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Objective To investigate the effects of Qishen Erlian Decoction on serum MMP-1 and TIMP-1 levels in thioacetamide (TAA) induced liver fibrosis rats; To discuss its mechanism of action. Methods Liver fibrosis model was created by the TAA gavage method. 120 SD male rats were randomly assigned to control group, model group, colchicine group, Qishen Erlian Decoction low-, medium- and high-dose group (20 in each group). Each medication group was given relevant medicine for gavage. Control group and model group were given the same amount of normal saline for gavage, once a day for 5 weeks. HE staining and Masson trichrome staining were used to observe the pathological changes in liver tissue and liver tissue damage. Biochemistry, radioimmunoassay, and ELISA were used to detect the serum liver function, hepatic fibrosis index, MMP-1 and TIMP-1 levels. Results Compared with the model group, serum ALT, AST, TBIL, γ-GGT, HA, LN, Ⅳ-C and PCⅢ levels, MMP-1 and the ratio of MMP-1/TIMP-1 increased significantly and level of TIMP-1 decreased significantly in Qishen Erlian Decoction groups, with statistical significance (P<0.05, P<0.01). And there is a certain dose-effect relationship, with Qishen Erlian Decoction high-dose group the best effect. Conclusion Qishen Erlian Decoction can improve the liver function and liver fibrosis indexes, regulate the level of MMP-1 and TIMP-1, and prevent the progression of liver fibrosis.
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Objective To observe the clinical efficacy ofQishen Erlian Decoction combined with entecavir for patients with liver fibrosis of hepatitis B.MethodsTotally 74 patients were divided into treatment group (38 cases) and control group (36 cases). The control group was given entecavir, while treatment group was given Qishen Erlian Decoction combined with entecavir, 48 weeks for 1 course. Entecavir was given to both groups after treatment, and two groups were followed up for 24 weeks. The liver function, DNA-HBV, serum TGF-β1, BMP-7, liver fibrosis indexes and clinical symptom changes of the two groups were observed.Results 3 cases were excluded and 3 cases were lost during follow-up in treatment group; 6 cases were lost during follow-up in the control group. Liver function and HBV-DNA in 12, 24, 36, 48 weeks and 24 weeks in follow-up were significantly lower than those pre-treatment (P<0.01) in the treatment group, and were significantly better than those in the control group (P<0.01). TGF-β1 decreased (P<0.05), BMP-7 increased (P<0.01), and the ratio of TGF-β1/BMP-7 decreased (P<0.01) in both groups after treatment. There was significant difference between the two groups (P<0.05). HA, LN, PCⅢ,Ⅳ-C, and FS decreased significantly in treatment group after treatment and in the follow-up (P<0.01), fatigue, discomfort in liver region, disgust oil and anorexia were improved (P<0.05), the difference was significant compared with control group (P<0.05).Conclusion Qishen Erlian Decoction combined with entecavir can not only protect liver and reduce aminotransferase, but also be antiviral and reverse liver fibrosis.
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Objective To investigate the diagnostic value of serum FER, AFP and AFP-L3 alone or in combination for diagnosis of primary hepatic carcinoma( PHC).Methods This was a case-control study. Serum FER, AFP and AFP-L3 were determined in 212 patients with PHC ( StageⅠ45 cases, StageⅡ78 cases, StageⅢ81 cases, StageⅣ8 cases) , 127 patients with cirrhosis, 101 patients with chronic hepatitis and 98 controls in the Beijing Youan Hospital affiliated to Capital Medical University from January 2014 to December 2014.Levels of FER, AFP and AFP-L3 were measured by chemiluminescence, while serum samples were pre-treatment with affinity adsorption before AFP-L3 detection.FER, AFP and AFP-L3 levels were analyzed using the nonparametric Wilcoxon test among all groups.Diagnostic performance were analyzed among the groups with the three biomarkers independently and combined.Logistic regression, plotted ROC curve and calculated the area under ROC curve ( AUC) were applied to assess the diagnostic value of each index.Results Serum concentration of FER in PHC, cirrhosis, chronic hepatitis groups and healthy controls were 308.45 ( 148.98 -662.80 ) , 151.70 ( 51.44 -507.40 ) , 298.20 ( 157.30 -701.80 ) , 113.50( 54.98-221.38) μg/L, respectively.The concentration of AFP were 48.50(5.25 -748.40), 3.91(1.80-17.53), 4.76 (2.29-30.56), 2.57 (0.93-3.68) μg/L in each group.The serum levels of AFP-L3 in each group were 4.75(0.61-127.95), 0.61 (0.61-2.50), 0.61 (0.61-2.85), 0.61 (0.61-0.61) μg/L.The concentration of FER, AFP and AFP-L3 differs statistically in PHC, cirrhosis, chronic hepatitis group and healthy controls (χ2 =67.66,146.31,119.02,P<0.001).The content of serum FER, AFP and AFP-L3 increased gradually as the stage level aggravating ( StageⅠ-Ⅳ) , there was significant differences among groups (χ2 =21.63,22.68,21.98, P<0.001) .When using one serum marker, FER had the highest sensitivity (75.00%) , while AFP-L3 had the highest specificity (82.52%). While using two serum markers, FER/AFP had the highest sensitivity (89.15%) , FER+AFP-L3 and AFP+AFP-L3 had a higher specificity (86.20%).The combined detection of FER/AFP/AFP-L3 improved the sensitivity of the test to 89.15%, while FER+AFP+AFP-L3 had a specificity of 86.50%.The AUC of combination of FER, AFP and AFP-L3 was 0.803 ±0.019 (95% CI:0.765-0.841), which was higher than the AUC of either FER(0.748 ±0.022,95% CI:0.705-0.790, Z=4.67,P<0.001) and AFP-L3 (0.726 ±0.024,95% CI: 0.679 -0.772, Z=3.64,P<0.001).However, there was no significant difference in AUC between AFP alone ( 0.776 ±0.021, 95% CI: 0.735 -0.818 ) and the combined detection ( Z=1.34, P=0.18 ) .Conclusions FER was a potential marker for PHC diagnosis.The combination of FER, AFP and AFP-L3 has higher value of clinical applications than one of them independently.
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Objective To observe the effects of combined generalepidural anesthesia on perioperative myocardial enzymogram and troponin T of the myocardium(cTnT)in old patients undergoing thoracic surgery.Methods Thirty-eight ASAⅠ-Ⅱ patients aged 60～80 years old were randomly divided into two groups.General anesthesia group(group G): anesthesia was induced with fentanly,propofol and vecuronium and maintained with isoflurane,propofol and vecuronium.Combined anesthesia group(group C):general anesthesia was performed as in group G and continuous epidural block with(1.6%) lidocaine was added during operation.Peripheral blood CK,CK-MB,AST,LDH and cTnT were measured before anesthesia,at the end of operation and at 6,24,48 hours after operation.Results Two groups could provide same postoperative analgesia.There was no change for HR,RR and MAP in two groups.Serum CK,AST,LDH and cTnT concentration in group G after operation were significantly higher than those before anesthesia(P