目的:探讨肝病生存质量量表(Liver Disease Quality of Life Questionnaire,LDQOL1.0)中文版在慢性病毒性肝炎患者生存质量测试中的信度和效度.方法:使用LDQOL1.0中文版对100例慢性病毒性肝炎患者进行进行生存质量测试,回收有效问卷91例...目的:探讨肝病生存质量量表(Liver Disease Quality of Life Questionnaire,LDQOL1.0)中文版在慢性病毒性肝炎患者生存质量测试中的信度和效度.方法:使用LDQOL1.0中文版对100例慢性病毒性肝炎患者进行进行生存质量测试,回收有效问卷91例,使用克朗巴赫系数(Cronbachα)、天花板效应和地板效应来检测量表的信度;通过计算各个肝病特异性维度与S F-36的8个维度之间的相关系数来评估量表的标准效度;通过探索性因子分析来评估量表的结构效度;通过比较不同Child Pugh评分的患者的得分,评估量表的区分度.相关性检测使用Pearson相关系数,区分度检测使用方差分析进行多重比较.结果:Cronbach α在各领域中的分值为0.33(95%C I:0.08-0.52)-0.9(95%C I:0.90-0.99),80%领域分值>0.7;天花板效应在0%-39.6%,地板效应在0%-34.1%,80%领域<20%.标准效度提示12个肝病特异性领域里,有6个领域与SF-36的相近领域相关度较好(Pearson系数>0.5,P<0.05);因子分析提示肝病特异性12个领域里7个领域因子分析结果与原量表构想相似.区分度检测提示肝病特异性12个领域里7个的区分度较好(F:0.353-21.29,P<0.05).结论:LDQOL1.0在中国慢性病毒性肝炎患者中测试生存质量,大部分领域信度、效度和区分度较好,可以用于临床工作.展开更多
AIM： To investigate the damaging effect of high-intensity focused ultrasound （HIFU） on cancer cells and the inhibitory effect on tumor growth. METHODS： Hurine H22 hepatic cancer cells were treated with HIFU at the...AIM： To investigate the damaging effect of high-intensity focused ultrasound （HIFU） on cancer cells and the inhibitory effect on tumor growth. METHODS： Hurine H22 hepatic cancer cells were treated with HIFU at the same intensity for different lengths of time and at different intensities for the same length oftime in vitro, the dead cancer cells were determined by trypan blue staining. Two groups of cancer cells treated with HIFU at the lowest and highest intensity were inoculated into mice. Tumor masses were removed and weighed after 2 wk, tumor growth in each group was confirmed pathologically.RESULTS： The death rate of cancer cells treated with HIFU at 1 000 W/cm^2 for 0.5, 1, 2, 4, 8, and 12 s was 3.11±1.21%, 13.37±2.56%, 38.84±3.68%, 47.22±5.76%,87.55±7.32%, and 94.33±8.11%, respectively. A positive relationship between the death rates of cancer cells and the length of HIFU treatment time was found （r = 0.96,P〈0.01）. The death rate of cancer cells treated with HIFU at the intensity of 100, 200, 400, 600, 800, and 1 000 W/cm^2 for 8 s was 26.31±3.26%, 31.00±3.87%, 41.97±5.86%,72.23±8.12%, 94.90±8.67%, and 99.30±9.18%, respectively. A positive relationship between the death rates of cancer cells and the intensities of HIFU treatment was confirmed （r= 0.98, P〈0.01）. The cancer cells treated with HIFU at 1 000 W/cm^2 for 8 s were inoculated intomice ed into. The tumor inhibitory rate was 90.35% compared to the control （P〈0.01）. In the experimental group inoculated with the cancer cells treated with HIFU at 1 000 W/cm^2 for 0.5 s, the tumor inhibitory rate was 22.9% （P〈0.01）. By pathological examination, tumor growth was confirmed in 8 out of 14 mice （57.14%, 8/14） inoculated with the cancer cells treated with HIFU at 1 000 W/cm^2 for 8 s, which was significantly lower than that in the control （100%, 15/15, P〈O.05）.CONCLUSION： HIFU is effective on killing or damage of H22 hepatic cancer cells in vitro and on inhibiting tumor growth in mice ex vivo.展开更多
AIM： To investigate the possible mechanism of the protective effects of a bioactive fraction, Ganoderma lucidum proteoglycan （GLPG）isolated from Ganoderma luddum mycelia, against carbon tetrachloride-induced liver ...AIM： To investigate the possible mechanism of the protective effects of a bioactive fraction, Ganoderma lucidum proteoglycan （GLPG）isolated from Ganoderma luddum mycelia, against carbon tetrachloride-induced liver injury. METHODS： A liver injury model was induced by carbon tetrachloride. Cytotoxicity was measured by MTY assay. The activities of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were determined with an automatic multifunction-biochemical analyzer and the levels of superoxide dismutase （SOD） and TNF-α were determined following the instructions of SOD kit and TNF radioimmunoassay kit. Uver sections were stained with hematoxylin and eosin （H＆E） for histological evaluation and examined under light microscope. RESULTS： We found that GLPG can alleviate the L-02 liver cells injury induced by carbon tetrachloride （CCh） through the measurements of ALT and AST activities and the administration of GLPG to L-02 cells did not display any toxicity. Furthermore, histological analysis of mice liver injury induced by CCh with or without GLPG pretreatment indicated that GLPG can significantly suppress the toxicity induced by CCh in mice liver. We also found that GLPG reduced TNF-α level induced by CCh in the plasma of mice, whereas increased SOD activity in the rat serum. CONCLUSION： GLPG has hepatic protective activity against CCl4 induced injury both in vitro and in vivo. The possible antihepatotoxic mechanisms may be related to the suppression of TNF-α level and the free radical scavenging activity.展开更多
AIM： To investigate the effects of filtrate of fermented mycelia from Antrodia camphorata （FMAC） on liver fibrosis induced by carbon tetrachloride （CCI4） in rats. METHODS： Forty Wistar rats were divided randomly...AIM： To investigate the effects of filtrate of fermented mycelia from Antrodia camphorata （FMAC） on liver fibrosis induced by carbon tetrachloride （CCI4） in rats. METHODS： Forty Wistar rats were divided randomly into control group and model group. All model rats were given 200 mL/L CCI4 （2 mL/Kg, po） twice a week for 8 wk. Four weeks after CCh treatment, thirty model rats were further divided randomly into 3 subgroups： CCh and two FMAC subgroups. Rats in CCI4 and 2 FMAC subgroups were treated with FMAC 0, 0.5 and 1.0 g/kg, daily via gastrogavage beginning at the fitch week and the end of the eighth week. Spleen weight, blood synthetic markers （albumin and prothrombin time） and hepatic malondialdehyde （MDA） and hydroxyproline （HP） concentrations were determined. Expression of collagen I, tissue inhibitor of metalloproteinases （TIMP）-1 and transforming growth factor β1 （TGF-β1） mRNA were detected by RTPCR. Histochemical staining of Masson＇s trichrome was performed. RESULTS： CCI4 caused liver fibrosis, featuring increased prothrombin time, hepatic MDA and HP contents, and spleen weight and decreased plasma albumin level. Compared with CCh subgroup, FMAC subgroup （1 g/kg） significantly decreased the prothrombin time （36.7±7.2 and 25.1±10.2 in CCh and FMAC groups, respectively, P〈 0.05） and increased plasma albumin concentration （22.7± 1.0 and 30.7±2.5 in CCk and FMAC groups, respectively, P 〈 0.05）. Spleen weight was significantly lower in rats treated with CCh and FMAC （1 g/kg） compared to CCh treated rats only （2.7±0.1 and 2.4±0.2 in CCk and FMAC groups, respectively, P〈0.05）. The amounts of hepatic MDA and HP in CCI4± FAMC （1 g/kg） subgroup were also lower thanthose in CCh subgroup （MDA： 3.9±0.1 and 2.4±0.6 in CCh and CCI4 ＋ FMAC groups, respectively, P〈 0.01; HP： 1730.7±258.0 and 1311.5±238.8 in CCI4 and CCI4＋FMAC groups, respectively, P〈0.01）. Histologic examinations showed that CCI4＋FMAC subgroups had thinner or less fibrotic septa than CCh group. RT-PCR analysis indicated that FMAC （1 g/kg） reduced mRNA levels of collagen I, TIMP-1 and TGF-β1 （collagen I： 5.63±2.08 and 1.78±0.48 in CCh and CCI4＋FMAC groups, respectively, P〈0.01; TIMP-1： 1.70±0.82 and 0.34±0.02 in CCh and CCI4 ＋ FMAC groups, respectively, P〈0.01; TGF-β1：38.03±11.9 and 4.26±2.17 in CCh and CCI4＋FMAC groups, respectively, P〈0.01） in the CCI4-treated liver. CONCLUSION： It demonstrates that FMAC can retard the progression of liver fibrosis induced by CCh in rats.展开更多
AIM: To investigate the effects of a novel Leukotriene B4 receptor antagonist and/or tacrolimus on ischemia-reperfusion in a rat liver model. METHODS: Male Lewis rats were pretreated with ONO-4057 (100 mg/kg) and/or t...AIM: To investigate the effects of a novel Leukotriene B4 receptor antagonist and/or tacrolimus on ischemia-reperfusion in a rat liver model. METHODS: Male Lewis rats were pretreated with ONO-4057 (100 mg/kg) and/or tacrolimus (1 mg/kg) orally, and divided into four experimental groups; group 1 (control), group 2 (ONO-4057), group 3 (tacrolimus), group 4 (ONO-4057 + tacrolimus). RESULTS: There was a tendency for long survival in the groups treated with tacrolimus alone and ONO-4057 plus tacrolimus. Post-reperfusion serum aspartate aminotransferase levels decreased more signif icantly in ONO-4057 plus tacrolimus group (P < 0.01), than in the tacrolimus alone group (P < 0.05), compared to controls. CONCLUSION: This study demonstrated that pretreat-ment with ONO-4057 in combination with tacrolimus produced additive effects in a rat model of liver isch-emia-reperfusion injury.展开更多
Ciliated hepatic foregut cyst (CHFC) is a very rare cystic lesion of the liver that is histologically similar to bronchogenic cyst. We report one case of CHFC that was hard to distinguish from solid-cystic neoplasm in...Ciliated hepatic foregut cyst (CHFC) is a very rare cystic lesion of the liver that is histologically similar to bronchogenic cyst. We report one case of CHFC that was hard to distinguish from solid-cystic neoplasm in imaging features. Magnetic resonance imaging was helpful in differentiating these cysts from other lesions.展开更多
AIM: To evaluate the spatial distribution of cerebral abnormalities in cirrhotic subjects with and without hepatic encephalopathy (HE) found with magnetization transfer imaging (MTI).METHODS: Nineteen cirrhotic patien...AIM: To evaluate the spatial distribution of cerebral abnormalities in cirrhotic subjects with and without hepatic encephalopathy (HE) found with magnetization transfer imaging (MTI).METHODS: Nineteen cirrhotic patients graded from neurologically normal to HE grade 2 and 18 healthy control subjects underwent magnetic resonance imaging. They gave institutional-review-board-approved written consent. Magnetization transfer ratio (MTR) maps were generated from MTI. We tested for significant differences compared to the control group using statistical non-parametric mapping (SnPM) for a voxelbased evaluation.RESULTS: The MTR of grey and white matter was lower in subjects with more severe HE. Changes were found in patients with cirrhosis without neurological defi cits in the basal ganglia and bilateral white matter. The loss in magnetization transfer increased in severity and spatial extent in patients with overt HE. Patients with HE grade 2 showed an MTR decrease in white and grey matter: the maximum loss of magnetization transfer effect was located in the basal ganglia [SnPM (pseudo-)t = 17.98, P = 0.0001].CONCLUSION: The distribution of MTR changes in HE points to an early involvement of basal ganglia and white matter in HE.展开更多
AIM： To study a more accurate quantification of hepatic fibrosis which would provide dinically useful information for monitoring the progression of chronic liver disease. METHODS： Using a cDNA microarray containing ...AIM： To study a more accurate quantification of hepatic fibrosis which would provide dinically useful information for monitoring the progression of chronic liver disease. METHODS： Using a cDNA microarray containing over 22000 clones, we analyzed the gene-expression profiles of non-cancerous liver in 74 patients who underwent hepatic resection. We calculated the ratio of azanstained： total area, and determined the morphologic fibrosis index （MFI）, as a mean of 9 section-images. We used the MFI as a reference standard to evaluate our method for assessing liver fibrosis. RESULTS： We identified 39 genes that collectively showed a good correlation （r 〉 0.50） between geneexpression and the severity of liver fibrosis. Many of the identified genes were involved in immune responses and cell signaling. To quantify the extent of liver fibrosis, we developed a new genetic fibrosis index （GFI） based on gene-expression profiling of 4 clones using a linear support vector regression analysis. This technique, based on a supervised learning analysis, correctly quantified the various degrees of fibrosis in both 74 training samples （r = 0.76, 2.2% vs 2.8%, P 〈 0.0001） and 12 independent additional test samples （r = 0.75, 9.8% vs 8.6%, P 〈 0.005）. It was far better in assessing liver fibrosis than blood markers such as prothrombin time （r = -0.53）, type IV collagen 7s （r = 0.48）, hyaluronic acid （r = 0.41）, and aspartate aminotransferase to platelets ratio index （APRI） （r = 0.38）. CONCLUSION： Our cDNA microarray-based strategy may help clinicians to precisely and objectively monitor the severity of liver fibrosis.展开更多
Various hepato-biliary complications are an increased incidence in patients with inflammatory bowel disease,and portal bacteremia is well documented in patients with ulcerative colitis (UC). However, few reports menti...Various hepato-biliary complications are an increased incidence in patients with inflammatory bowel disease,and portal bacteremia is well documented in patients with ulcerative colitis (UC). However, few reports mention UC in association with liver abscesses. Recently, there are several reports describing cytomegalovirus (CMV) infection in association with disease exacerbation and steroid refractoriness in patients with UC. Here we present a case of refractory UC accompanied with multiple liver abscesses and CMV colitis. The patient, a 72-year-old male, with a five-year history of repeated admissions to our hospital for UC, presented with an exacerbation of his UC.Sigmoidoscopy performed on admission suggested that his UC was exacerbated, then he was given prednisolone and mesalazine orally, and betamethasone enemas.However, he had exacerbated symptoms. Repeat sigmoidoscopy revealed multiple longitudinal ulcers and pseudopolyps in the rectosigmoid colon. Although immunohistochemical staining of biopsy specimens and the serum testing for antigenemia were negative on admission and after the repeat sigmoidoscopy, they became histologically positive for CMV. Nonetheless, the patient developed spiking fevers, soon after ganciclovir was administered. Laboratory studies revealed an increased white cell count with left shift, and Enterococcus fecalis grew in blood cultures. An abdominal computed tomography (CT) scan was obtained and the diagnosis of liver abscesses associated with UC was made, based on CT results. The hepatic abscesses were successfully treated with intravenous meropenem for 6 wk, without further percutaneous drainage. To our knowledge, this is the first reported case of multiple liver abscesses that develop during UC exacerbation complicated by CMV colitis.展开更多
目的:通过超声实时剪切波评估正常成人肝杨氏模量值是否受进餐的影响.方法:利用超声实时剪切波弹性成像(realtime shear wave elastography,SWE)技术分别测量158例健康志愿者空腹(8 h以上)、餐后1 h、餐后2 h肝脏杨氏模量值,分析进餐对...目的:通过超声实时剪切波评估正常成人肝杨氏模量值是否受进餐的影响.方法:利用超声实时剪切波弹性成像(realtime shear wave elastography,SWE)技术分别测量158例健康志愿者空腹(8 h以上)、餐后1 h、餐后2 h肝脏杨氏模量值,分析进餐对肝杨氏模量值的影响.所有受检者均在同一条件下接受3次测量并求平均值进行统计学分析.结果:158例受检者中有154例获得成功,成功率为97.5%.餐前正常肝杨氏模量均值为5.89 k Pa±0.92 k Pa,95%可信区间(95%confidence interval,95%CI)为4.88-7.21 k Pa;餐后1 h肝脏杨氏模量均值为6.09 k Pa±1.05k Pa,95%CI为5.00-7.55 k Pa;餐后2 h肝杨氏模量均值为5.95 k Pa±1.10 k Pa,95%CI为4.75-7.48 k P a.经统计学分析,患者在进餐前后的肝脏杨氏模量均值变化均无统计学意义(P>0.05),而餐后2 h与餐后1 h最大值及餐后2 h与餐前最小值比较有统计学意义(P<0.05).结论:通过SWE技术对正常人进食前后肝杨氏模量值进行测量的结果说明其弹性变化不受进餐影响,可进行稳定重复.展开更多
基金Supported by the Grant from National Economic Trade Committee, No. 2000-312-2
文摘AIM： To investigate the damaging effect of high-intensity focused ultrasound （HIFU） on cancer cells and the inhibitory effect on tumor growth. METHODS： Hurine H22 hepatic cancer cells were treated with HIFU at the same intensity for different lengths of time and at different intensities for the same length oftime in vitro, the dead cancer cells were determined by trypan blue staining. Two groups of cancer cells treated with HIFU at the lowest and highest intensity were inoculated into mice. Tumor masses were removed and weighed after 2 wk, tumor growth in each group was confirmed pathologically.RESULTS： The death rate of cancer cells treated with HIFU at 1 000 W/cm^2 for 0.5, 1, 2, 4, 8, and 12 s was 3.11±1.21%, 13.37±2.56%, 38.84±3.68%, 47.22±5.76%,87.55±7.32%, and 94.33±8.11%, respectively. A positive relationship between the death rates of cancer cells and the length of HIFU treatment time was found （r = 0.96,P〈0.01）. The death rate of cancer cells treated with HIFU at the intensity of 100, 200, 400, 600, 800, and 1 000 W/cm^2 for 8 s was 26.31±3.26%, 31.00±3.87%, 41.97±5.86%,72.23±8.12%, 94.90±8.67%, and 99.30±9.18%, respectively. A positive relationship between the death rates of cancer cells and the intensities of HIFU treatment was confirmed （r= 0.98, P〈0.01）. The cancer cells treated with HIFU at 1 000 W/cm^2 for 8 s were inoculated intomice ed into. The tumor inhibitory rate was 90.35% compared to the control （P〈0.01）. In the experimental group inoculated with the cancer cells treated with HIFU at 1 000 W/cm^2 for 0.5 s, the tumor inhibitory rate was 22.9% （P〈0.01）. By pathological examination, tumor growth was confirmed in 8 out of 14 mice （57.14%, 8/14） inoculated with the cancer cells treated with HIFU at 1 000 W/cm^2 for 8 s, which was significantly lower than that in the control （100%, 15/15, P〈O.05）.CONCLUSION： HIFU is effective on killing or damage of H22 hepatic cancer cells in vitro and on inhibiting tumor growth in mice ex vivo.
基金Supported by a grant from the Institute of Virology, College of Life Sciences, Wuhan University
文摘AIM： To investigate the possible mechanism of the protective effects of a bioactive fraction, Ganoderma lucidum proteoglycan （GLPG）isolated from Ganoderma luddum mycelia, against carbon tetrachloride-induced liver injury. METHODS： A liver injury model was induced by carbon tetrachloride. Cytotoxicity was measured by MTY assay. The activities of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were determined with an automatic multifunction-biochemical analyzer and the levels of superoxide dismutase （SOD） and TNF-α were determined following the instructions of SOD kit and TNF radioimmunoassay kit. Uver sections were stained with hematoxylin and eosin （H＆E） for histological evaluation and examined under light microscope. RESULTS： We found that GLPG can alleviate the L-02 liver cells injury induced by carbon tetrachloride （CCh） through the measurements of ALT and AST activities and the administration of GLPG to L-02 cells did not display any toxicity. Furthermore, histological analysis of mice liver injury induced by CCh with or without GLPG pretreatment indicated that GLPG can significantly suppress the toxicity induced by CCh in mice liver. We also found that GLPG reduced TNF-α level induced by CCh in the plasma of mice, whereas increased SOD activity in the rat serum. CONCLUSION： GLPG has hepatic protective activity against CCl4 induced injury both in vitro and in vivo. The possible antihepatotoxic mechanisms may be related to the suppression of TNF-α level and the free radical scavenging activity.
基金Supported by Department of Health, Executive Yuan of our country, No. DOH90-TD-1027
文摘AIM： To investigate the effects of filtrate of fermented mycelia from Antrodia camphorata （FMAC） on liver fibrosis induced by carbon tetrachloride （CCI4） in rats. METHODS： Forty Wistar rats were divided randomly into control group and model group. All model rats were given 200 mL/L CCI4 （2 mL/Kg, po） twice a week for 8 wk. Four weeks after CCh treatment, thirty model rats were further divided randomly into 3 subgroups： CCh and two FMAC subgroups. Rats in CCI4 and 2 FMAC subgroups were treated with FMAC 0, 0.5 and 1.0 g/kg, daily via gastrogavage beginning at the fitch week and the end of the eighth week. Spleen weight, blood synthetic markers （albumin and prothrombin time） and hepatic malondialdehyde （MDA） and hydroxyproline （HP） concentrations were determined. Expression of collagen I, tissue inhibitor of metalloproteinases （TIMP）-1 and transforming growth factor β1 （TGF-β1） mRNA were detected by RTPCR. Histochemical staining of Masson＇s trichrome was performed. RESULTS： CCI4 caused liver fibrosis, featuring increased prothrombin time, hepatic MDA and HP contents, and spleen weight and decreased plasma albumin level. Compared with CCh subgroup, FMAC subgroup （1 g/kg） significantly decreased the prothrombin time （36.7±7.2 and 25.1±10.2 in CCh and FMAC groups, respectively, P〈 0.05） and increased plasma albumin concentration （22.7± 1.0 and 30.7±2.5 in CCk and FMAC groups, respectively, P 〈 0.05）. Spleen weight was significantly lower in rats treated with CCh and FMAC （1 g/kg） compared to CCh treated rats only （2.7±0.1 and 2.4±0.2 in CCk and FMAC groups, respectively, P〈0.05）. The amounts of hepatic MDA and HP in CCI4± FAMC （1 g/kg） subgroup were also lower thanthose in CCh subgroup （MDA： 3.9±0.1 and 2.4±0.6 in CCh and CCI4 ＋ FMAC groups, respectively, P〈 0.01; HP： 1730.7±258.0 and 1311.5±238.8 in CCI4 and CCI4＋FMAC groups, respectively, P〈0.01）. Histologic examinations showed that CCI4＋FMAC subgroups had thinner or less fibrotic septa than CCh group. RT-PCR analysis indicated that FMAC （1 g/kg） reduced mRNA levels of collagen I, TIMP-1 and TGF-β1 （collagen I： 5.63±2.08 and 1.78±0.48 in CCh and CCI4＋FMAC groups, respectively, P〈0.01; TIMP-1： 1.70±0.82 and 0.34±0.02 in CCh and CCI4 ＋ FMAC groups, respectively, P〈0.01; TGF-β1：38.03±11.9 and 4.26±2.17 in CCh and CCI4＋FMAC groups, respectively, P〈0.01） in the CCI4-treated liver. CONCLUSION： It demonstrates that FMAC can retard the progression of liver fibrosis induced by CCh in rats.
文摘AIM: To investigate the effects of a novel Leukotriene B4 receptor antagonist and/or tacrolimus on ischemia-reperfusion in a rat liver model. METHODS: Male Lewis rats were pretreated with ONO-4057 (100 mg/kg) and/or tacrolimus (1 mg/kg) orally, and divided into four experimental groups; group 1 (control), group 2 (ONO-4057), group 3 (tacrolimus), group 4 (ONO-4057 + tacrolimus). RESULTS: There was a tendency for long survival in the groups treated with tacrolimus alone and ONO-4057 plus tacrolimus. Post-reperfusion serum aspartate aminotransferase levels decreased more signif icantly in ONO-4057 plus tacrolimus group (P < 0.01), than in the tacrolimus alone group (P < 0.05), compared to controls. CONCLUSION: This study demonstrated that pretreat-ment with ONO-4057 in combination with tacrolimus produced additive effects in a rat model of liver isch-emia-reperfusion injury.
文摘Ciliated hepatic foregut cyst (CHFC) is a very rare cystic lesion of the liver that is histologically similar to bronchogenic cyst. We report one case of CHFC that was hard to distinguish from solid-cystic neoplasm in imaging features. Magnetic resonance imaging was helpful in differentiating these cysts from other lesions.
文摘AIM: To evaluate the spatial distribution of cerebral abnormalities in cirrhotic subjects with and without hepatic encephalopathy (HE) found with magnetization transfer imaging (MTI).METHODS: Nineteen cirrhotic patients graded from neurologically normal to HE grade 2 and 18 healthy control subjects underwent magnetic resonance imaging. They gave institutional-review-board-approved written consent. Magnetization transfer ratio (MTR) maps were generated from MTI. We tested for significant differences compared to the control group using statistical non-parametric mapping (SnPM) for a voxelbased evaluation.RESULTS: The MTR of grey and white matter was lower in subjects with more severe HE. Changes were found in patients with cirrhosis without neurological defi cits in the basal ganglia and bilateral white matter. The loss in magnetization transfer increased in severity and spatial extent in patients with overt HE. Patients with HE grade 2 showed an MTR decrease in white and grey matter: the maximum loss of magnetization transfer effect was located in the basal ganglia [SnPM (pseudo-)t = 17.98, P = 0.0001].CONCLUSION: The distribution of MTR changes in HE points to an early involvement of basal ganglia and white matter in HE.
基金Supported partly by Grants-in-Aid for Scientific Research (S) (17109013) and for Scientific Research (C) (17591411 and 15591411)a Health and Labor Sciences Research Grant on Hepatitis and BSE (14230801)the Uehara Memorial Foundation, Yasuda Medical Research Foundation, Japanese Foundation for Multidisciplinary Treatment of Cancer, and Princes Takamatsu Cancer research Fund
文摘AIM： To study a more accurate quantification of hepatic fibrosis which would provide dinically useful information for monitoring the progression of chronic liver disease. METHODS： Using a cDNA microarray containing over 22000 clones, we analyzed the gene-expression profiles of non-cancerous liver in 74 patients who underwent hepatic resection. We calculated the ratio of azanstained： total area, and determined the morphologic fibrosis index （MFI）, as a mean of 9 section-images. We used the MFI as a reference standard to evaluate our method for assessing liver fibrosis. RESULTS： We identified 39 genes that collectively showed a good correlation （r 〉 0.50） between geneexpression and the severity of liver fibrosis. Many of the identified genes were involved in immune responses and cell signaling. To quantify the extent of liver fibrosis, we developed a new genetic fibrosis index （GFI） based on gene-expression profiling of 4 clones using a linear support vector regression analysis. This technique, based on a supervised learning analysis, correctly quantified the various degrees of fibrosis in both 74 training samples （r = 0.76, 2.2% vs 2.8%, P 〈 0.0001） and 12 independent additional test samples （r = 0.75, 9.8% vs 8.6%, P 〈 0.005）. It was far better in assessing liver fibrosis than blood markers such as prothrombin time （r = -0.53）, type IV collagen 7s （r = 0.48）, hyaluronic acid （r = 0.41）, and aspartate aminotransferase to platelets ratio index （APRI） （r = 0.38）. CONCLUSION： Our cDNA microarray-based strategy may help clinicians to precisely and objectively monitor the severity of liver fibrosis.
文摘Various hepato-biliary complications are an increased incidence in patients with inflammatory bowel disease,and portal bacteremia is well documented in patients with ulcerative colitis (UC). However, few reports mention UC in association with liver abscesses. Recently, there are several reports describing cytomegalovirus (CMV) infection in association with disease exacerbation and steroid refractoriness in patients with UC. Here we present a case of refractory UC accompanied with multiple liver abscesses and CMV colitis. The patient, a 72-year-old male, with a five-year history of repeated admissions to our hospital for UC, presented with an exacerbation of his UC.Sigmoidoscopy performed on admission suggested that his UC was exacerbated, then he was given prednisolone and mesalazine orally, and betamethasone enemas.However, he had exacerbated symptoms. Repeat sigmoidoscopy revealed multiple longitudinal ulcers and pseudopolyps in the rectosigmoid colon. Although immunohistochemical staining of biopsy specimens and the serum testing for antigenemia were negative on admission and after the repeat sigmoidoscopy, they became histologically positive for CMV. Nonetheless, the patient developed spiking fevers, soon after ganciclovir was administered. Laboratory studies revealed an increased white cell count with left shift, and Enterococcus fecalis grew in blood cultures. An abdominal computed tomography (CT) scan was obtained and the diagnosis of liver abscesses associated with UC was made, based on CT results. The hepatic abscesses were successfully treated with intravenous meropenem for 6 wk, without further percutaneous drainage. To our knowledge, this is the first reported case of multiple liver abscesses that develop during UC exacerbation complicated by CMV colitis.
文摘目的:通过超声实时剪切波评估正常成人肝杨氏模量值是否受进餐的影响.方法:利用超声实时剪切波弹性成像(realtime shear wave elastography,SWE)技术分别测量158例健康志愿者空腹(8 h以上)、餐后1 h、餐后2 h肝脏杨氏模量值,分析进餐对肝杨氏模量值的影响.所有受检者均在同一条件下接受3次测量并求平均值进行统计学分析.结果:158例受检者中有154例获得成功,成功率为97.5%.餐前正常肝杨氏模量均值为5.89 k Pa±0.92 k Pa,95%可信区间(95%confidence interval,95%CI)为4.88-7.21 k Pa;餐后1 h肝脏杨氏模量均值为6.09 k Pa±1.05k Pa,95%CI为5.00-7.55 k Pa;餐后2 h肝杨氏模量均值为5.95 k Pa±1.10 k Pa,95%CI为4.75-7.48 k P a.经统计学分析,患者在进餐前后的肝脏杨氏模量均值变化均无统计学意义(P>0.05),而餐后2 h与餐后1 h最大值及餐后2 h与餐前最小值比较有统计学意义(P<0.05).结论:通过SWE技术对正常人进食前后肝杨氏模量值进行测量的结果说明其弹性变化不受进餐影响,可进行稳定重复.
