Objective To observe the anti-fibrosis effect of tenofovir combined with fuzheng huayu capsule in the treatment of compensatory hepatitis B cirrhosis.Methods Sixty patients with compensatory hepatitis b cirrhosis were randomly divided into observation group and control group.The observation group received tenofovir and fuzheng huayu capsule, while the control group received tenofovir for 30 months.The mean values of ALB,PTA and APRI before and after treatment were compared.The inner diameter of portal vein, thickness of spleen and mean of maximum flow of portal vein before and after treatment were compared in the two groups.Liver hardness test results before and after treatment were compared between the two groups.Results The results of liver function, HBVDNA and HBeAg were compared between the two groups.results after treatment, liver function was normal in both groups, HBVDNA decreased below the detection line, and there were 42% and 36.8% negative HBeAg in the two groups, respectively.The mean values of ALB,PTA and APRI in serum of the two groups were compared before and after treatment.After further comparison, ALB,PTA and APRI of the two groups were all P＜0.05.Comparison of portal vein diameter, spleen thickness and portal vein maximum flow mean before and after treatment in the observation group showed P＜0.05,while comparison of portal vein diameter before and after treatment in the control group showed P＞0.05.Comparison of portal vein diameter, spleen thickness and maximum portal vein flow between the observation group and the control group after treatment showed P＜0.05.After treatment, the mean value of liver hardness test in the two groups was P＜0.05,and the observation group was better than the control group.Conclusion The two methods can improve liver function and antiviral therapy.Tenofovir combined with fuzheng huayu capsule improved liver circulation and liver fibrosis and reduced portal vein pressure in the treatment group, which was better than tenofovir alone.

目的:观察梓醇对2型糖尿病(T2DM)大鼠损伤肝脏的保护作用,并从过氧化物酶体增殖物激活受体γ(PPARγ)/核因子κB(NF-κB)信号通路的角度探讨其可能机制.方法:通过高糖高脂饮食联合腹腔注射小剂量链脲佐菌素构建SD大鼠T2DM模型,并随机分为模型组、二甲双胍组、水飞蓟素组、梓醇低剂量组、梓醇中剂量组和梓醇高剂量组,并取正常SD大鼠为对照组.8周后生化分析大鼠空腹血糖、糖化血红蛋白、血脂及血清丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)水平;ELISA法检测血清白细胞介素6(IL-6)和肿瘤坏死因子α(TNF-α)水平;计算肝脏指数,HE染色和油红O染色观察肝脏损伤情况;RT-qPCR检测肝脏组织中IκB的mRNA表达;Western blot检测肝脏组织中PPARγ和核内NF-κB蛋白的表达.结果:梓醇高剂量组的血糖和血脂显著下降,肝脏损伤明显减轻,ALT、AST、IL-6和TNF-α水平均显著降低(P<0.05);梓醇高剂量组PPARγ蛋白和IκB mRNA表达明显增多,核内NF-κB p65蛋白的表达明显减少,抑制了NF-κB的活化(P<0.05).结论:梓醇对T2DM大鼠损伤的肝脏具有保护作用,其机制可能是通过PPARγ/NF-κB信号通路减轻其炎症反应.

Objective To study the invasive treatment of upper gastrointestinal bleeding. Methods The clinical data of 3 patients with upper gastrointestinal hemorrhage who were treated in our hospital from January to November 2016 were retrospectively analyzed. Results After surgical treatment, 3 cases of patients with hemorrhage of upper digestive tract symptoms had been effectively alleviated in a very short period of time. Hospital stay was 5 to 8 days, with an average of (6.31±1.09) days after discharge. Conclusion The surgical treatment of upper gastrointestinal bleeding in patients with treatment, can help patients recover in a short period of time will affect the disease on patients caused by the lowest.

目的探析某小区(溧水庆丰小区)人员营养状况调查。方法本研究结合小区每年免费体检，随机抽取2012年~2014年接受体检的300例作为调查对象，观察分析体格检查、血清生化检查、血常规检查等营养相关指标，采用24h饮食回顾法进行饮食和营养状况调查。结果调查对象人群的食物结构不够合理，脂肪占总能量比例过高，而碳水化合物低于推荐摄入量(RNI)标准，钠摄入量远高于中国营养学会推荐的每天食盐应在6g以下，达到了日均摄入20g以上；营养过剩者与糖尿病、血脂异常、高血压、高尿酸血症、肥胖的发病情况密切相关，差异有统计学差异(<0.05)。结论小区人员营养过剩，多发生肥胖、高血脂、高血压、高血糖、冠心病等病变，需调整饮食结构。

浅谈膳食纤维的主要理化特性,包括吸水作用,粘滞作用,菌群调理作用,吸附作用,阳离子交换作用,并研讨出膳食纤维通过这些主要特性对人体产生了良好的保健效果,如:可以保持消化系统健康、增强免疫系统、预防高血压和高血脂、预防心血管和癌症的发生等相关疾病.

目的 对还原型谷胱甘肽联合门冬氨酸钾镁治疗药物性肝炎的临床疗效进行观察.方法 选取我院2011年8月至2012年8月收治的80例药物性肝炎患者,将患者随机分为两组,观察组患者40例,对照组患者40例,对照组患者采用甘利欣治疗,观察组患者在接受甘利欣治疗基础上,还接受还原型谷胱甘肽联合门冬氨酸钾镁治疗.规定患者接受治疗3周为1疗程.结果 观察组治疗后总有效为100％,对照组治疗总有效为70.0％,观察组总有效明显高于对照组,差异显著,(P＜0.05)有统计学意义.观察组患者治疗后肝功能指标和治疗前肝功能指标差异明显高于对照组,差异显著,(P＜0.05)有统计学意义.结论 药物性肝炎患者接受还原型谷胱甘肽联合门冬氨酸钾镁治疗后显示出了良好的治疗效果,对患者肝功能改善较为显著,在临床中值得推广.

目的：通过对268例甲沟炎患者的分期治疗探讨甲沟炎不同阶段的治疗方法及疗效。方法对本组患者采用分期治疗，I期局部应用酒精浸泡、保持局部干燥清洁，II期先采用局部应用酒精浸泡、保持局部干燥清洁，配合抗菌药物治疗，效果欠佳或复发者进行部分甲板及甲基质切除术（Winograd手术），III期及复发患者采用甲沟重建术。结果共治疗268例，251治愈（其中230例一期愈合，36例感染，经引流、换药后二期愈合）。随访5个月~2年，平10个月；17例复发：7例仍用保守治疗痊愈，未再复发，10例行手术治疗后治愈，未再复发。结论甲沟炎不同病程阶段采用不同的治疗方法可取的满意疗效。

目的：对手法结合牵引治疗腰椎小关节紊乱进行临床疗效分析。方法自2010年1月至2012年6月采用手法结合牵引治疗腰椎小关节紊乱161例，急性发作患者采用腰部斜搬法复位，复位效果欠佳、反复发作及慢性患者采用骨盆带牵引治疗，配合消炎止痛、活血化瘀药物，针灸理疗，并进行腰背肌功能锻炼。结果治愈131例，好转30例，无效0例，治愈率为81.37%，总有效率为100%。结论手法结合牵引治疗腰椎小关节紊乱效果良好。

Objective To investigate the clinical relationship between the expressions of p53, CD34, Ki-67, NF-κB, TGF-β1 and the recurrence of small hepatocellular carcinoma after radical hepatectomy. Methods The expressions of p53, CD34, Ki-67, NF-κB and TGF-β1 in specimen of small hepatocellular carcinoma were detected by immunohistochemisty techniques. The specimens contain 40 small hepatocellular carcinoma and 50 paracancer tissues which were obtained from the patients with small hepatocellular carcinoma that was undergone radical hepatectomy in recent years. Results The expressions of p53, CD34, Ki-67, NF-κB and TGF-β1 in small hepatocellular carcinoma were significantly higher than that in paracancer tissues (P0.05). The expressions of p53, CD34, Ki-67, NF-κB and TGF-β1 in the recurrent group were higher than that in the non-recurrent group (P0.05). But the difference of expression of NF-κB was not statistically significant (P0.05). The expression of p53 was related with the expression of TGF-β1 in the recurrent group (P0.05). Conclusion p53, CD34, Ki-67and TGF-β1 are related with the recurrence of small hepatocellular carcinoma, while p53, coordinated with TGF-β1 , promotes the recurrence. Detection all of these proteins contributes to predict the recurrence of small hepatocellular carcinoma after radical hepatectomy.

背景:细胞表面免疫抑制性受体信号调节蛋白(SIRPs)广泛表达于各类细胞,可减弱或抑制诱导性信号,对细胞内生物学活动具有负向调控作用.目的:探讨SIRPα1在胃溃疡发病机制中的可能作用.方法:20只雄性Sprague-Dawley大鼠随机分为正常对照组和胃溃疡模型组,每组10只.以冰乙酸作用于胃窦部浆膜面1 min诱导胃溃疡模型.术后14 d处死大鼠,胃溃疡模型组于溃疡部位取材,以免疫组化方法检测胃壁细胞SIRPα1表达.以胃囊翻转与酶消化法分离大鼠胃壁细胞,以免疫细胞化学方法检测SIRPα1表达.结果:正常对照组大鼠胃壁细胞SIRPα1呈弥漫强阳性表达.阳性染色主要定位于细胞质.胃溃疡模型组大鼠胃壁细胞SIRPα1表达强度较正常对照组显著减低(免疫组化评分:2.6±0.8对6.2+0.7,P＜0.001).分离的大鼠胃壁细胞SIRPα1亦呈强阳性表达,与正常对照组免疫组化染色结果一致.结论:胃壁细胞SIRPα1低表达使之对胃酸分泌的负向调控作用减弱可能参与了胃溃疡的形成.免疫调节因素在溃疡病发生、发展中的作用及其机制值得进一步研究.

OBJECTIVE To observe the expression change of signal regulatory protein alpha1 (SIRPalpha1) in autoimmune hepatitis (AIH) and approach the relationship between SIRPalpha1 and the extent of inflammation. METHODS Immunohistochemistry is used to detect the expression of SIRPalpha1 in the paraffin section preparations of 33 AIH and 10 normal hepatic tissue. RESULTS SIRPalpha1 is positive or weakly positive expressed in AIH. The staining is localized in the cytoplasm of Kupffer cells in the hepatic sinusoid with focal distribution. It is negative in normal hepatic tissue. In light AIH, it is negative or weakly positive expressed with a 36.4 percent of the positive rate (4/11). The positive or strong positive expression is found in the moderate AIH with an 84.2 percent of the positive rate(16/19). There is statistical significance between both light AIH, moderate AIH and severe AIH (P less than 0.001) and moderate AIH and light AIH (P less than 0.001). There is no statistical significance between both light AIH and severe AIH (P = 0.145 ) and moderate AIH and severe AIH (P = 0.084). CONCLUSIONS As a negative regulatory factor, the expression of SIRPalpha1 in hepatic sinusoid Kupffer cells is some associated with the extent of AIH.

Background: Signal regulatory proteins (SIRPs), a group of cell surface immunoinhibitory receptors, are widely expressed in various kinds of cells. It attenuates or suppresses the inducible signaling, and modulates the intracellular biological behaviors by negative regulation. Aims: To investigate the possible role of SIRPα1 in the pathogenesis of gastric ulcer. Methods: Twenty male Sprague-Dawley rats were randomly divided into two groups, 10 in normal control group and 10 in gastric ulcer model group. Model of gastric ulcer was induced by corroding the serous membrane of antrum with glacial acetic acid for one minute. All rats were sacrificed 14 days after the procedure. Specimens were obtained from the ulcerous lesions in gastric ulcer model group and SIRPal expression in parietal cells was determined by immunohistochemistry. Simultaneously, the rat parietal cells isolated by using gastric pouch turning and enzyme digestion were examined for expression of SIRPal by immunocytochemistry. Results: SIRPα1 was highly and diffusely expressed in cytoplasm of parietal cells in normal control group, and was significantly lower in gastric ulcer model group (immunohistochemical score: 2.6±0.8 vs. 6.2±0.7, P<0.001). High expression of SIRPα1 also could be observed in isolated rat parietal cells, which was consistent with the immunohistochemical result in normal control group. Conclusions: Lower expression of SIRPα1 in parietal cells attenuates its negative regulatory effect on acid secretion, which might be involved in the development of gastric ulcer. The roles and mechanisms of immunoregulatory factors in the pathogenesis and development of ulcer disease deserve further studies.

>患者男,42岁。因"反复上腹不适2个月"于2009年6月9日收入我院。患者于2009年4月起无明显诱因出现上腹隐痛不适,伴有反酸、嗳气,于当地医院口服抑酸药治疗,服药期间症状消失,停药后复现。于我院门诊行胃镜检查示

OBJECTIVE To explore the potential risk factors of intrahepatic cholangiocarcinoma (ICC) in China. METHOD A case-control study including 317 patients with pathologically confirmed ICC and 634 healthy individuals was conducted. The cases and controls were matched in age, sex and inhabitancy. Data were statistically analyzed by Chi-square test and conditional logistic regression. RESULTS Univariate analysis showed significant difference in HBsAg seropositivity, liver cirrhosis, hepatolithiasis, choledocholithiasis and schistosomiasis between ICC patients and healthy controls (P < 0.05). Multivariate analysis confirmed that HBsAg seropositivity, liver cirrhosis, hepatolithiasis and hepatic schistosomiasis were associated with ICC, and their adjusted odds ratio (95% confidence interval) were 10.265 (6.676-15.783), 13.101 (5.265-32.604), 18.242 (3.580-92.958), 18.435 (1.930-176.082), 15.102 (4.607-49.499) and 11.820 (3.522-39.668), respectively. The incidence of hepatic cyst, cholecystolithiasis, hepatic hemangioma, fatty liver, diabetes mellitus, smoking and drinking were not significantly different between ICC patients and controls. CONCLUSIONS The HBV infection, liver cirrhosis, hepatolithiasis and hepatic schistosomiasis may be the risk factors for ICC in China.

Objective To investigate the reasons of a group of unexplained sepsis and enhance the understanding of the diseases and seek the effective treatment measures. Methods Unexplained sepsis patients in our hospital for 4 years were reviewed retrospectively,40 patients were enrolled and clinical data were investigated. Results All 40 patients were demonstrated with leukopenia and thrombocytopenia which accompanied with varied degrees of multiple organ functional disorder,but bacterial culture,viruses and richettsia serology tests were negative. This disease progressed rapidly with acute onset and high mortality if not treated early. Conclusions These patients may be diagnosed as sepsis of unexplained reasons. The human granulocytic anaplasmosis may be the reason but can not be proved due to limited conditions. Therapies included support treatments,antibiotics,anti-virus and symptomatic treatments. In severe cases,glucocorticoids was used in short time. No cross-infection from person to person was found.

Somatostatin is a kind of cytokine having general biologic activity, and has strongly inhibitoy action on neuroendocrine tumor. Many clinical trials and animal experiments confirmed that somatosatin analog has anti-tumor effect obviously and can improve prognosis of HCC and the survival rate. However, there are contradictions between clinical test results, in recent years. Anti-tumor effect of somatoststin analog has been questioned. The role of somatostatin in the therapy of hepatocellular carcinoma will be reviewed in this article.