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中国肝脏病杂志（电子版）

中国肝脏病杂志（电子版）

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Chinese Journal of Liver Diseases(Electronic Version)
《中国肝脏病杂志（电子版）》是一本在载体形式上与纸媒体相互补的多媒体光盘期刊（CD-ROM）。本刊已被《中国科技论文统计源期刊（中国科技核心期刊）》、《美国化学文摘数据库（Chemical Abstracts Service）》、《中国核心期刊遴选数据库》（万方数据-数字化期刊群）、《中文生物医学期刊文献数据库——CMCC》、《中文科技期刊数据库》（重庆维普）、《中国学术期刊网络出版总库》收录。 本刊以电子期刊特有的表现形式，运用影视语言和多媒体技术登载有关肝脏病的专业论著、专家讲坛、临床病例讨论及学术会议等，图文声像并茂，是广大肝脏病工作者了解当前学科前沿、掌握最新技术的有效工具。本刊内容主要包括各种肝脏病的病原学、流行病学、免疫学、临床诊断及预防的实践经验和研究成果，以及本领域新技术、新方法的重要进展。本刊常设的主要栏目有述评、专家讲座、论著、指南、继续医学教育、经验交流、短篇报道、综述、临床病例讨论、设备技术介绍、国内外学术动态等。
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  • 发文量：1104
  • 被引量：715
  • H指数：1
  • 开始收录时间：2008(1)
  • CNKI综合因子：0.771
  • 维普期刊影响因子： 1.12
  • 万方期刊影响因子：0.99
  • 创刊时间：2008
  • 国内刊号/CN：11-9299/R
    国际刊号/ISSN：1674-7380
  • 发行周期：季刊
    邮发代号：82-137
  • 主管单位：中华人民共和国卫生部
    主办单位：人民卫生出版社
中国肝脏病杂志（电子版）-联系信息
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  • 电话：010-84322058
  • 邮箱：editordt@163.com
  • 地址：北京市朝阳区京顺东街8号
  • 邮编：100015
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  • 摘要：在病毒性肝炎的病原学研究历程中,随着乙型肝炎病毒（HBV）和甲型肝炎病毒（HAV）的确立,在临床上很快认识到有一类临床上诊断为病毒性肝炎,但病原学检查HBV和HAV都是阴性。因此,从20世纪70年代开始,临床上称之为非甲非乙型肝炎（non-A,non-B hepatitis,N A N B H）[1]。确立了这个诊断名称以后,很快又发现N A N A B H实际上也不是均一的。
  • 摘要：Objective To investigate the effect of Colgalt2 gene knockout on hepatocyte proliferation and apoptosis on course of hepatocyte regeneration.Methods Colgalt2+/+wild type control mice and Colgalt2-/-mice models of 70% partial hepatectomy (PH) were established according to the protocols by Higgins and Anderson in 1931. Then the part of right lateral lobes of liver from normal mice and those 1, 3, 7 days after PH were harvested, ifxed in 10% neutral buffered formalin, embedded in parafifn and cut into tissue sections. Immunohistochemistry was used to compare the expressive difference of proliferating cell nuclear antigen (PCNA) in the mouse liver slices at different time points after partial hepatectomy. Primary hepatocytes of normal Colgalt2+/+wild type control mice, normal Colgalt2-/- mice and those treated by partial hepatectomyafter 1, 3, 5 days were isolated and puriifed by two steps of collagenase perfusion. Flow cytometry was used to detect apoptotic rate in each group.Results The number of PCNA positive cells of Colgalt2-/-mice was much larger than that of Colgalt2+/+mice on 1, 3, 7 days after PH, and the difference was statistically signiifcant (P<0.01). The viability of primary hepatocytes was 94%. The apoptotic rate of normal Colgalt2+/+ mice was (23.36 ±0.83)%, and that of normal Colgalt2-/-mice was (21.04 ±1.16)%. The apoptotic rates of Colgalt2+/+control mice and Colgalt2-/-mice in the ifrst day after PH were (8.27 ±0.33)%, (8.44 ±0.30)%. The apoptotic rates declined to the lowest on the ifrst day after PH and then they began to increase gradually. While, the apoptotic rates of Colgalt2+/+ mice and Colgalt2-/- mice in the third day after PH were (15.92 ±0.56)%, (12.14 ± 0.37)%. The apoptotic rate of Colgalt2-/- mice was much lower than that of wild type control mice (P<0.01). The apoptotic rates of Colgalt2+/+ mice and Colgalt2-/- mice in the iffth day after PH were (21.36 ±0.51)%, (18.92 ±0.92)% which showed that the apoptotic rate of Colgalt2-/- mice was still lower than that of wild type control mice (P<0.05). The apoptotic rates of both groups had approached to normal level approximately. Conclusions Glycosyltransferase Colgalt2 gene knockout has the effects of promoting hepatocyte proliferation in certain degree and inhibiting hepatocyte apoptosis during liver regeneration, which suggests that Colgalt2 which mediates collagen Glcα1, 2Galβ1-glycosylation may play an important regulating role in liver regeneration.%目的：初步探讨Colgalt2基因敲除对小鼠肝细胞再生过程中细胞增殖和凋亡的作用。方法根据Higgins和Anderson于1931年提出的肝大部分切除模型，实施Colgalt2＋/＋野生型对照组小鼠和Colgalt2－/－小鼠（均为C57BL/6J品系）70%肝大部分切除术（PH），分别取正常小鼠和PH后1、3、7天的小鼠再生肝脏的右外叶，于10%中性福尔马林固定，石蜡包埋，切片。采用免疫组织化学方法比较细胞增殖核抗原（PCNA）在小鼠肝部分切除术后各时间点组间的表达阳性率差异；胶原酶两步灌注法分别分离正常和PH后1、3、5天的Colgalt2＋/＋小鼠和Colgalt2－/－小鼠的肝细胞。流式细胞仪检测各组肝细胞凋亡率。结果 PH后1、3、7天，Colgalt2－/－小鼠肝细胞PCNA阳性表达率显著高于Colgalt2＋/＋小鼠肝细胞PCNA阳性表达率，且差异有显著统计学意义（P＜0.01）。分离的肝细胞活细胞比率达94%，正常Colgalt2＋/＋小鼠和Colgalt2－/－小鼠分离的肝细胞凋亡率分别为（23.36±0.83）%、（21.04±1.16）%；PH后1天， Colgalt2＋/＋对照组小鼠肝细胞凋亡率和Colgalt2－/－小鼠肝细胞凋亡率分别为（8.27±0.33）%、（8.44±0.30）%，PH后1天肝细胞凋亡率均降至最低，随即肝细胞凋亡率逐渐升高；PH后3天，Colgalt2＋/＋小鼠和Colgalt2－/－小鼠肝细胞凋亡率分别为（15.92±0.56）%、（12.14±0.37）%，Colgalt2－/－小鼠的肝细胞凋亡率明显低于野生型对照组小鼠的肝细胞凋亡率（P ＜0.01）；PH后5天，Colgalt2＋/＋小鼠和Colgalt2－/－小鼠肝细胞凋亡率分别为（21.36±0.51）%、（18.92±0.92）%，Colgalt2－/－小鼠的肝细胞凋亡率仍低于野生型对照组小鼠的肝细胞凋亡率（P＜0.05），肝细胞凋亡率均接近于恢复正常水平。结论糖基转移酶Colgalt2基因敲除在肝再生过程中在一定程度上具有促进肝细胞增殖和抗肝细胞凋亡的作用，提示该基因介导的胶原Glcα1，2Galβ1-糖基化修饰对肝再生可能起着重要的调控作用。
  • 摘要：《中国医学前沿杂志（电子版）》创刊于2008年9月,是国家卫生和计划生育委员会主管、人民卫生出版社主办的集光盘、纸版导读、网络、手机报、微信、微博等多位一体的国家级电子期刊,现为月刊,国内统一刊号：CN 11-9298/R,国际标准刊号：ISSN 1674-7372,全国公开发行,邮发代号：82-136,光盘定价：20元/期,2013年9月加入中国科技核心期刊（中国科技论文统计源期刊）。
  • 摘要：本刊现已被《中国科技论文统计源期刊（中国科技核心期刊）》、《美国化学文摘数据库（Chemical Abstracts Service）》、《中国核心期刊遴选数据库》（万方数据-数字化期刊群）、《中文生物医学期刊文献数据库——CMCC》、《中文科技期刊数据库》（重庆维普）、《中国学术期刊网络出版总库》收录。
  • 摘要：《中国肝脏病杂志（电子版）》为中华人民共和国国家卫生和计划生育委员会主管、人民卫生出版社主办、人民卫生电子音像出版社出版的国家级医学科技期刊。为了保护作者和杂志的合法权益,避免引起著作权纠纷,根据《中华人民共和国著作权法》和相关法规,遵照人民卫生出版社相关规定。
  • 摘要：目的：探讨超声引导下介入治疗艾滋病合并肝脓肿的临床价值。方法回顾性分析2009年10月至2014年1月在本科室行超声引导下介入治疗的艾滋病合并肝脓肿患者17例（31个肝脓肿）的治疗情况。结果全部17例患者中，单发脓肿9例，多发脓肿8例，脓肿总数31个。穿刺抽吸16个脓肿，置管引流15个脓肿，成功率100%，引流时间6～30天。手术未出现医护人员职业暴露，患者未出现不良反应，全部患者均治愈。1例患者肝脓肿治愈3个月后出现肝内新发脓肿，再次经皮穿刺抽吸后治愈。结论超声引导下介入治疗AIDS合并肝脓肿是一种安全、有效的治疗方式，亦是首选治疗方式。%ObjectiveTo observe the effect of interventional therapy guided by ultrasound in AIDS patients with liver abscess.Methods Clinical dataabout17 patients of AIDS with liver abscesses(31 lesions) who underwent interventional therapy guided by ultrasound in our department from October 2009 to January 2014 were retrospectively analyzed.ResultsThere are 31 abscesses among the 17 patients, single abscess in 9 cases,andmultiple abscess in 8 cases. Wepunctured16 abscessesandcatheterized 15 abscesses with a success rate of100%,the range of drainagetime was6-30 days. There was no medical staff exposed infection and deifnite complication with patients. All the patients were cured. One patient withanew abscess was punctured again after3months.Conclusions Interventional therapywith ultrasound guided is safe and effective for AIDS patients with liver abscess, also is the preferred treatment.
  • 摘要：为了更好地服务于广大读者、作者及审稿专家,方便查询论文信息、投稿、询稿及审稿,提高杂志工作效率,《中国肝脏病杂志（电子版）》编辑部已开通期刊采编系统,并建设了门户网站。该采编系统在功能上可以实现作者在线投稿、在线查询稿件处理进展;编辑在线收稿、送审,在线编辑加工;审稿专家在线审稿;各种表格、数据的批量生成和保存等。
  • 摘要：LAM、ADV、ETV、Ld T等核苷（酸）类似物口服抗H B V治疗是乙型肝炎、肝硬化患者最基本与最常用的治疗,患者的治疗与定期复查依从性直接与治疗效果密切相关,擅自停药导致乙型肝炎复发甚至死亡屡见不鲜,本研究报告1例并进行相关文献复习,企图唤起更多传染病科、消化科等临床医生的高度关注,尽力避免核苷类似物停药致肝功能衰竭相关死亡的发生,确保患者用药安全。
  • 摘要：抗病毒治疗是慢性乙型肝炎（CHB）治疗的关键。近年来随着抗病毒治疗不断进展,一般患者的治疗逐渐趋于规范,而CHB特殊患者由于循证医学证据相对不足、相关指南无统一的推荐意见等原因成为临床治疗的难点。为进一步规范这些特殊患者的治疗,2010年《中华实验和临床感染病杂志（电子版）》、《临床肝胆病杂志》与《中国肝脏病杂志（电子版）》编辑部组织相关专家对相关资料进行整理与分析。
  • 摘要：肝脏局灶性结节性增生（focal nodular hyperplasia,F N H）是发病率仅次于排在首位的肝血管瘤（h e p a t i c hemangioma）的肝脏实质性良性占位性病变[1],实际上并非真正的肿瘤。FNH在人群中总的发病率约为0.9%,可发生于各个年龄段,以30~40岁为多见,尤以育龄女性为主,男女发病率之比为1︰8~10[2]。近年来,FNH在分子水平的特殊分型已发生了改变。
  • 摘要：《中华实验和临床感染病杂志（电子版）》为中华医学会主办、首都医科大学附属北京地坛医院承办的感染病学专业学术电子期刊，是一本在载体形式上与纸媒体相互补的多媒体光盘期刊（CD-ROM）。本刊以电子期刊特有的表现形式，运用影视语言和多媒体技术登载有关感染病的专业论著、专家讲坛、临床病理讨论及学术会议等，图文声像并茂，是广大感染病工作者了解当前学科前沿、掌握最新技术的有效工具。
  • 摘要：ObjectiveTo observe of liver stagnation and spleen deficiency, bruising internal resistance of clinical efficacy of hepatitisC liver cirrhosis treated by combination of traditional Chinese and Western medicine.MethodsWe collected 136 hepatitis C patients with cirrhosis in our hospitalfrom January 2012 to February 2014 and make a retrospective analysis of clinical data.Thispatients randomly,equally divided into treatment group androutine group.Routine group treated with conventional Western medicine therapy, whiletreatment group add with Sophora reconciliation poison liver decoction treatment on the basis of routine group,and then observed the clinical efifcacy of two groups of patients.ResultsTreatment group total effective rate reached 82.35%,routine group 60.29%, the clinical efifcacy of the treatment group was signiifcantly better than the routine group (P< 0.05), and treatment group curative effect wasmorestable aftersix months.Conclusions The combination of traditional Chinese and Western medicine treatment of hepatitisC cirrhosis can effectively improve patient quality of life, gain signiifcant clinical curative effect, is worthy of popularization and application.%目的：观察肝郁脾虚、瘀血内阻型丙型肝炎肝硬化采用中西医结合治疗的临床疗效。方法回顾性分析2012年1月至2014年2月收治的136例丙型肝炎肝硬化患者的临床资料，随机分为治疗组和常规组各68例。常规组单用西医常规治疗，治疗组在常规组治疗方法的基础上，加用苦参和解毒化肝煎进行治疗，分析两组患者的临床疗效。结果治疗组总有效率达82.35%，常规组达60.29%，治疗组临床疗效显著优于常规组（P ＜0.05），且治疗组治疗24周的疗效较常规组稳定。结论采用中西医结合治疗丙型肝炎肝硬化可有效改善患者生活质量，获得显著临床疗效，值得推广应用。
  • 摘要：Objective To research the effect factors of postpartum hemorrhage of puerpera with liver diseases, and to propose corresponding preventive measures regarding to these relevant risk factors.Methods Total of 96 cases of puerpera in our hospital between January 2010 and December 2012 were selected, from which, 98 cases postpartum hemorrhage of puerpera with liver diseases were and were selected as experimental group, meanwhile 96 cases puerpera without postpartum hemorrhage were selected as control group. Then all the possible factors that may contribute to postpartum hemorrhage of puerpera were compared and analysed. Results Univariate analysis showed that postpartum hemorrhage of puerpera with liver diseases were related to that total protein, packed cell volume (Hct), blood platelet (PLT), albumin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood transfusion, hemoglobin. Multivariate analysis showed that the increasing of alanine aminotransferase (ALT) was independent risk factor of postpartum hemorrhage of puerpera with liver diseases, while the increasing of PLT was independent protective factor of postpartum hemorrhage of puerpera with liver diseases.Conclusions ALT and PLT were independent risk factors of postpartum hemorrhage of puerpera with liver diseases. These risk factors should be targeted prevention and control measures.%目的：探讨肝病孕妇产后出血的影响因素，针对相关危险因素，提出相应防治措施。方法本院2010年1月至2012年12月期间分娩的产妇患者资料中，发生产后出血的98例肝病孕妇作为研究组，未发生产后出血的98例肝病孕妇作为对照组。统计分析对肝病孕妇产后容易导致出血的各种因素。结果单因素分析表明，肝病孕妇产后出血与总蛋白量、红细胞压积、PLT、ALB、AST、ALT、有无输血、Hb有关。多因素分析表明，ALT的增加对于肝病孕妇产后出血来说是独立危险因素（P ＜0.05），PLT增加是导致肝病孕妇产后出血的独立保护因素（P＜0.05）。结论 ALT的增加是肝病孕妇产后出血的独立危险因素，PLT增加是导致肝病孕妇产后出血的独立保护因素，应有针对性地做好防治措施。
  • 摘要：Objective To study an appropriate murine model for this research, the mice were administrated by gastrogavage with CCl4, D-GalN/LPS, D-GalN/TNF-α and ConA to induce acute liver injury in different group, respectively.Methods The 80 mice were randomly separated from 152 male mice (6-8 weeks). The 80 mice were randomly divided into CCl4+H2O group, CCl4+ Sedum Sarmentosum (SS) group, D-GalN/LPS+H2O group, D-GalN/LPS+SS group, D-GalN/TNF-α+H2O group, D-GalN/TNF-α+SS group, ConA+H2O group, and ConA+SS group (10 mice per group) with the injection of CCl4, D-GalN/LPS, D-GalN/TNF-α and ConA in different groups, and all the mice were administraged by gastrogavage with SS at same time. The survival rate were observed. The 72 mice were randomly divided into Normal group, CCl4+H2O group, CCl4+ Sedum Sarmentosum (SS) group, D-GalN/LPS+H2O group, D-GalN/LPS+SS group, D-GalN/TNF-α+H2O group, D-GalN/TNF-α+SS group, ConA+H2O group, and ConA+SS group (8 mice per group). The mice were sacriifced and plasma alanine aminotransferase (ALT), aspartateaminotransferase (AST) and lactate dehydrogenase (LDH) were measured.Results The survival rate of CCl4+SS group mice was elevated from 55% to 90% (P = 0.0128). After 24 hourschallenge, the serum ALT level was (5500.00± 426.20) U/L, AST (4383.00± 358.00) U/L and LDH (6764.00± 691.30) U/L of CCl4+SS group, lower than CCl4+H2O group ALT (10521.00± 1374.00) U/L, AST (7328.00± 947.80) U/L and LDH (13589.00± 1542.00) U/L (P< 0.05).Conclusions Sedum Sarmentosum has an obvious protecting effect for acute liver injury induced by CCl4in mice.%目的：复制四氯化碳（CCl4）、D-氨基半乳糖胺联合内毒素（D-GalN/LPS）、D-氨基半乳糖胺联合肿瘤坏死因子-α（D-GalN/TNF-α）及刀豆蛋白A（ConA）诱导小鼠急性肝损伤模型，筛选针对垂盆草（Sedum Sarmentosum，SS）水煎液有效的急性肝损伤小鼠模型。方法采用152只雄性6～8周龄C57BL/6小鼠，其中80只小鼠随机分为CCl4＋H2O组、CCl4＋SS组、D-GalN/LPS＋H2O组、D-GalN/LPS＋SS组、D-GalN/TNF-α＋H2O组、D-GalN/TNF-α＋SS组、ConA＋H2O组及ConA＋SS组共8组，每组10只，观察各组生存率。其余72只小鼠随机分为Normal组、CCl4＋H2O肝功能组、CCl4＋SS肝功能组、D-GalN/LPS＋H2O肝功能组、D-GalN/LPS＋SS肝功能组、D-GalN/TNF-α＋H2O肝功能组、D-GalN/TNF-α＋SS肝功能组、ConA＋H2O肝功能组及ConA＋SS肝功能组共9组，每组8只，检测血浆ALT、AST和乳酸脱氢酶（LDH）水平。结果垂盆草水煎液将CCl4小鼠急性肝损伤模型的生存率由55%提高到90%（P =0.0128）。造模24小时后，CCl4＋SS组ALT为（5500.00±426.20）U/L，AST为（4383.00±358.00）U/L，LDH为（6764.00±691.30）U/L，分别低于CCl4＋ H2O组ALT[（10521.00±1374.00）U/L]、AST[（7328.00±947.80）U/L]、LDH[（13589.00±1542.00）U/L]，差异均有统计学意义（P均＜0.05）。结论垂盆草水煎液对CCl4诱导小鼠急性肝损伤模型有保护作用。
  • 摘要：Objective To investigate the clinical characteristics and risk factors for thyroid disease in patients before and during interferon treatment in viral hepatitis patients.Methods Total of 185 patients with chronic hepatitis B and chronic hepatitis C who received interferon treatments were enrolled. All patients took one year follow-up. Clinical data was analyzed to elucidate the relationship between IFN therapy and thyroid dysfunction.Results The 98 cases of chronic hepatitis B (CHB group) and 87 cases of chronic hepatitis C patients (CHC group) were enrolled. The 27 patients (14.6%) had thyroid dysfunction before IFN treatment. Less male patients (3.5%, 4/115) had thyroid dysfunction before IFN therapy than female patients (32.9%, 23/70). More CHC patients 23.0% (20/87) had thyroid dysfunction before IFN therapy than CHB patients (7.1%, 7/98). And more CHC patients were TPOAb positive before IFN treatment than CHB patients. More female patients (80.0%, 56/70) had thyroid dysfunction during IFN therapy than male patients (16.5%, 19/115). More CHC patients (66.7%, 58/87) had thyroid dysfunction during IFN therapy than CHB patients (17.3%, 17/98). And more CHC patients were TPOAb positive during IFN treatment than CHB patients. Logistic regression indicates that female, chronic hepatitis C and TPOAb positive are independent risk factors for thyroid dysfunction.Conclusions Female CHC patients with TPOAb positive are more likely to have thyroid disease.%目的：研究病毒性肝炎进行干扰素治疗前和治疗中甲状腺疾病的临床特点及相关危险因素。方法临床收集慢性病毒性肝炎（乙型和丙型）患者应用干扰素治疗共185例，进行跟踪随访1年，对其临床资料进行统计学分析，探索病毒性肝炎与甲状腺疾病发病的相关因素。结果185例患者中，男性115例，女性70例，慢性乙型病毒性肝炎（乙型肝炎组）98例，慢性丙型病毒性肝炎（丙型肝炎组）87例。干扰素治疗前甲状腺异常患者共27例，男性4例，女性23例，基线时甲状腺异常的发生率男性3.5%（4/115），女性32.9%（23/70），女性高于男性；治疗前乙型肝炎组甲状腺异常7例（7.1%），丙型肝炎组20例（23%），丙型肝炎组患病率高于乙型肝炎组；甲状腺过氧化物酶抗体（TPOAb）浓度也表现为丙型肝炎组高于乙型肝炎组；且差异均有统计学意义。干扰素治疗中甲状腺功异常75例，男性19例，女性56例，甲状腺异常发生率分别是男性16.5%，女性80.0%，女性明显高于男性；治疗中乙型肝炎组甲状腺异常17例（17.3%），丙型肝炎组58例（66.7%）丙型肝炎组高于乙型肝炎组， TPOAb浓度丙型肝炎组明显高于乙型肝炎组，差异均有统计学意义。Logistic多元回归分析结果显示，性别（女性）、病毒性肝炎类型（丙型肝炎）、甲状腺过氧化物酶抗体阳性是发生甲状腺异常的独立危险因素。结论慢性丙型病毒性肝炎合并甲状腺过氧化物酶抗体阳性的患者，干扰素治疗后更易出现甲状腺疾病，女性尤为多见。
  • 摘要：Objective To observe the clinical effect and safety of Jianpiqinghua method combined with adefovir dipivoxil (ADV) on treating chronic hepatitis B (CHB).Methods Total of 158 cases with CHB were randomly double-blind divided into treatment group (n = 80, using ADV combined with Jianpiqinghua apozem) and control group (n = 78, only using ADV). Two groups were given conventional liver protection, suit the case and supportive treatment. The treatment lasted 24 weeks. Clinical symptoms, liver function and HBV DNA changes were observed before and treatment in patients.Results After treatment, the clinical symptoms, liver function and HBV DNA undetectable ratio of treatment group were better than that in control group (P<0.05).Conclusions Jianpiqinghua method combined with ADV is safe and effective treatment on CHB.%目的：观察健脾清化法联合阿德福韦酯（ADV）治疗CHB的临床疗效及安全性。方法采用随机、双盲方法，选择CHB患者158例，随机分为治疗组80例，对照组78例。治疗组给予健脾清化煎剂联合ADV治疗，对照组单用ADV治疗。两组均给予常规保肝、对症、支持治疗，疗程均为24周，观察患者治疗前后临床症状、肝功能及HBV DNA变化。结果治疗后，两组患者临床症状及HBV DNA指标均有所改善，且治疗组总有效率高于对照组（P＜0.05）。结论健脾清化法联合ADV治疗CHB临床疗效显著，且安全性良好。
  • 摘要：ObjectiveTo investigate the effect of clinical surgical techniques of congenital choledochal cyst on improving liver function and its long-termed effect.MethodsWe selected 41cases, including 23 males and 18 females, aged 1.5-14 years old, who are suffering from congenital choledochal cyst in Setemper 2009 to December 2013. All the patients were operated on with complete cyst excision combined with Roux-en-Y hepaticojejunostomy after diagnosis by imaging tests. The serum indexes of liver function, total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST) before operation were tested to compared with that ofone week after operation.ResultsThe result of experiments shows that 27 cases of 41 patients were higher than normal in TBil and DBil, which decreased signiifcantly after the procedure(P<0.01), the difference means something in statistics. In addition, 14 cases are within the range of normal reference value, their postoperative TBil and DBil shows no signiifcant difference (P>0.01). Their preoperative ALT and AST indexes were higher than the normal value, which signiifcantly decreased after the operation. There are signiifcant differences between preoperative and postoperative surgery (P<0.01). Thirty-seven cases which are visited regularly have good prognosis. Two patients suffered from stone formation in bile duct with cholangitis,and their symptoms were relieved after reoperation of lithotomy through original anastomosis, one of them received Partial resection of the left liver with the left lateral lobe of liver ifbrosis. Among them there were two casewith early postoperative complication, one case acute pancreatitis and the other case of adhesion ileus, both of them were relieved after conservative treatment.ConclusionsWe draw a conclusion that complete cyst excision combined with Roux-en-Y hepaticojejunostomy is the best surgical method to cure patients suffering from congenital choledochal cyst.%目的：探讨先天性胆总管囊肿的临床手术方法对肝功能改善的作用及其长期疗效的分析。方法回顾性研究2009年9月至2013年12月手术治疗的先天性胆总管囊肿患者41例，其中男性23例，女性18例，年龄1.5～14岁。所有病例均经影像学确诊后行囊肿及胆囊切除、肝总管-空肠Roux-Y吻合术。术前、术后1周分别测定血清肝功能指标[TBil、直接胆红素（DBil）、ALT、AST]进行比较。结果41例患者术前检测TBil和DBil，其中27例术前高于正常值，其术后TBil和DBil值较术前显著下降，差异有统计学意义（P＜0.01）；另外14例在正常参考值范围内，其术后TBil和DBil值较术前差异无显著性（P＞0.01）；两者术前ALT和AST指标均高于正常值，且术后均明显下降，术前术后比较差异有统计学意义（P ＜0.01）。长期随访37例预后良好。2例患者术后肝胆管结石伴胆管炎，两次手术经原吻合口处切开取石后缓解。其中1例伴有左肝外叶纤维化，予切除部分左肝。2例患者在术后早期出现了并发症，1例出现急性胰腺炎，1例出现肠黏连肠梗阻，经保守治疗后均缓解。结论囊肿及胆囊切除、肝总管-空肠Roux-Y吻合术，是治疗先天性胆总管囊肿的最佳手术方法。
  • 摘要：Objective To explore the relationship between the expression of TGF-β, IL-17 in serum and hepatitis B disease progression.MethodsWe used ELISA method to detect the serum level of TGF-β, IL-17 in epatient,which were choosed from our hospital from 2010 June to 2012 December and were diagosised hepatitis B by thelivertissuepathology biopsy,then to analysis the relationship of between inlfammatory activity, fibrosis degree and TGF-β IL-17 level.Results The TGF-β, IL-17 serum levels have significant difference among different degree of inlfammatory activity,being analysisedby Bonferroni method (P<0.05). There are positive correlationbetween the serum levels and grade of inflammation by Sypearman rank correlation analysis (r=0.517,P = 0.004;r=0.747,P =0.002).The TGF-β, IL-17 serum levels have signiifcant differenceamong different degree of ifbrosis group byBonferroni methodhas (P<0.05). There arepositivecorrelatioshipbetween TGF-βserum level and the different degree of ifbrosis by Spearman rank correlation analysis (r=0.677,P =0.010).There are significant correlationship between the serum expression of IL-17 and TGF-βin chronic hepatitis B patients (r=0.683,P = 0.010).Conclusions The high expression level of TGF-β IL-17 in peripheral bloodin patients with hepatitis Bparticipate in the activity of inlfammation reaction and ifbrosis, TGF-βplay an important role in liver ifbrosis.%目的：探讨乙型肝炎患者外周血清中TGF-β、IL-17的表达与乙型肝炎病变进展的关系。方法收集2010年6月至2012年12月本院感染科确诊为乙型病毒性肝炎且同期进行肝组织活检病例89例，同时采集外周血利用ELISA进行TGF-β、IL-17检测对比分析炎症活动度、纤维化程度与TGF-β、IL-17表达水平间的关系。结果TGF-β、IL-17在不同炎症活动程度的血清水平经Bonferroni法组间比较，差异有统计学意义（P =0.010、0.001）；Spearman等级相关分析结果显示两者血清水平与不同炎症分级间均存在正相关（r=0.517，P =0.004；r=0.747，P =0.002）。经Bonferroni法两两比较，TGF-β、IL-17在不同纤维化程度组别间血清值差异有统计学意义（P =0.030、0.004）；Spearman等级相关分析结果显示TGF-β与不同纤维化程度呈正相关（r=0.677，P =0.010）。本组慢性乙型病毒性肝炎患者外周血清TGF-β、IL-17的表达存在明显的相关性（r=0.683，P =0.010）。结论乙型肝炎患者外周血中TGF-β、IL-17表达升高，共同参与炎症活动度反应和纤维化，TGF-β在肝纤维化中发挥重要作用。
  • 摘要：失代偿期肝硬化是各种病因引起的慢性肝病发生、发展的共同结果,临床以腹水、脾大、侧支循环建立和开放等门静脉高压表现为特征。腹水是失代偿期肝硬化最常见的临床表现,部分患者可合并胸腔积液。临床上,失代偿期肝硬化合并胸腔积液称之为肝性胸水（hepatichydrothorax,HO）。HO多合并腹水,也可单独出现[1,2]。
  • 摘要：半透膜隔开的有浓度差别的溶液,其溶剂通过半透膜由低浓度溶液向高浓度溶液扩散的现象称为渗透（osmose）;为维持溶液与纯溶剂之间的渗透平衡而需要的超额压力称为渗透压（osmotic pressure）,其量的符号为π。国际纯粹化学和应用化学联合会（IUPAC）临床化学部和国际临床化学联合会推荐,在临床化学中使用渗透质量摩尔浓度和渗透体积摩尔浓度两个量,单位分别是mol/kg和mol/L。
  • 摘要：Blumberg博士在1963年通过蛋白电泳技术,在来源于澳大利亚的一份血样中发现了一种新型的抗原,并命名为澳大利亚抗原（Australia antigen,Au Ag）,后来证实这种Au Ag与乙型肝炎（hepatitis B,HB）相关,事实上属于乙型肝炎病毒（hepatitis B virus,HBV）的表面抗原,从而开启了乙型肝炎研究的新时代[1]。也正是因为这一重要发现,Blumberg博士于1976年获得了诺贝尔医学与生理学奖。
  • 摘要：Objective To evaluate and compare the level of liver inlfammation and ifbrosis in patients with chronic hepatitis B (CHB), and its ability of predicting antiviral efifcacy.Methods We select ALT≥4 ULN and HBV DNA≤6.55 log10 copies/ml as the indicators to predict effective anti-hepatitis B virus. There are 365 patients were recruited in the study, according to different damage of liver inlfammation and ifbrosis, patients were divided into four groups: groupⅠ (the grade of inlfammation
  • 摘要：《中国肝脏病杂志（电子版）》已开通官方微博（http：//weibo.com/zggzbzz）,并已经通过新浪官方机构认证。扫描二维码（见封底）即可关注。杂志官方微博的开通,进一步加强了与国内外学者/作者的交流,拓展了即时沟通渠道,也是对外发布信息、宣传的一个窗口。
  • 摘要：目的：观察绞股蓝皂苷（GPS）和银杏叶提取物（GBE）混合物对2型糖尿病（T2DM）合并非酒精性脂肪性肝病（NAFLD）大鼠脂肪肝程度的影响。方法40只SPF级雄性SD大鼠随机分为空白组、T2DM合并NAFLD模型组，造模周期8周。将T2DM合并NAFLD模型随机分为模型组（给予同等体积的纯净水灌胃）、对照组[给予GPS 0.5 g/（kg·d）灌胃]、治疗组[给予GPS 0.5 g/（kg·d）加GBE 0.1 g/（kg·d）灌胃]。继续予高糖高脂饲料，自由饮水；治疗周期为6周；实验周期14周。检测血糖（BS）、甘油三酯（TG）、总胆固醇（TC）、ALT、AST。检测肝组织TG及肝脏病理学。结果空白组、模型组、治疗组、对照组BS水平分别为（5.50±0.51）mmol/L、（18.76±4.20）mmol/L、（10.78±3.38）mmol/L、（14.62±3.32）mmol/L，治疗组、对照组低于模型组（P＜0.01），治疗组低于对照组（P＜0.01）。空白组、模型组、治疗组、对照组TG水平分别为（0.81±0.11）mmol/L、（1.29±0.14）mmol/L、（0.90±0.09）mmol/L、（1.09±0.10）mmol/L，治疗组、对照组低于模型组（P＜0.01），治疗组低于对照组（P＜0.05）。空白组、模型组、治疗组、对照组TC水平分别为（1.39±0.13）mmol/L、（3.69±0.27）mmol/L、（2.59±0.19）mmol/L、（3.11±0.18）mmol/L，治疗组、对照组低于模型组（P均＜0.01），治疗组低于对照组（P＜0.01）。空白组、模型组、治疗组、对照组ALT水平分别为（35.12±3.34）U/L、（60.68±5.12）U/L、（42.13±4.99）U/L、（50.12±4.68）U/L，治疗组、对照组低于模型组（P均＜0.01），治疗组低于对照组（P＜0.05）。空白组、模型组、治疗组、对照组AST水平分别为（81.15±7.14）U/L、（168.12±10.49）U/L、（112.23±10.12）U/L、（139.12±11.68）U/L，治疗组、对照组低于模型组（P＜0.01），治疗组低于对照组（P＜0.01）。空白组、模型组、治疗组、对照组肝组织TG水平分别为（30.26±2.48）mg/G、（228.46±8.48）mg/G、（153.12±9.98）mg/G、（196.24±9.78）mg/G，治疗组、对照组低于模型组（P＜0.05），治疗组低于对照组（P＜0.01）。空白组为正常肝组织，模型组为重度脂肪肝，治疗组和对照组为中-重度脂肪肝，脂肪肝程度治疗组轻于对照组。结论 GPS和GBE混合物通过调整血糖、脂质代谢，减少肝组织TG沉积，保护肝细胞，达到降低T2DM合并NAFLD大鼠模型脂肪肝程度的目的。%Objective To observe effect of the degrees of fatty liver disease in rat with type 2 diabetes mellitus and nonalcoholic fatty liver disease was inhibited by Gypenosides and Ginkgo Biloba Extract Mixture.Methods Total of 40 SPF male SD rats, body mass 220-250 g, were randomly divided into blank control group, model group with type two diabetes mellitus and nonalcoholic fatty liver disease. After eight weeks the NAFLD model in rats was maked, model group were divided into three groups: treatment group were perfused with 500 mg/(kg·d) GPS and 0.1g/(kg·d) ginkgo biloba extract mixture, control group were perfused with 500 mg/(kg·d) GPS, model group were perfused with the same volume of water, and high fat diet at the same time, the experimental period was six weeks. The experimental period was 14 weeks. Blood sugar, triglycerides, total cholesterol (TC), ALT, AST in the plasma in rat was test. It was tested that triglycerides in the liver tissue. The Liver tissue was detected by pathology.Results BS levels in plasma: blank control group (5.50 ±0.51) mmol/L, model group (18.76 ±4.20) mmol/L, treatment group (10.78 ±3.389) mmol/L, control group (14.62 ±3.32) mmol/L, treatment group and control group was lower than model group, there was a signiifcant difference (P< 0.01),treatment group was lower than control group, there was a signiifcant difference (P< 0.05).TG levels in plasma: blank control group (0.81 ±0.11) mmol/L, model group (1.29 ±0.14) mmol/L, treatment group (0.90 ±0.09) mmol/L, control group (1.09 ± 0.10) mmol/L, treatment group and control group was lower than model group, there was a signiifcant difference (P< 0.01),treatment group was lower than and control group, there was a signiifcant difference (P< 0.05). TC levels in plasma: blank control group (1.39 ±0.13) mmol/L, model group (3.69 ±0.27) mmol/L, treatment group (2.59 ± 0.19) mmol/L, control group (3.11 ±0.18) mmol/L, treatment group and control group was lower than model group, there was a signiifcant difference (P< 0.05),treatment group was lower than control group (P< 0.05). ALT levels in plasma: blank control group (35.12 ±3.34) U/L, model group (60.68 ±5.12) U/L, treatment group (42.13 ±4.99) U/L, control group (50.12 ±4.68) U/L, treatment group and control group was lower than model group, there was a signiifcant difference (P< 0.05),treatment group was lower than control group (P< 0.05). AST levels in plasma: blank control group (81.15 ±7.14) U/L, model group (168.12 ±10.49) U/L, treatment group (112.23 ±10.12) U/L, control group (139.12 ±11.68) U/L, treatment group and control group was lower than model group (P< 0.01), treatment groupwas lower than control group (P< 0.01).TG levels in liver tisue: blank control group (30.26 ±2.48) mg/g, model group (228.46 ±8.48) mg/g, treatment group (153.12 ±9.98) mg/g, control group (196.24 ±9.78) mg/g, treatment group and control group was lower than model group, there was a signiifcant difference (P< 0.05),treatment group was lower than control group (P< 0.05). Liver pathology:blank control group was normal liver tissues. Model group was severe fatty liver disease. Treatment group and control group was moderate to severe fatty liver disease, and treatment group was lighter than control group.Conclusions The degree of T2DM and nonalcoholic fatty liver disease in rats was inhibited by gypenosides and ginkgo biloba extract mixture, through blood sugar and lipid metabolism adjusted, and reduce the liver tissue TG deposition, protecting liver cells.
  • 摘要：《中国肝脏病杂志（电子版）》为国家卫生和计划生育委员会主管、人民卫生出版社主办的肝脏病学专业学术电子期刊,是一本在载体形式上与纸媒体相互补的多媒体光盘期刊（CD-ROM）。本刊以电子期刊特有的表现形式,运用影视语言和多媒体技术登载有关肝脏病的专业论著、专家讲坛、临床病理讨论及学术会议等,图文声像并茂。
  • 摘要：ObjectiveTo establish a diagnosis model combining four serum markers of hepatic ifbrosis (HA, LN,PⅢNP,CⅣ) and assess the diagnostic performance of model aimed to discriminate between patients with and without signiifcant hepatic ifbrosis in patients with hepatitis B.Methods Total of485 patients with hepatitis B were randomly divided into an estimation group (324 cases) and a validation group (161 cases). The serum levels of HA, LN, PⅢNP and CⅣ were measured by radiommunoassay in all patients and liver biopsy was used as the gold standard. A binary logistic regression model was established combining four serum markers and applied to the validation group to test its accuracy. The diagnostic value of the model was assessed by the receiver operating characteristic (ROC) curves.ResultsBinary logistic regression identiifed HA, PⅢNP and CⅣ as independent predictors of ifbrosis. We constructed a model named FSM combining HA, PⅢNP and CⅣ that proved useful to identify patients with or without significant hepatic fibrosis in patients with hepatitis B. FSM=1.56 ×ln(HA)+0.92 ×ln(PⅢNP)+1.9 ×ln(CⅣ)-8.18. The area under the ROC curve (AUC) was 0.85 for predicting signiifcant ifbrosis. In validation group, the AUC was also 0.85 for predicting significant fibrosis. Using optimized cutoff values, the sensitivity and negative predictive value of predicting the absence of significant fibrosis (FSM<10.8) were 88.31% and 69%,while the speciifcity and positive predictive value of predicting the presence of signiifcant ifbrosis (FSM≥12.6) were 93.55% and 95.3%. Comparing the FSM diagnostic model and HA, the Youden’s index, positive likelihood ratio, sensitivity, speciifcity and accuracy of FSM model were higher than those of HA, and AUC had signiifcant difference between the two (Z=2.06,P<0.05).ConclusionsThe FSM model established in this study improved the diagnostic performance. It can make the 65%-70% patients without signiifcant hepatic ifbrosis to avoid “liver biopsy”. As a noninvasive method, it can be employed for monitoring the progression of hepatic ifbrosis.%目的：构建以“肝纤四项”为变量的诊断模型，并探讨该诊断模型对明显肝纤维化的诊断效能。方法选取485例乙型病毒性肝炎患者，随机分为建模组324例和验证组161例，采用放射免疫分析法检测建模组和验证组患者血清中HA、LN、PⅢNP、CⅣ的含量；采用二元Logistic回归分析法，以肝组织活检作为“金标准”，构建以“肝纤四项”为变量的诊断模型；采用受试者工作特征（ROC）曲线，评价该诊断模型的诊断效能；用独立的验证组检验该模型的诊断效率。结果在二元Logistic回归分析中，确定了3项与研究终点相关的独立预测指标（HA、PⅢNP和CIV），由这3个指标建立了诊断模型FSM，FSM=1.56 ln（HA）＋0.92 ln（PⅢNP）＋1.90 ln（CⅣ）－8.18。FSM用于预测明显肝纤维化具有较高的诊断价值，ROC曲线下面积（AUC）为0.85。该模型应用于验证组，其诊断明显肝纤维化的AUC同样为0.85。根据ROC曲线，用于预测明显肝纤维化时，FSM取10.8为排除界值，敏感性和阴性预测值分别为88.31%和69%；取12.6为诊断界值，特异性和阳性预测值分别为93.55%和95.3%。比较FSM模型与HA的诊断效能，FSM模型的约登指数、阳性似然比、敏感性、特异性和准确率均高于HA，两者的AUC差异有统计学意义（Z =2.06，P ＜0.05）。结论本研究所建立的“肝纤四项”联合检测FSM模型，一定程度上提高了诊断效能。将该模型应用于预测明显肝纤维化，可使65%～70%无或轻度肝纤维化乙型肝炎患者避免“肝组织活检”。作为一种非创伤性检查手段，该模型可用于动态监测乙型肝炎患者肝纤维化进程。
  • 摘要：Objective To investigate the changes of coagulation function in patients with chronic liver disease. Methods Total of 97 cases with various types of chronic hepatitis measure prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), ifbrinogen (FIB) with the healthy control group for comparison.Results Chronic hepatitis, cirrhosis patients with PT, APTT, TT were signiifcantly prolonged (P<0.01), the content of FIB was decreased (P<0.01), chronic alcoholic liver disease, drug induced liver injury in patients with PT, APTT signiifcantly prolonged (P<0.01), there were no signiifcant difference between TT and FIB content (P>0.05).Conclusions Coagulation tests have a high reference value to monitor patients with bleeding tendency, guide clinical treatment and evaluate prognosis.%目的：探讨慢性肝病患者凝血功能的变化。方法对97例各型慢性肝炎患者进行血浆凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（FIB）测定并与健康对照组进行比较。结果慢性肝炎及肝硬化患者PT、APTT、TT显著延长（P＜0.01），FIB含量明显降低（P＜0.01）。慢性酒精性肝病及药物性肝病患者PT、APTT显著延长（P＜0.01），其TT和FIB含量差异无统计学意义（P＞0.05）。结论进行凝血功能检查对监测慢性肝病患者出血倾向及指导临床治疗和估计预后具有重要的参考价值。
  • 摘要：文内表格的设置应有助于简洁、明了、直观地表达结果。若表中的内容简单,仅少数几个统计数字,用简洁文字可表达清楚的,可删去表格,选用文字描述;若文字叙述冗长繁琐,而用表格表达便于理解,则建议作者选用表格。表、图、文字描述三者之间应无重复。表格设计的基本原则是重点突出、简单明了,主谓分明、层次清楚,结构完整、有自明性。自明性即只看表,不阅读正文,即可理解统计或对比的意义。
  • 摘要：药物性肝损伤（drug induced liver injury,DILI）指在药物使用过程中,因药物本身和（或）其代谢产物或由于特殊体质对药物的超敏感性或耐受性降低所导致的肝脏损伤。DILI约占药物不良反应的7%,住院黄疸患者的2%~30%的暴发性肝衰竭,且发病率持续上升,其中急性肝损伤是药物性肝损伤最常见的发病形式,约占报告病例的90%以上[1,2]。在引起DILI的药物上,国内外有所不同。

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