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1.
Journal of Clinical Hepatology ; (12): 104-109, 2022.
Article in Chinese | WPRIM | ID: wpr-913122

ABSTRACT

Objective To investigate the association of five noninvasive diagnostic methods for liver cirrhosis, i.e., liver stiffness measurement (LSM) on FibroScan, aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis-4 (FIB-4), gamma-glutamyl transpeptidase-to-platelet ratio (GPR), and red blood cell distribution width-to-platelet ratio (RPR), with traditional Chinese medicine (TCM) syndrome types in patients with compensated hepatitis B cirrhosis. Methods A retrospective analysis was performed for the clinical data of 327 patients who were diagnosed with compensated hepatitis B cirrhosis in The First Affiliated Hospital of Henan University of Chinese Medicine from January 2017 to January 2020, and based on their TCM syndrome type, they were divided into liver depression and spleen deficiency group with 160 patients, liver-gallbladder damp-heat syndrome group with 84 patients, liver-kidney Yin deficiency group with 13 patients, spleen-kidney Yang deficiency group with 5 patients, and blood stasis obstructing the collaterals group with 65 patients. Related data were collected, including clinical data, routine blood test results, liver function, LSM, and color Doppler ultrasound findings of liver, gallbladder, spleen, and pancreas. TCM syndrome differentiation was performed, and the models of APRI, FIB-4, GPR, and RPR were established. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups; the multiple independent samples Kruskal-Wallis H rank sum test was used for comparison of non-normally distributed continuous data between multiple groups, and the one- way Kruskal-Wallis ANOVA (k-sample) was used for multiple comparison; the binary logistic regression analysis was used to investigate the association between TCM syndrome types and non-invasive diagnosis of liver cirrhosis; the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic capability of five noninvasive methods for predicting TCM syndrome type in compensated hepatitis B cirrhosis. Results The logistic regression analysis showed that in the liver-gallbladder damp-heat syndrome group, aspartate aminotransferase OR =1.981, 95% CI : 1.8225-2.139, P < 0.05), and LSM ( OR =2.002, 95% CI : 1.840-2.160, P < 0.05) were influencing factors for compensated hepatitis B cirrhosis; in the liver depression and spleen deficiency group, portal vein width ( OR =4.402, 95% CI : 4.050-4.754, P < 0.05), LSM ( OR =3.901, 95% CI : 3.589-4.213, P < 0.05), APRI ( OR =1.891, 95% CI : 1.740-2.042, P < 0.05), and FIB-4 ( OR =1.845, 95% CI : 1.697-1.993, P < 0.05) were influencing factors for compensated hepatitis B cirrhosis; in the blood stasis obstructing the collaterals group, LSM ( OR =2.465, 95% CI : 2.268-2.662, P < 0.05), APRI ( OR =1.298, 95% CI : 1.194-1.402, P < 0.05), and FIB-4 ( OR =1.849, 95% CI : 1.701-1.997, P < 0.05) were influencing factors for compensated hepatitis B cirrhosis. The ROC curve analysis showed that LSM and RPR had a significantly better diagnostic value than the other methods in evaluating liver-gallbladder damp-heat syndrome, and LSM and FIB-4 had a significantly better diagnostic value than the other methods in evaluating liver depression and spleen deficiency; all five noninvasive diagnostic methods had a good value in evaluating the syndrome of blood stasis obstructing the collaterals. Conclusion The five noninvasive diagnostic methods have their own advantages in evaluating different syndrome types, which provide a reference for the diagnosis of TCM syndrome types in patients with compensated hepatitis B cirrhosis.

2.
Journal of Clinical Hepatology ; (12): 2869-2873, 2021.
Article in Chinese | WPRIM | ID: wpr-906877

ABSTRACT

Objective To investigate the application value of controlled attenuation parameter (CAP) of hepatocyte steatosis measured by FibroScan in the diagnosis and traditional Chinese medicine (TCM) syndrome differentiation of nonalcoholic fatty liver disease (NAFLD). Methods A retrospective analysis was performed for related data of 364 patients with NAFLD who attended The First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2017 to December 2019, including basic information (age, sex, and body mass index [BMI]), CAP measured by FibroScan, ultrasound findings of the liver, gallbladder, spleen, and pancreas, liver function parameters, and blood lipid parameters. TCM syndrome differentiation was performed based on the information obtained by four diagnostic methods, and then the patients were divided into liver depression and spleen deficiency group, damp turbidity and stagnation group, damp-heat accumulation group, intermingled phlegm and blood stasis group, and spleen-kidney deficiency group. The association of CAP, color Doppler ultrasound findings, liver function parameters, blood lipid parameters, and BMI with TCM syndrome was analyzed. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups; the Kruskal-Wallis H rank sum test with multiple sets of independent samples was used for comparison of non-normally distributed continuous data between multiple groups and further comparison between two groups. The chi-square test or Kruskal-Wallis H rank sum test was used for comparison of categorical data between multiple groups and further comparison between two groups. A Spearman's rank correlation analysis was used to investigate the correlation between CAP and ultrasound grading. Results Among the 364 patients with NAFLD, 169 had the syndrome of liver depression and spleen deficiency, 71 had the syndrome of damp turbidity and stagnation, 60 had the syndrome of damp-heat accumulation, 41 had the syndrome of intermingled phlegm and blood stasis, and 23 had the syndrome of spleen-kidney deficiency. There was a significant difference in CAP value between the different syndrome types ( F =14.839, P < 0.001), and further comparison between two groups showed that the spleen-kidney deficiency group and the intermingled phlegm and blood stasis group had a significantly higher CAP value than the liver depression and spleen deficiency group, the damp turbidity and stagnation group, and the damp-heat accumulation group (all P < 0.05). There was a significant difference in ultrasound grading between the different syndrome types ( χ 2 =22.947, P < 0.001); the liver depression and spleen deficiency group mainly had a mild grade (40.2%), the damp turbidity and stagnation group and the damp-heat accumulation group mainly had a moderate grade (53.5% and 53.3%, respectively), and the intermingled phlegm and blood stasis group and the spleen-kidney deficiency group mainly had a severe grade (68.3% and 43.5%, respectively). CAP was positively correlated with the severity of fatty liver ( r =0.431, P < 0.001). The spleen-kidney deficiency group and the intermingled phlegm and blood stasis group had significantly higher levels of alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, and BMI than the other three groups (all P < 0.001). Conclusion Association is observed between CAP and the TCM syndrome types of NAFLD, and patients with the syndrome of spleen-kidney deficiency and the syndrome of intermingled phlegm and blood stasis have a higher CAP value than those with the other syndrome types. CAP has similar efficiency to color Doppler ultrasound in the diagnosis of NAFLD.

3.
Journal of Clinical Hepatology ; (12): 2689-2691, 2021.
Article in Chinese | WPRIM | ID: wpr-905022

ABSTRACT

Autophagy is a process of self-defense and self-repair of cells and tissues and plays an important role in regulating the body's immune inflammatory response and maintaining the homeostasis of liver cells. This article summarizes the mechanism of autophagy in the development and progression of autoimmune hepatitis (AIH) from the aspects of the role of autophagy in regulating immune inflammatory response, regulating immune signal transduction, and preventing overactivated innate immune response. It is believed that autophagy may reveal the mechanism of AIH and provide new ideas and methods for the research on AIH.

4.
Journal of Clinical Hepatology ; (12): 2225-2230, 2021.
Article in Chinese | WPRIM | ID: wpr-904874

ABSTRACT

The association between circadian rhythm and metabolic diseases has attracted more and more attention in recent years. A large number of clinical studies have shown that people who often stay up late or work in shifts have a significantly higher risk of nonalcoholic fatty liver disease than those with regular work and rest. Based on current research findings, this article reviews the mechanism of action of circadian rhythm genes in nonalcoholic fatty liver disease from the five aspects of lipid metabolism, glucose metabolism, intestinal flora, oxidative stress, and endoplasmic reticulum stress.

5.
Journal of Clinical Hepatology ; (12): 2005-2008, 2021.
Article in Chinese | WPRIM | ID: wpr-904839

ABSTRACT

Treatment regimens for primary liver cancer mainly include surgical resection, liver transplantation, local treatment, and systemic treatment, but there are still problems such as easy metastasis, easy recurrence, and poor prognosis. Most patients are already in the advanced stage at the time of diagnosis and thus lose the opportunity for surgery and require multidisciplinary combined treatment. Traditional Chinese medicine (TCM) has unique advantages in the treatment of primary liver cancer and can exert a synergistic effect in collaboration with different Western medicine treatment methods. This article establishes TCM treatment regimens based on the different clinical stages of primary liver cancer, i.e., surgical resection for early-stage liver cancer to strengthen vital Qi and prevent recurrence, minimally invasive treatment of middle-stage liver cancer to eliminate cancer toxicity and improve efficacy, and symptomatic treatment of advanced liver cancer to reduce pain and maintain quality of life.

6.
Journal of Clinical Hepatology ; (12): 212-215, 2021.
Article in Chinese | WPRIM | ID: wpr-862573

ABSTRACT

MicroRNA(miRNA) affect various biological processes such as cell differentiation, proliferation, and apoptosis by inhibiting the translation of target genes after transcription and are widely involved in the regulation of immune and inflammatory responses in organisms. Autoimmune liver diseases are a group of chronic inflammatory diseases of the hepatobiliary system mediated by abnormal immunity, and abnormal immune inflammatory response of liver tissue with the involvement of miRNA is closely associated with the development and progression of autoimmune liver diseases. This article reviews the current research advances in miRNA in autoimmune liver diseases.

7.
Journal of Clinical Hepatology ; (12): 947-950, 2021.
Article in Chinese | WPRIM | ID: wpr-875909

ABSTRACT

Metabolic associated fatty liver disease (MAFLD) is currently one of the most important liver diseases worldwide, and its incidence rate is increasing year by year. This article summarizes the current research status of medical treatment of MAFLD, including lifestyle changes and individualized drug treatment. Lifestyle changes include diet management, exercise intervention, biological clock adjustment, and psychological intervention, and individualized drug treatment includes insulin sensitizer, vitamin E, weight-loss and lipid-lowering drugs, liver-protecting and transaminase-lowering drugs, and traditional Chinese medicine treatment. At the same time, multidisciplinary treatment is the trend of clinical treatment of MAFLD.

8.
Journal of Clinical Hepatology ; (12): 809-812, 2021.
Article in Chinese | WPRIM | ID: wpr-875886

ABSTRACT

ObjectiveTo investigate the association of gene mutations in the pre-C, C, and basic core promoter (BCP) regions of hepatitis B virus (HBV) with traditional Chinese medicine (TCM) syndrome types in patients with chronic hepatitis B (CHB). MethodsA retrospective analysis was performed for the clinical data of CHB patients who were diagnosed and treated at the outpatient service and ward of Spleen, Stomach, and Hepatobiliary Department, The First Affiliated Hospital of Henan University of Chinese Medicine, from November 2014 to June 2018. Related clinical data were collected and recorded, including general information, HBV serological markers, HBV gene mutations, and information obtained by four TCM diagnostic methods. Syndrome differentiation and typing were performed for each patient with reference to the criteria for TCM syndrome differentiation of viral hepatitis, and the association of gene mutation in the pre-C, C, and BCP regions of HBV with TCM syndrome types was analyzed. The chi-square test was used for comparison of categorical data between groups, and the Kruskal-Wallis H test was used for comparison of continuous data between multiple or two groups. ResultsA total of 235 patients with CHB were enrolled, among whom 101 had internal retention of damp-heat, 88 had stagnation of liver Qi and spleen deficiency, 17 had blood stasis obstructing the collaterals, 19 had liver-kidney Yin deficiency, and 10 had spleen-kidney Yang deficiency. There were significant differences in sex, age, and course of disease between the patients with different TCM syndrome types (χ2=17.389, H=173.280, H=86.520, all P<0.01), and there was a significant difference in age between the CHB patients with gene mutations in the pre-C, C and BCP regions of HBV (H=30.150, P<0.001). There was a significant difference in the distribution of TCM syndrome types between the CHB patients with gene mutations in the pre-C, C and BCP regions of HBV (χ2=58.117, P<0.001), and internal retention of damp-heat and stagnation of liver Qi and spleen deficiency were major TCM syndrome types accounting for 80.43%. The patients with internal retention of damp-heat tended to have A1762T and G1764A mutations, and those with stagnation of liver Qi and spleen deficiency tended to have G1896A, A1762T, and G1764A mutations; G1764A mutation was often observed in the patients with blood stasis obstructing the collaterals or liver-kidney Yin deficiency, and I97L mutation was often observed in the patients with spleen-kidney Yang deficiency. ConclusionGene mutations in the pre-C, C, and BCP regions of HBV are associated with TCM syndrome types in CHB patients, and internal retention of damp-heat and stagnation of liver Qi and spleen deficiency are the most common TCM syndrome types. I97L mutation is often observed in patients with spleen-kidney Yang deficiency.

9.
Journal of Clinical Hepatology ; (12): 463-466, 2021.
Article in Chinese | WPRIM | ID: wpr-873423

ABSTRACT

Nonalcoholic fatty liver disease (NAFLD) is currently the leading cause of abnormal liver biochemical parameters, but the mechanism of its development and progression remains unclear and there is a lack of effective treatment methods. This article reviews that lipotoxicity drives the transformation of NAFLD to nonalcoholic steatohepatitis and liver cirrhosis by triggering the three pathological responses in the liver, i.e., endoplasmic reticulum stress, cell death, and inflammation. It is believed that lipotoxicity is an important factor that promotes the progression of NAFLD to inflammation and fibrosis, which provides a new method for the prevention and treatment of NAFLD.

10.
Journal of Clinical Hepatology ; (12): 458-462, 2021.
Article in Chinese | WPRIM | ID: wpr-873422

ABSTRACT

Nonalcoholic fatty liver disease (NAFLD) is one of the most important liver diseases worldwide. Traditional Chinese medicine has a significant effect in the treatment of NAFLD, possibly by improving lipid metabolism, reducing liver inflammation, regulating intestinal flora, improving innate immunity, and reducing liver fibrosis. This article summarizes the current data on the mechanism of action of traditional Chinese medicine in the treatment of NALFD, so as to provide a reference for clinical application.

11.
Journal of Clinical Hepatology ; (12): 1621-1625, 2019.
Article in Chinese | WPRIM | ID: wpr-779088

ABSTRACT

The incidence rate of nonalcoholic fatty liver disease-related hepatocellular carcinoma (NAFLD-HCC) is gradually increasing. Its pathogenesis is associated with the changes in genetic and epigenetic modifications, metabolism, immunity, intestinal microecology, endocrine pathways, and circadian rhythm. This article summarizes the available data on the pathogenesis of NAFLD-HCC and points out that HCC is caused by the interactions between multiple factors.

12.
Article in Chinese | WPRIM | ID: wpr-498250

ABSTRACT

Objective To analyze medication rules of TCM treatment for primary hepatic carcinoma in recent ten years;To provide references for clinical medication. Methods Literature about primary hepatic carcinoma in CNKI, VIP and Wanfang database from January 2005 to September 2015 was searched by computers to carry out statistical analysis of medicine classification and frequency of usage. Results Through screening, 131 articles were included, covering 131 compound TCM prescriptions, 228 kinds of medicine, and 1416 times of frequency of usage. Medicines with relatively high frequency were tonifying deficiency medicine 430 times (30.37%), damp-clearing medicine 233 times (16.45%), medicine for invigorating blood circulation and eliminating stasis (12.99%). Medicines with relatively high frequency were Atractylodis Macrocephalae Rhizoma 64 times (4.52%), Poria 62 times (4.38%), Glycyrrhizae Radix et Rhizoma 52 times (3.67%), Bupleuri Radix 49 times (3.46%), Paeoniae Radix Alba 45 times (3.18%), Astragali Radix 44 times (3.22%), Curcumae Rhizoma 43 times (3.04%), and Artemisiae Scopariae Herba 41 times (2.90%). Conclusion This study summarizes the medicine classification and frequency of usage of TCM treatment for primary hepatic carcinoma in recent ten years, which can provide data support for clinical treatment.

13.
Article in Chinese | WPRIM | ID: wpr-432118

ABSTRACT

Objective To study the value of hCG ratio of blood in peritoneal cavity versus venous blood (RPhCG/VhcG) in diagnosis of early ectopic pregnancy (EP).Methods From Mar.2009 to Oct.2012,268 cases with EP (EP group) and 53 women with intrauterine pregnancy with haemoperitoneum (hIUP) (hIUP group) from International Peace Maternity and Child Health Hospital of Shanghai Jiaotong University School of Medicine,Shanghai 6th People Hospital and Shanghai Jiangwan Hospital were enrolled in this prospective study.The HCG of all subjective were measured in blood in peritonea cavity and venous blood,then calculate the ratio of RPhCG/VhCG.Scatter point analysis and ROC were used to differentiate EP,determine threshold of hlUP and evaluate the sensitivity,specificity and accuracy in diagnosis EP preoperatively.Results The mean RPhCG/VhCG; of EP group was 4.35,which was significantly higher than 0.81 in hIUP group (P < 0.01).Scatter point analysis showed that the threshold value of RPhCG/VhCG between ectopic pregnancy and hIUP was 1.0.The overall sensitivity of RPhCG/VhcG in the diagnosis of EP was 98%,the specificity was 100%,the positive predictive value was 100% and the negtive predictive value was 93%.Conclusion RPhCG/VhCG > 1.0 could be used to diagnose and differentiate EP from hIUP accurately.

14.
Article in Chinese | WPRIM | ID: wpr-589149

ABSTRACT

Objective To study the toxic effect of exotoxin A of Pseudomonas aeruginosa on keratocytes.Methods Three-dimensional gels of type I collagen containing rabbit keratocytes were incubated in the presence of different concentrations of exotoxin A(0.1,1.0,10 mg?L-1),cultivated for 24 h at 37℃,the change of keratocytes in morphology was observed under the light microscope,and the amount of lactate dehydrogenase(LDH) was measured by enzyme linked immunosorbent assay(ELISA).Results The LDH contents in different concentrations(0.1,1.0,10 mg?L-1)of exotoxin A groups were higher than that in the group without exotoxin A(P

15.
Article in Chinese | WPRIM | ID: wpr-449755

ABSTRACT

OBJECTIVE: To observe the effects of Huatan Xiezhuo Recipe (HTXZR) on fatty liver of rats. METHODS: Forty-eight SD rats were randomly divided into five groups: normal control group, untreated group, Dongbao Gantai Tablet (DBGTT)-treated group, low-dose HTXZR-treated group and high-dose HTXZR-treated group. Fatty liver was induced in the rats by hyperlipid diet and intraperitoneal injection of tetracycline. The pathological changes of liver tissues in rats were observed, and the liver function, serum leptin, insulin resistance index, triglyceride (TG) and free fatty acid (FFA) in the liver were detected. RESULTS: The levels of serum leptin, insulin resistance index, FFA and TG in rats of the three treated groups were lower than those of the untreated group (P<0.01), and such effects in the HTXZR-treated groups were more significant than those in the DBGTT-treated group (P<0.05). CONCLUSION: The main action mechanisms of HTXZR in treating fatty liver are probably to promote the lipid metabolism, decrease the leptin and insulin resistance.

16.
Article in Chinese | WPRIM | ID: wpr-564608

ABSTRACT

Objective:To observe the curative effect of traditional Chinese medicine on non-alcoholic fatty liver patients and CTN(computerized tomographynumber)of liver,than to appraise the role of assessment and diagnosis on non-alcoholic fatty liver for CT.Methods:60 patients with non-alcoholic fatty liver were divided into treatment group and contrast group in average,the patients in treatment group were treated by Xiaozhihugan capsule and Dangfeiliganning capsule,and those in contrast group were treated by Kezhi capsule and Shuifeijibin capsule.Changes of symptom,liver function,blood fat,ultrasonic report and liver CTN were observed.Results:In the treat group,the liver function,blood fat and liver CT value were improved obviously,which had superiority to that of contrast group.CT can diagnose the degree of fatty liver accurately and appraise curative effect,but ultrasonic report has no specific data and is inconvenient to statistics.Conclusions:Treatment group has notable curative effect on non-alcoholic fatty liver;CT is the important index of diagnosis and appraisement of curative effect on non-alcoholic fatty liver.

17.
Article in Chinese | WPRIM | ID: wpr-569809

ABSTRACT

Objective To investigate the correlation of metabolism disturbance of oxygen free radical(OFR) with endometriosis and endometrioma, to provide an evidence for the diagnosis and treatment. Methods (1) The lipid peroxide (LPO), selenium (Se), superxide dismutase (SOD) and vitamine E (VE) levels were respectively in the vein blood, ovary tissue of the chocolate cyst wall and chocolate cyst fluid in 32 operated patients with endometriosis (endometriosis group). (2) The levels above were determined seperately in 23 operated patients with endometrioma (endometrioma group) and 30 cases of hysteroma (control group). Results (1)The LPO levels in vein blood and ovary tissue of endometriosis group were (6 357?1 251) ?mol/L and (3 735?1 546) nmol/g protein. Which significantly higher than those of control group ( P 0 05). Conclusion The endome triosis and endometrioma is related to the produce or metabolistic inbalance of oxygen free radical, and so to the increasing of lipid peroxide.

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