肝局灶性结节性增生

摘要： 肝局灶性结节性增生(FNH)是肝脏较少见的良性肿瘤样病变,可发生于任何年龄段,多见于20~50岁,男女发病率国内外报道不一致,少数儿童也可发病。一般无明显临床症状及体征,故多于体检或因其他疾病就诊时偶然发现。少数患者可表现为右上腹不适、腹部包块或因瘤体过大出现临近器官压迫症状而就诊。实验室检查一般并无任何特殊,个别病例可因其肿块压迫肝胆管,可引起肝功能异常,但甲胎蛋白、CA199等肿瘤标志物指标为阴性,这可与肝细胞癌等恶性病变相鉴别。

摘要： Objective To analyze the ultrasonographic features for differential diagnosis of nodular hepatocellular carcinoma and focal nodular hyperplasia (FNH). Method 40 patients with nodular hepatocellular carcinoma and 40 pa-tients with FNH who were tested by conventional ultrasound and contrast-enhanced ultrasonography were enrolled. The ultrasonographic features of nodular hepatocellular carcinoma and FNH and the characteristics of contrast-enhanced ultra-sound at different phases were observed. Result Compared to the FNH, the frequencies of vein tumor thrombus (22.5％vs 0), liver cirrhosis (60.0％vs 15.0％) and lymph nodes (20.0％vs 2.5％) in nodular hepatocellular carcinoma were signifi-cantly higher (P0.05); in the portal venous phase and delayed phase, nodular hepatocellular carcinoma mostly with low enhancement while FNH with equal and low enhancement, the differences were statistically significant (Z=2.754, 3.556, P<0.01). The RT [(21.9±8.7) s vs (27.8±9.2) s], TTP [(29.6+9.3) s vs (36.1+11.8) s] and mTT [(102.1+37.7) s vs (136.2+42.1) s] of nod-ular hepatocellular carcinoma were significantly lower than those of FNH, and the PI [(122.8+31.6) vs (85.9+22.2)] was significantly higher than that of FNH, the difference was statistically significant (P<0.01). Conclusion The ultrasonic morphological features and contrast-enhanced ultrasound features of nodular hepatocellular carcinoma and FNH were identifiable, which can be used for accurate identification.%目的 分析结节性肝癌及肝局灶性结节性增生(FNH)的超声特征及超声造影特征.方法 回顾性分析40例结节性肝癌患者(结节性肝癌组)及40例FNH患者(FNH组)的临床资料,所有患者均接受常规超声及超声造影检查,观察两组患者的超声特征及不同时相的超声造影特征.结果 结节性肝癌组患者门静脉癌栓(22.5％vs 0)、肝硬化(60.0％vs 15.0％)及淋巴结肿大(20.0％vs 2.5％)的发生率高于FNH组,中心瘢痕(15.0％vs 62.5％)的发生率低于FNH组,病灶位于肝包膜下的比例(22.5％vs 52.5％)低于FNH组,差异均有统计学意义(P﹤0.05).两组患者的超声动脉相均以高增强为主,动脉相增强模式比较,差异无统计学意义(P﹥0.05);对于门脉相及延迟相,结节性肝癌组患者均以低增强为主,FNH组患者均以等低增强为主,两组患者的门脉相及延迟相增强模式比较,差异均有统计学意义(Z=2.754、3.556,P﹤0.01).结节性肝癌组患者的上升时间(RT)[(21.9±8.7)s vs(27.8±9.2)s]、达峰时间(TTP)[(29.6±9.3)s vs(36.1±11.8)s]及平均通过时间(mTT)[(102.1±37.7)s vs(136.2±42.1)s]均明显短于FNH组,灌注指数(PI)[(122.8±31.6)vs(85.9±22.2)]明显高于FNH组,差异均有统计学意义(P﹤0.01).结论 结节性肝癌和FNH具有较为典型的超声特征及超声造影特征,可对两者进行较准确的鉴别诊断.

摘要： 目的:探讨肝局灶性结节性增生(FNH)的影像学特点,提高FNH诊断水平.方法:回顾性分析30例FNH病人的临床资料,对照分析CT、MRI与病理学结果.结果:30例中共发现45个病灶,其中26例(86.67％)为孤立存在,4例(13.33％)为多发,并发现2例女性儿童FNH病人,占6.67％.典型FNH影像学表现为CT、MRI平扫时密度/信号与正常组织难以分清,增强扫描动脉期明显强化,门静脉期及延迟期密度/信号不出现廓清,具有中央瘢痕者在延迟期明显强化.结论:MRI对中央瘢痕检出率高于CT,MRI对FNH的诊断优于CT.

摘要： 目的 分析＜3 cm肝局灶性结节性增生(focal nodular hyperplasia , FN H )超声造影表现,探讨超声造影诊断小病灶FN H的价值.方法 回顾性分析我院经手术及病理证实的48个＜3 cm的FN H病灶.团注造影剂SonoVue后观察并记录5 min内病灶的增强表现.结果 所有FN H病灶在动脉期均表现为快速增强,其中39个病灶表现为泉涌状增强, 8个表现为轮辐状增强, 1个表现为分支状增强.超声造影中央瘢痕显示率为 6 .3% (3／48) ,外周滋养动脉显示率为 52 .1% (25／48 ) .根据病灶在超声造影各时相的增强－消退的变化, 20 .8% (10／48)表现为"快进慢出" , 64 .6% (31／48)表现为"快进同出" , 14 .6% (7／48)表现为"快进快出" .以"快进同出"或"快进慢出"为依据诊断良性占位,准确性达85 .4% (41／48) .以泉涌状增强、轮辐状增强、瘢痕和滋养动脉中任何一种征象为依据诊断FN H ,超声造影诊断＜3 cm的FN H的准确性可达97 .9% (47／48) ,其中81 .3% (39／48)病灶通过泉涌状增强诊断为 FN H .结论 超声造影可显示3 cm以下 FN H的增强特点,其中泉涌状增强是诊断＜3 cm FN H的最主要征象.超声造影对＜3 cm的FN H具有较高的诊断价值.%Objective To analyze the typical contrast-enhanced ultrasound ( CEUS ) enhancement characteristics of hepatic focal nodular hyperplasia ( FNH) within 3 cm ,and to discuss the diagnostic value of CEUS in small FNH lesions . Methods Forty-eight cases of FNH were retrospectively studied . All lesions were confirmed histopathologically after surgical resection . CEUS examinations with SonoVue were performed to characterize the enhancement patterns of lesions in 5 minutes . The whole wash in and wash out enhancement procedure of lesions were recorded and analyzed . Results All FNH lesions displayed a rapid hyper-enhancement in arterial phase by CEUS ,39 lesions of which showed spring-like enhancement ;8 lesions showed spoke-like enhancement ;1 lesion showed dendritic enhancement . 6 .3% (3/48) of the lesions showed central scar ,and feeding arteries was found in 52 .1% (25/48) lesions . According to echogenicity shift of the lesions in various phases ,20 .8% (10/48) FNH showed fast-in and slow-out" ,64 .6% (31/48) showed fast-in and synchronous-out" ,and 14 .6% (7/48) showed fast-in and fast-out" . According to fast-in and synchronous-out" or fast-in and slow-out" by CEUS ,the accuracy rate of benignity reached 85 .4% (41/48) . According to any of the spring-like enhancement ,spoke-like enhancement ,central scars or feeding arteries ,the accuracy rate of diagnosis of FNH within 3 cm reached 97 .9% (47/48) ,and 81 .3%(39/48) of which were diagnosed through spring-like enhancement . Conclusions CEUS is helpful in diagnosis of FNH within 3 cm by showing various characteristic enhancement patterns ,and spring-like enhancement is the most important sign in diagnosis of FNH less than 3 cm . CEUS has high diagnostic value for FN H less than 3 cm .

摘要： 目的 分析原发性肝癌(PLC)和肝局灶性结节性增生(FNH)磁共振成像(MRI)平扫及强化特征的差异,以探讨应用MRI鉴别诊断两者的方法.方法 2014年7月~2016年6月我院诊治的26例FNH和36例PLC患者,使用SuperMark 1.5 T磁共振成像仪行MRI平扫和动态增强扫描.比较两组病灶分布情况和影像学表现特征.结果 FNH病灶在左叶和右叶的比例分别为30.8%和69.2%,与PLC病灶(38.9%和61.1%)比,差异无统计学意义(均P>0.05),但FNH病灶位于肝包膜下的比例为46.2%,显著高于PLC组的16.7%(P0.05);平扫结果显示FNH病灶T1低信号和等信号比例分别为84.6%和15.4%,与PLC病灶(88.9%和11.1%)比,差异无统计学意义(P>0.05);FNH病灶T2高信号和等信号比例分别为88.5%和11.5%,与PLC病灶(91.7%和8.3%)比,差异无统计学意义(P>0.05);PLC病灶内往往显示长T1和长T2两个信号的坏死区,还出现短T1和混杂T2的出血信号,而部分FNH病灶中心处可见星芒状的结构,呈现出长T1和长T2信号.FNH显示中心瘢痕和供血动脉的比例分别为65.4%和46.2%,均显著高于PLC病灶(8.3%和8.3%,P0.05).结论 使用MRI检查可清晰地区分PLC与FNH的影像学特征,有助于两者的判别和鉴别诊断.%Objective To study the difference of magnetic resonance imaging (MRI) scan and enhanced features of patients with primary liver cancer (PLC) and focal nodular hyperplasia (FNH). Methods 26 patients with FNH and 36 patients with PLC between July 2014 and June 2016 were enrolled in this study,and all of them finished MRI check-up. Lesion distribution and imaging manifestation were compared between the two lesions. Results The proportion of lesions in the left lobe and right lobe in FNH foci were 30.8% and 69.2%), not statistically different as compared with PLC foci (38.9% and 61.1%,P>0.05),while the foci under hepatic capsule in FNH was 46.2%,much higher than in PLC (16.7%,P0.05];plain scan results showed that the proportion of low and equal signal in T1 in FNH foci were 84.6% and 15.4%,no significant difference compared with PLC foci (88.9% and 11.1%,P>0.05);the proportion of high and equal signal in T2 in FNH foci were 88.5% and 11.5%,not statistically significantly different as compared with PLC foci (91.7% and 8.3%, respectively,P>0.05);Tumor lesions often showed long T1 and long T2 signals in necrotic area in PLC foci,while FNH exhibited a central stellate structure and a signal of long T1 and long T2;the proportion of central scar and feeding arteries in FNH foci were radiologically 65.4% and 46.2%,much higher than 8.3% and 8.3% in PLC foci (P0.05). Conclusion MRI can clearly distinguish PLC and FNH,which can help the diagnosis in clinical practice.

摘要： 目的 探讨超声造影和微血流成像技术对不典型原发性肝癌(PLC)和肝局灶性结节性增生(FNH)病变的鉴别诊断价值.方法 2014年1月~2015年12月本院收治的不典型PLC患者35例和FNH患者40例,术前行超声造影检查和微血流成像检查,对比分析两种检查方法诊断指标的异同.结果 PLC病灶造影剂到达时间为(4.1±0.7)s,达峰时间为(37.8±11.4)s,分别显著长于FNH组的(2.5±1.0)s和(24.2±9.5)s(P<0.05);PLC组峰值强度为(23.1±5.7)dB,明显低于FNH组的(30.6±4.3)dB(P<0.05);35例不典型PLC患者中,病灶斑块状增强19例,环状增强16例,在40例FNH患者中,病灶动脉相离心性"轮辐状"增强29例,偏心性增强11例,门脉相均为高增强,延迟相高增强15例,等增强22例,低增强3例;在微血流成像检查方面,PLC组动脉最大血流速度(Vmax)为(64.7±3.3)v·cm-1·s-1,显著低于FNH组的(77.8±5.1)v·cm-1·s-1(P<0.05),血流阻力指数(RI)为(0.70±0.05),显著高于FNH组的[(0.53±0.03),P<0.05];在血流信号等级分布方面,不典型PLC组1级3例(8.6%)、2级19例(54.3%)、3级13例(37.1%),FNH组0级33例(82.5%)、1级7例(17.5%),两组差异有统计学意义(P<0.05).结论 超声造影和微血流成像技术分别能从造影的时相和增强模式及血流动力学特征上正确区分不典型PLC与FNH,具有较好的鉴别诊断价值.%Objective To explore the application of ultrasound contrast and micro blood flow imaging in differential diagnosis of atypical primary liver cancer (PLC) and focal nodular hyperplasia (FNH). Methods 35 patients with atypical PLC and 40 with FNH were selected in our hospital between January 2014 and December 2015. All the patients underwent ultrasound contrast and micro blood flow imaging,and the features of PLC and FNH were analyzed and compared. Results The ultrasound contrast showed that the arrive time of contrast agent [(4.1±0.7) s] and the time to peak [(37.8±11.4) s] in the PLC group were significantly longer than those [(2.5±1.0) s and (24.2±9.5) s] in the FNH group,while the peak strength [(23.1±5.7) dB] was obviously lower than [(30.6±4.3) dB] in the FNH group (P<0.05);As showed by the ultrasonogram of liver tumors in enhancement, there were 19 foci being with patchy enhancement and 16 with ring-enhancement in the PLC group,while in the FNH group,there were 29 foci being with annulare enhancement and 11 with eccentric enhancement in arterial phase,40 foci showing hyper-enhancement in portal phase,16 being with hyper-enhancement,22 with same enhancement and 3 with low-enhancement in delayed phase (P<0.05);the results of micro blood flow imaging showed that the maximum artery blood flow velocity (Vmax) was [(64.7±3.3) v·cm-1·s-1] in patients with PLC, obviously lower than[(77.8±5.1) v·cm-1·s-1] in the FNH group,while the resistant index (RI) was [(0.70±0.05)], much higher than [(0.53±0.03)] in the FNH group (P<0.05);There were 3 foci (8.6%) with blood signals of grade 1,19(54.3%) with that of grade 2 and 13(37.1%) with that of grade 3 in the PLC group,while there were 33 foci (82.5%) with blood signals of grade 0 and 7 (17.5%) with that of grade 1 in the FNH group (P<0.05). Conclusion The ultrasound contrast and micro blood flow imaging could distinguish atypical PLC and FNH by the characteristics of time phase,contrast enhancement and the hemodynamic changes.

摘要： 肝局灶性结节性增生是一种较少见的肝脏良性肿瘤样病变,肝脏良性肿瘤发病率中仅次于肝血管瘤.病理上,FNH由正常肝细胞、血管、胆管和Kupffer细胞组成,但无正常肝小叶结构,境界清楚,但无包膜.FNH并非真正的肿瘤,正确诊断可避免不必要的手术创伤.鉴别诊断典型的肝脏FNH表现有一定的特异性，较易明确诊断，但部分肝脏FNH的表现不典型，则需要与肝脏的其他肿瘤鉴别。肝细胞癌(HCC):HCC多见于中老年，且多有肝硬化背景。肿块边界较清，边缘可见线状“包膜”。FNH的CT表现有一定的特异性，越来越多的FNH明确诊断，对于不典型的FNH，影像诊断较困难，可结合临床和病史，必要时穿刺活检，以避免误诊。

摘要： 目的:探讨肝局灶性结节性增生的临床病理学特点。rn 方法:分析10例肝局灶性结节性增生患者的临床资料,采用HE染色观察该病的形态特点。rn 结果:男性6例,女性4例,年龄16~55岁(平均34岁)。形态学上6例均有特征性的中央瘢痕,由纤维结缔组织和扭曲的血管组成,并向外放射状形成纤维间隔。纤维间隔围绕无明显异型的肝细胞形成结节,结节周边肝细胞与纤维间隔内增生的小胆管上皮相互移行。10例随访1-52个月,均无复发。rn 结论:肝局灶性结节性增生是肝脏良性增生性病变,组织学上应与肝细胞腺瘤、AFP阴性的肝细胞肝癌和纤维板层型肝细胞癌进行鉴别。

摘要： 肝局灶性结节性增生(FNH)是一种少见的肝细胞的良性占位性病变.在日常影像诊断中,与高分化肝细胞肝癌(HCC)、肝细胞腺瘤(HA)或肝其他瘤样病变等很难鉴别.本文通过对某院近8年间经病理确诊为FNH的17例病例的临床及影像资料分析,对FNH的影像学特点进行了探讨.

摘要： 本发明涉及肝疾病、其分类和诊断的技术领域。本发明提供了一种新方法，该方法使用用参照样本校准的算法、根据体外基因表达谱的确定和表达谱的分析，用于分类非肝细胞样本间的肝样本；进一步分类为亚组G1至G6之一的肝细胞癌(HCC)样本；局灶性结节不典型增生(FNH)样本；进一步分类为HNF1A突变的HCA、炎性HCA、β连环蛋白突变的HCA或其它HCA样本的肝细胞腺瘤(HCA)样本；和其它良性肝样本。本发明还提供了用于分类肝样本的试剂盒，以及根据对受试者肝样本的初步分类治疗所述受试者中肝疾病的方法。

摘要： 本发明属于生物医药技术领域，具体公开了一种肠道结节性淋巴组织增生症大鼠模型的建立方法，包括以下步骤：将SD大鼠随机分为对照组、低剂量组和高剂量组；低剂量组每日灌胃给药溶于0.3％羧甲基纤维素钠的Z14G 2.5‑5mg/kg，高剂量组每日灌胃给药溶于0.3％羧甲基纤维素钠的Z14G 7.5‑10mg/kg，对照组每日灌胃等量0.3％羧甲基纤维素钠；每天记录三组SD大鼠的体重情况；给药至第7‑28天，分析各组SD大鼠体重变化情况，对每组随机抽取SD大鼠进行检测。该模型建立方法简便易行，稳定、重复性好，造模时间短，造模效率高，便于长期研究，具有良好的应用前景。

摘要： 本发明涉及生物医药技术领域，尤其涉及GLUT1作为色素沉着性绒毛结节性滑膜炎的预防和/或治疗靶点的应用。申请人首次发现GLUT1在色素沉着性绒毛结节性滑膜炎滑膜细胞高表达，提供GLUT1作为色素沉着性绒毛结节性滑膜炎的预防和/或治疗靶点的应用，可通过将GLUT1作为药物靶点，进行预防和/或治疗色素沉着性绒毛结节性滑膜炎药物的筛选，为色素沉着性绒毛结节性滑膜炎预防和/或治疗药物提供了一种新的筛选方法和研发思路。

摘要： 本发明公开了一种治疗回归热型结节性非化脓性脂膜炎的中药，是由中草药实葫芦、瑞苓草、水虾子草、金纳香、女娄菜、矮人陀、龙葵根、上山龙、月季花叶、独角芋、玉簪花根、葫芦茶根、甘肃棘豆、玉屑、竹叶菜、金花菜、香榧草、野席草根、慈竹气笋、蚬肉海棠组成。本发明以纯天然的中草药为原料，标本兼治，疗效确切、无毒副作用，不易复发。

摘要： 本发明公开了一种治疗变应性皮肤结节性血管炎的中药，是由中草药半边莲、桃花、海金沙、茯苓、泽泻、泽漆、白屈菜、椒目、防己、苦竹笋、金针菜、金丝草、挂金灯、火炭母草、紫杉、排钱草、节节花、龙须草、李核仁、盾翅藤、红毛走马胎组成。本发明以纯天然的中草药为原料，标本兼治，疗效确切、无毒副作用，不易复发。

摘要： 本发明公开了一种治疗游走性结节性脂膜炎的中药，是由中草药独角芋、桑蠹虫、桂花跌打、鸦葱、蟹壳、油茶根皮、红蓝地花、金纳香、香花刺、观音苋根、瑞苓草、铁藤根、跌打老、乌鸦翅羽、小叶石楠、三钻风、秤砣梨根、虎掌草、水红袍、落新妇根组成。本发明以纯天然的中草药为原料，标本兼治，疗效确切、无毒副作用，不易复发。

摘要： 一种用于治疗变应性结节性皮肤血管炎的中药，是由下列药物制备而成的：半枝莲、金银花、连翘、鸡血藤、丹参、黃柏、牛膝、薏米、苍术、桂枝、茯苓皮、丹皮、赤芍、夏枯草、牡蛎、象贝母、甘草，将上述药物第一剂加水700毫升煎至200毫升，第二剂加水500毫升煎至200毫升，每日两次，早晚空服。

摘要： 本发明公开了一种中药组合物，包含以下重量份比例的原料：厚朴10‑30份、枳壳10‑30份、制香附10‑30份、虎杖10‑35份、郁金5‑30份、延胡索10‑35份、煅牡蛎10‑40份、柴胡10‑20份、川楝子10‑20份、陈皮10‑20份。本发明根据结节性甲状腺肿的病理机制，在中医药理论的指导下筛选确定组方。实验结果表明，本发明中药组合物具有促进甲状腺细胞凋亡，防止甲状腺肿大的作用，可以用于防治结节性甲状腺肿。

摘要： 本发明提供一种牛结节性皮肤病病毒LSDV、山羊痘病毒GTPV和绵羊痘病毒SPPV的快速检测方法，以及应用于检测方法的Taqman‑MGB探针三重荧光PCR引物对和探针组。其中用于羊痘病毒属CaPV检测的正向引物，其序列为SEQ ID NO：1、用于羊痘病毒属CaPV检测的反向引物，其序列为SEQ ID NO：2；用于检测牛结节性皮肤病病毒LSDV的探针，其序列为SEQ ID NO：3；用于检测山羊痘病毒GTPV的探针，其序列为SEQ ID NO：4；用于检测绵羊痘病毒SPPV的探针，其序列为SEQ ID NO：5。本发明的方法检测的灵敏度高、特异性好、快速高通量；且检测方法操作简便。

摘要： 本发明公开了一种治疗牛结节性皮肤病的组合物，它是由下述重量配比的原料制备而成：苍耳子3‑12份、蛇床子6‑15份、地肤子6‑20份、苦参10‑22份。本发明组合物能够祛风除湿杀虫，有效抑制病毒生长，有效治疗牛结节性皮肤病，同时，还具有良好的广谱杀菌效果，对于圈舍的消杀具有良好的效果。