目的:研究Toll样受体4(TLR4) mRNA及其下游炎性因子肿瘤坏死因子-α(TNF-α)与肝衰竭肠源性内毒素血症(IETM)大鼠肝细胞凋亡的关系,并探索温阳解毒化瘀颗粒对内毒素介导的肝细胞凋亡的调控机制.方法:SPF级雄性SD大鼠85只,随机分为正常组,模型组,TLR4单克隆抗体组和温阳解毒化瘀颗粒组(8.925 g·kg-1).采用D-半乳糖胺(D-Gal)腹腔注射建立肝衰竭IETM模型,TLR4单克隆抗体组和温阳解毒化瘀颗粒组在造模前5d给予温阳解毒化瘀颗粒溶液灌胃,正常组、模型组以等容积蒸馏水代替,直至处死.各组分别在24,48,72 h随机处死大鼠并采集标本.检测24,48,72 h各组时间点血清丙氨酸氨基转移酶(ALT),天门冬氨酸氨基转移酶(AST)水平,苏木素-伊红(HE)染色观察肝组织病理变化,实时荧光定量聚合酶链式反应(Real-time PCR)检测肝组织TLR4 mRNA表达,酶联免疫吸附测定法(ELISA)检测肝组织TNF-α表达,流式细胞仪检测肝细胞凋亡率.结果:与正常组比较,模型组ALT,AST升高,肝组织病理损伤程度明显加重,TLR4mRNA,TNF-α表达均增高(P＜0.05,P＜0.01),肝细胞凋亡率明显上升(P＜0.05,P＜0.01);与模型组比较,温阳解毒化瘀颗粒组ALT,AST显著降低(P＜0.01),肝组织病理损伤程度明显减轻(P＜0.05),TLR4 mRNA,TNF-α表达显著下降(P＜0.01),肝细胞凋亡率亦显著降低(P＜0.01).结论:TLR4 mRNA,TNF-α在肝衰竭时与肝细胞凋亡呈正相关,温阳解毒化瘀颗粒能够改善肝衰竭IETM大鼠肝功能,减轻肝细胞损伤,减少肝细胞凋亡,其机制可能与其下调肝脏TLR4 mRNA表达,抑制TNF-α释放,降低肝细胞凋亡率有关.

目的:观察利湿化瘀方药退黄合剂治疗湿热瘀阻型肝细胞性黄疸的临床疗效以及对患者肝脏炎症指标(ALT、AST、GGT)、胆红素代谢指标(TBIL、DBIL、DBIL/TBIL)、凝血功能的检测结果和中医症状、体征的改善作用.方法:60例患者随机分为两组,治疗组34例,对照组26例,两组均按统一诊断标准纳入病例,两组患者的性别、年龄、病程经统计学处理,差异无显著性(P>0.05),具有可比性.两组均于治疗前1周开始直至疗程结束停用其他影响疗效判定的中药和西药,治疗组用退黄合剂口服,30mL/次,3次/d;对照组用茵栀黄颗粒,2袋/次,3次/d.疗程:两组均以4周为一个疗程.主要疗效指标:血清总胆红素(TBIL)及综合退黄效果评价.次要疗效指标:其他肝功能指标及中医证候评分.安全性指标:治疗前后血常规、尿常规、大便常规和肾功能测定及心电图检查.并观察记录药物不良反应.结果:治疗组和对照组的总有效率分别为88.24%(30/34)和76.92%(20/26),两组的愈显率分别为67.65%(23/34)和23.08%(6/26),其中治疗组黄疸症状明显改善,肝脏炎症指标ALT(P<0.05)、AST(P<0.05)、GGT(P<0.05)以及胆红素代谢指标TBIL(P<0.01)、DBIL(P<0.01)、DBIL/TBIL(P<0.05)均有明显改善.治疗组和对照组均能有效改善肝脏炎症指标和胆红素代谢指标,但治疗组更为明显,治疗组总有效率和愈显率显著高于对照组.结论:退黄合剂对湿热瘀阻型肝细胞性黄疸有显著疗效,而且对肝脏炎症指标(ALT、AST、GGT)、胆红素代谢指标(TBIL、DBIL、DBIL/TBIL)、凝血功能等实验室指标也有明显改善作用,提示利湿化瘀法具有有效保护肝脏和降低黄疸,改善症状等作用.

Objective: To investigate the effect of Wenyang Jiedu Huayu granule on tight connection of colon mucosain rats with intestinal endotoxemia ( IETM) and explore its potential mechanism of anti-hepatic failure.Methods: Rats were randomly divided into four groups: normal group , model group , Wenyang Jiedu Huayu granule group ( experimental group ) and control group.The model of hepatic failure intestinal endotoxemia was established by intraperitoneal injection of D -galactosamine.Nor-mal group were put to death twenty-four hours after intraperitoneal injection of saline.Respectively select 10 rats and put them to death from the rest groups at 24h, 48h, 72h after modeling, the liver function, endotoxin, expression of occlusal protein (oc-cludin) and myosin light chain kinase (MLCK) in intestinal epithelial were inspected.Results: In model group, serum levels of alanine/grass transaminase (ALT/AST), endotoxin, expression of MLCK were higher than nomal group; while expression of occludin were lower than normal group (P<0.01); In experimental group, serum levels of alanine/grass transaminase (ALT/AST), endotoxin expression of MLCK were lower than model group; while expression of occludin were higher than model group (P<0.05) .Conclusion: The possible mechanisms of Wenyang Jiedu Huayu granule in anti-hepatic liver failure might be it could strengthen the tight connection of intestinal tissue , reducing the absorption of endotoxin.

目的:以D-半乳糖胺(D-gal)不同剂量腹腔注射诱导建立肝衰竭肠源性内毒素血症(IETM)实验动物模型,研究符合肝衰竭IETM改变的最佳造模剂量.方法:将SD大鼠随机分为正常组和D-gal低、中、高、超剂量组,D-gal低、中、高、超剂量组分别以不同剂量D-gal腹腔注射建立肝衰竭IETM模型,正常组在腹腔注射等量生理盐水后24h全部处死,观察D-gal各组大鼠在造模后24h、48h死亡率、肝功能、血清内毒素、肝组织及结肠组织病理等变化.结果:D-gal各组大鼠死亡率、肝功能、血清内毒素、肝组织及结肠组织损伤均明显高于正常组(P＜0.01),且随D-gal剂量的增加而加重.结论:①腹腔注射D-gal可诱导建立肝衰竭IETM模型;②D-gal 1.8g/kg腹腔注射诱导建立的IETM模型符合肝衰竭IETM相关改变且更易于观察药物对IETM的干预作用.

<正>后循环缺血(PCI)是指供应脑部的椎基底动脉缺血引起的病变[1],是临床常见的缺血性脑血管病。其症状包括:头昏、眩晕、头痛、恶心、呕吐等[1、2],眩晕是后循环缺血的常见症状。后循环缺血性眩晕属于中医学中"眩晕"的范畴,因本病在多年的临床治疗中疗效不佳,而笔者运用益气养阴法治疗疗效确切,故将该病

Objective To discuss the optimum process conditions of Chitosan on the adsorption condition of Zn2+ and influence on the adsorption performance after regeneration, in order to deal with heavy metal ion in the waste water of laboratory. Methods Laboratory simulation wastewater was established, Chitosan was used for heavy metal ions of Zn2+ of laboratory simulation wastewater in adsorption experiment. Difference pH value, chitosan dosage, time and the best adsorption effect under the temperature were observed. Results In lab condition , the best adsorption condition of Chitosan to Zn2+ liquor was with the pH value of 6, Chitosan dosage was 4 g, time was 30 min and the best temperature of adsorption was 35℃. Conclusion Chitosan has a better adsorbing effect to Zn2+, which can be a absorbent to deal with heavy metal ion in the waste water of laboratory.