血液生化、形态学、行为活动观察等检测。结果 1.肉眼下可见模型组肝脏普遍肿大,表面较粗糙,有较粗的颗粒,暗红色;正常组肝脏未见异常。模型组肝内有大量纤维增生,肝细胞溶解,弥漫性大片坏死,残留肝细胞成片气球样变。2.与对照组大鼠比较,造模组第九周水迷宫测试逃避潜伏期明显延长,以潜伏期延长超过正常x＋2.5 s为标准,本实验有14/20（55%）只大鼠水迷宫潜伏期明显延长;3.HE模型组血氨浓度明显高于正常对照组,组间比较差异有显著性（P〈0.01）;4.正常组脑电图以α波为主,无明显异常;模型组出现肝性脑病变化。结论 1.建立了肝硬化合并肝性脑病较为理想的动物模型;2.水迷宫测试联合检测更易检出HE。     

固有免疫信号因子TRIF在肝纤维化中的表达

目的初步探讨TOLL样受体下游重要信号因子TRIF与肝纤维化发生发展的病理机制关系。方法以四氯化碳皮下注射+低蛋白高脂饮食+酒精饮料的方法复制大鼠肝纤维化模型。将SD大鼠随机分成正常对照组和模型组,在完成制备模型实验后进行取材。部分实验鼠进行心脏生理盐水和多聚甲醛灌注后,取肝脏组织制备石蜡切片,进行常规HE染色和免疫组化实验;另一部分实验鼠脱颈安乐死后,取新鲜肝组织进行电镜标本的制备和Western Blot实验检测。结果 HE染色结果显示与而正常对照组大鼠相比,模型组大鼠肝小叶结构明显破坏,肝细胞数量明显减少和肝纤维化程度等特点明显;电镜结果也显示,肝纤维化组可见大量胶原纤维沉积现象,胞质可见明显的溶解现象,在狄氏腔内,肝星状细胞的细胞核溶解,血窦内皮细胞胞质、胞核皆溶解;免疫组化模型组大鼠肝组织均显示内皮细胞、星形细胞等TRIF都有强烈高表达,并且以胞核表达为主,亦见胞质表达,而正常组呈现弱阳性表达;与正常对照组相比,模型组大鼠肝组织TRIF蛋白表达都明显升高,呈显著性差异(P<0.01),与形态学的表达特点相一致。结论 TRIF在肝纤维化中表达显著增强,说明在肝纤维化过程中,TOLL样受体明显激活,并且通过下游信号转导途径,在机体内产生一系列的免疫应答反应。通过该现象的观察,我们初步证实了TOLL样受体固有免疫信号因子TRIF在纤维化形成中起着重要的作用。     

中药复方保肝作用的组织化学、免疫组织化学研究

目的为观察活血化瘀类保肝中药复方对肝损伤的保肝作用,并探讨其抗肝纤维化作用机制.方法采用组织化学酶显示法和免疫组织化学方法,经图像分析系统定量测定对照组、模型组、预防组、治疗组和自然恢复组各组动物标本中琥珀酸脱氢酶,5-核苷酸酶及热休克蛋白70活性与表达程度.结果琥珀酸脱氢酶、5-核苷酸酶活性和热休克蛋白70的表达模型组与对照组比P<0.01;自然恢复组、预防组与模型组比P<0.01;治疗组与自然恢复组比P>0.05.结论活血化瘀类中药复方具有一定的保肝功效.肝星形细胞热休克蛋白70的表达是否提示细胞凋亡的发生,将有待进一步研究.     

肝泡状棘球蚴病不同手术疗效及预后的分析研究

目的:比较肝泡状棘球蚴病(HAE)不同手术方式的疗效,并分析影响HAE手术患者预后的相关因素。方法:回顾性分析2003年9月-2015年2月期间在我院进行手术治疗的HAE病人的诊疗记录。根据手术方式的不同,将病人分为非移植性根治性切除组(A组)、术中病灶绝大部分切除(90%以上)组(B组)、术中不能90%以上切除或仅引流组(C组)、肝移植组(D组)。结合随访资料,评价四组的疗效,并分析影响患者预后的相关因素。结果:A组死亡率低于其他三组,差异具有统计学意义(P0.001)。生存曲线结果显示,A组预后生存状况优于其他三组,差异具有统计学意义(P=0.001)。多因素分析结果表明,非移植性根治性切除、术中出血量是影响患者生存的独立危险因素(均P0.05)。结论:在早期发现早期诊断的前提下,对HAE病人行非移植性根治性切除术治疗效果最好,且非移植性根治性切除是患者预后的独立危险因素。     

Brain-specific natriuretic peptide receptor-B deletion attenuates high-fat diet-induced visceral and hepatic lipid deposition in mice

C-type natriuretic peptide (CNP) and its receptor, natriuretic peptide receptor-B (NPR-B), are abundantly distributed in the hypothalamus. To explore the role of central CNP/NPR-B signaling in energy regulation, we generated mice with brain-specific NPR-B deletion (BND mice) by crossing Nestin-Cre transgenic mice and mice with a loxP-flanked NPR-B locus. Brain-specific NPR-B deletion prevented body weight gain induced by a high-fat diet (HFD), and the mesenteric fat and liver weights were significantly decreased in BND mice fed an HFD. The decreased liver weight in BND mice was attributed to decreased lipid accumulation in the liver, which was confirmed by histologic findings and lipid content. Gene expression analysis revealed a significant decrease in the mRNA expression levels of CD36, Fsp27, and Mogat1 in the liver of BND mice, and uncoupling protein 2 mRNA expression was significantly lower in the mesenteric fat of BND mice fed an HFD than in that of control mice. This difference was not observed in the epididymal or subcutaneous fat. Although previous studies reported that CNP/NPR-B signaling inhibits SNS activity in rodents, SNS is unlikely to be the underlying mechanism of the metabolic phenotype observed in BND mice.Taken together, CNP/NPR-B signaling in the brain could be a central factor that regulates visceral lipid accumulation and hepatic steatosis under HFD conditions. Further analyses of the precise mechanisms will enhance our understanding of the contribution of the CNP/NPR-B system to energy regulation.     

Releases of Norepinephrine and Dopamine in Ventriculocisternal Perfusions in Hepatectomized and Laparotomized Rats

Abstract: The completely hepatectomized rat has frequently been used as a model to study changes in the economy of norepinephrine (NE) and dopamine (DA) in hepatic coma. Hypothermia characteristically develops in hepatectomized rats and also occurs in patients in hepatic coma and is associated with improved survival in both. The aims of the present study were to measure both release and uptake of NE and release of DA in brain in warm (37°C) and cool (30–32°C) rats at 3–5 h after laparotomy or hepatectomy. Ventriculocisternal perfusions of the brain were performed on rats under basal conditions and during releases evoked by 40 m M K⁺. Basal releases of NE and DA and evoked release of DA were greater in the warm hepatectomized rats than in all other groups. In some studies, 10⁻⁵ M amitriptyline was added to the perfusates to assess whether neuronal uptake was changed after hepatectomy. Uptake of released NE was equally robust in cool hepatectomized as in cool laparotomized rats but could not be measured in warm hepatectomized rats because of amitriptyline toxicity in these rats. Decreases in NE and increases in DA content were found in most areas of the brain after perfusion. Increased releases of NE and DA may contribute to the pathogenesis of hepatic encephalopathy.     

Paeoniflorin diminishes ConA-induced IL-8 production in primary human hepatic sinusoidal endothelial cells in the involvement of ERK1/2 and Akt phosphorylation

Liver diseases are closely associated with elevated levels of interleukin-8 (IL-8), suggesting the ability to inhibit IL-8 production could enhance the treatment of liver diseases. Paeoniflorin is a major active constituent of dried Paeoniae Radix Alba root (Baishao in Chinese) which is widely used in China to treat liver diseases. We examined the effects and underlying mechanisms of paeoniflorin on IL-8 production in primary human hepatic sinusoidal endothelial cells (HHSECs). Concanavalin A (ConA) at 20 μg/mL produced a 5.2-fold increase in IL-8 mRNA by 8 h, and a 14.2-fold rise in IL-8 levels by 16 h. Inhibition of MEK (ERK kinase) and extracellular signal-regulated kinase (ERK) by PD98059 and U0126, or inhibition of phosphatidylinositol 3-kinase (PI3K) by LY294002 blocked both ConA-induced IL-8 mRNA expression and IL-8 secretion. Paeoniflorin reduced ConA-induced IL-8 mRNA expression and IL-8 release by 57.9% and 52.8%, respectively, and also decreased ConA-stimulated phosphorylation of ERK1/2 and Akt, suggesting paeoniflorin inhibits IL-8 expression and release by inhibiting the ERK1/2 and Akt pathways. Combining paeoniflorin with U0126 or LY294002 at low doses showed supra-additive inhibition of not only phospho-ERK1/2 and phospho-Akt by 46.4% and 35.0%, but also IL-8 release by 42.4% and 36.1% and IL-8 mRNA expression by 43.5% and 31.8%, respectively. In conclusion, paeoniflorin most likely contributes to the therapy for liver disease by exerting anti-inflammatory effects on HHSECs through blocking IL-8 secretion via downregulation of ERK1/2 and Akt phosphorylation.     

C. elegans Eats Its Own Intestine to Make Yolk Leading to Multiple Senescent Pathologies

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