New frontiers in endovascular therapies for locally advanced hepatocellular carcinoma / Novas fronteiras em terapias endovasculares para carcinoma hepatocelular localmente avançado

Abstract Hepatocellular carcinoma is the most common primary malignant liver tumour and is a leading cause of death worldwide. Despite the advent of screening programmes, most cases of hepatocellular carcinoma are diagnosed late (in an advanced stage) which precludes curative treatments such as surgery and ablation. Therefore, intra-arterial locoregional treatments now play a central role in the management of advanced hepatocellular carcinoma, such treatments ranging from trans-arterial chemo-embolisation to the more recently developed trans-arterial radio-embolisation technique. In this essay, we discuss the state of the art of intra-arterial treatment for locally advanced hepatocellular carcinoma and the future directions for such treatment.

Resumo O carcinoma hepatocelular é o tumor hepático maligno primário mais frequentemente observado, sendo uma das principais causas de mortalidade mundial. Apesar do advento dos programas de triagem, na maioria dos casos o diagnóstico tardio está associado a um estágio avançado da doença que impede o tratamento curativo, como cirurgia ou ablação. Assim, os tratamentos locorregionais intra-arteriais têm agora um papel central no gerenciamento avançado do carcinoma hepatocelular, passando por quimioembolização transarterial e radioembolização. Neste ensaio, discutimos o estado da arte do tratamento intra-arterial atualmente disponível para o carcinoma hepatocelular localmente avançado e suas direções futuras.

Impact of gender on hepatic pathology and antibody - mediated immunity caused by Schistosoma japonicum infection in C57BL/6 mice / 中国血吸虫病防治杂志

Objective To investigate the effect of gender on hepatic pathology and antibody-mediated immunity in Schistosoma japonicum-infected C57BL/6 mice. Methods Female and male C57BL/6 mice were infected with S. japonicum, and the hepatic pathological changes were observed using HE and picrosirius red staining in mice 8 weeks post-infection. The serum specific IgG antibody levels against the soluble adult worm antigen (SWA) and soluble egg antigen (SEA) were measured in mice using enzyme-linked immunosorbent assay (ELISA), and the percentages of follicular helper T (Tfh) cells and regulatory T (Treg) cells were detected in mouse spleen and lymph nodes using flow cytometry. Results HE staining showed no significant difference in the mean area of a single hepatic egg granuloma between female and male mice 8 weeks post-infection with S. japonicum [(28.050 ± 3.576) × 104 μm2 vs. (26.740 ± 4.093) × 104 μm2; t = 0.241, P = 0.821], and picrosirius red staining revealed no statistical differences between female and male mice in terms of the mean proportion of picrosirius red stained hepatic tissues [(7.667 ± 1.856)% vs. (7.667 ± 1.764)%; t = 0, P = 1] or the mean optical density [(0.023 ± 0.003) vs. (0.027 ± 0.007); t = 0.447, P = 0.678]. ELISA detected no significant differences in the serum IgG antibody levels against SWA [(2.098 ± 0.037) vs. (1.970 ± 0.071); t = 1.595, P = 0.162] or SEA [(3.738 ± 0.039) vs. (3.708 ± 0.043); t = 0.512, P = 0.623] between female and male mice 8 weeks post-infection with S. japonicum. Flow cytometry detected significantly greater percentages of Tfh cells in the spleen [female mice, (8.645 ± 1.356)% vs. (1.730 ± 0.181)%, t = 5.055, P = 0.002; male mice, (8.470 ± 1.161)% vs. (1.583 ± 0.218)%, t = 5.829, P = 0.001] and lymph nodes [female mice, (3.218 ± 0.153)% vs. (1.095 ± 0.116)%, t = 11.040, P < 0.001; male mice, (3.673 ± 0.347)% vs. (0.935 ± 0.075)%, t = 8.994, P = 0.001) of both female and male mice 8 weeks post-infection with S. japonicum than in uninfected mice; however, no significant differences were seen between female and male mice 8 weeks post-infection with S. japonicum in terms of the percentages of Tfh cells in the spleen [(8.645 ± 1.356)% vs. (8.470 ± 1.161)%; t = 0.098, P = 0.925] or lymph nodes [(3.218 ± 0.153)% vs. (3.673 ± 0.347)%; t = 1.332, P = 0.241]. There was no significant difference in the proportion of Treg cells in the spleen of male mice between infected and uninfected mice [(10.060 ± 0.361)% vs. (10.130 ± 0.142)%; t = 0.174, P = 0.867], while a higher proportion of Treg cells was seen in the spleen of female mice 8 weeks post-infection with S. japonicum than in uninfected mice [(10.530 ± 0.242)% vs. (9.450 ± 0.263)%; t = 3.021, P = 0.023]. There was no significant difference in the proportion of Treg cells in the spleen between female and male mice infected with S. japonicum [(10.530 ± 0.242)% vs. (10.060 ± 0.361)%; t =1.077, P = 0.323]. In addition, the proportions of Treg cells were significantly greater in the lymph node of S. japonicum -infected female [(17.150 ± 0.805)% vs. (13.100 ± 0.265)%; t = 4.781, P = 0.003] and male mice [(18.550 ± 0.732)% vs. (12.630 ± 0.566)%; t = 6.402, P = 0.001] than in uninfected mice; however, no significant difference was seen between female and male mice 8 weeks post-infection [(17.150 ± 0.805)% vs. (18.550 ± 0.732)%; t = 1.287, P = 0.246]. Conclusion There are no gender-specific hepatic pathological changes or antibody-mediated immunity in C57BL/6 mice post-infection with S. japonicum.

Undifferentiated embryonal sarcoma of the liver in elderly: Case report and review of the literature

Sarcomas are rare lesions of the liver and represent <1% of primary liver tumors. Embryonic sarcoma (undifferentiated) of the liver is a rare and aggressive malignant tumor that usually occurs in children with a peak incidence between 6 and 10 years. In adults, it is extremely rare with only 13 cases described in patients older than 40 years and 68 cases reported in patients older than 15 years. There is a slight predominance of females in adults. With an emphasis on morphological and immunohistochemical features, as well as on clinical data and imaging studies, we present this case report, in addition to extensive literature review on the topic.

Bioimpedância: nova abordagem para detecção não invasiva da fibrose hepática - estudo piloto / Bioimpedance: new approach to non-invasive detection of liver fibrosis - a pilot study

ABSTRACT BACKGROUND: Fibrosis are common structural hepatic change in patients with chronic hepatitis. Liver biopsy is the gold standard for determining the extent of liver fibrosis. Considering the technical difficulties and cost, improvements in non-invasive screening tools are greatly needed. Bioimpedance have been shown to be safe to evaluate tissue fibrosis. OBJECTIVE: To assess the utility of using monofrequential bipolar bioimpedance for the detection of severity of liver fibrosis consistent with chronic viral hepatitis C infections. METHODS: One hundred and ten patients were studied prospectively and formed two groups according to the lab tests results for the detection of HCV, ALT and AST: Group 1 Control (n=50 healthy patients with HCV negative and with ALT and AST values within the normal clinical range) and Group 2 Positive (n=60 patients positive for anti-HCV positive) which were biopsied. All patients underwent an examination with an Electro Sensor Complex, bioimpedance technology. To compare the groups 1 and 2, the ROC curves was used to determine the specificity and sensitivity of the bioimpedance to detect liver fibrosis. To identify liver fibrosis severity the Group 2 Positive was subdivided according to the liver biopsy results (Metavir fibrosis score) into: Sub Group 2A (F0-F1 n=25) - patients without or with minimal portal fibrosis and Sub Group 2B (F3-F4 n=20) patients with numerous septa/cirrhosis. A statistical analysis was conducted to analyze the bioimpedance data differences in delta of the conductance. RESULTS: From the comparison between Groups 1 and 2: 1) The delta value for conductance in the pathway representing the right foot-left hand minus left hand-right foot demonstrated a sensitivity of 85% and a specificity of 78% with a cutoff value ≤5 and P=0.0001. 2) For the comparison between Sub Group 2A (Metavir F0+F1) and Sub Group 2B (Metavir F3+F4), the neural network for the Electro Sensor Complex data demonstrated a sensitivity of 85% and a specificity of 72% with a cutoff probability >50% and P=0.001. AUCROC=0.81. CONCLUSION: Bioimpedance technology had good level sensitivity and acceptable specificity for detecting liver fibrosis using delta of the conductance. There is a potential for the use of bioimpedance technology as non-invasive approaches for screening of liver fibrosis.

RESUMO CONTEXTO: A fibrose é uma alteração hepática estrutural comum em pacientes com hepatite crônica. A biópsia hepática é o padrão ouro para determinar a extensão da fibrose hepática. Considerando as dificuldades técnicas e os custos, melhorias em ferramentas de rastreio não-invasivas são bastante necessárias. A tecnologia bioimpedância tem se mostrado ser segura para avaliar fibrose tecidual. OBJETIVO: Avaliar a utilidade do uso da bioimpedância bipolar para detectar a severidade da fibrose hepática compatível com a hepatite viral B e C. MÉTODOS: Cento e dez pacientes foram estudados, prospectivamente e dois grupos foram formados de acordo com os resultados dos testes laboratoriais para a detecção de HCV, ALT e AST: Grupo 1 Controle (n=50 pacientes saudáveis com HCV negativos e com valores de ALT e AST dentro do padrão de normalidade) e Grupo 2 Positivo (n=60 pacientes positivos para a infecção viral anti-VHC ou HBsAg positiva) que foram biopsiados. Todos os pacientes foram submetidos a um exame com o Electro Sensor Complex, que utiliza a bioimpedância bipolar. Para comparar os Grupos 1 e 2, a curva ROC foi utilizada para determinar a especificidade e sensibilidade da bioimpedância em detectar a fibrose hepática. Para identificar a severidade da fibrose hepática, o Grupo 2 Positivo foi subdividido de acordo com os resultados da biópsia (escore Metavir) em: Sub Grupo 2A (F0-F1 n=25 ) - pacientes sem ou com fibrose portal mínima e Sub Grupo 2B (F3-F4 n=20) pacientes com numerosos septos/cirrose. A análise estatística foi realizada para analisar as diferenças dos valores delta de condutância da bioimpedância. RESULTADOS: A comparação entre os Grupos 1 e 2 mostrou: 1) O valor delta de condutância na via do pé direito à mão esquerda menos o valor do delta da mão esquerda ao pé direito demonstrou uma sensibilidade de 85% e uma especificidade de 78%, com um valor de corte ≤5 e P=0,0001. 2). Na comparação entre o Sub Grupo 2A (Metavir F0+F1) e o Sub Grupo 2B (Metavir F3 + F4), a rede neural para os dados aferidos pelo Electro Sensor Complex demonstrou uma sensibilidade de 85% e uma especificidade de 72%, com um corte de probabilidade >50% P=0,001 e AUCROC=0,81. CONCLUSÃO: Bioimpedância apresentou boa sensibilidade e aceitável especificidade para a detecção da fibrose hepática utilizando o delta da condutância da bioimpedância. Existe um potencial para o uso da bioimpedância como abordagens não-invasivas para o rastreamento da fibrose hepática.

Liver pathology and gene analysis in children with Shwachman-Diamond syndrome / 临床儿科杂志

Objective To analyze the gene abnormality and liver pathology in Shwachman-Diamond syndrome (SDS) in a child. Method The clinical data of one child with SDS were analyzed retrospectively. Result A male patient was 1 month old at onset with neutrophil decrease as the first manifestation, accompanied by anemia, elevated transaminase and repeated infection. Exocrine pancreatic dysfunction was atypical. Pathological examination of liver biopsy showed slight damage of liver cells under light microscope. The blood samples of child and parents were collected, and homozygous mutations of SBDS (NM_016038.2) Intron2 c.258+2T>C p.? were detected by two generation gene sequencing. And these mutations were from both his parents. Conclusion Gene testing is helpful in diagnosing SDS and we suggest that liver biopsy should be performed if condition allows.

Protective Effect of Shenxi Dan on Multiple Organ Damage of Rats with Endotoxic Shock / 广州中医药大学学报

Objective To investigate the protective effect of Shenxi Dan,a recipe for cooling blood,activating blood and inducing resuscitation,on multiple organ damage of rats with endotoxic shock.Methods The SD rats were randomly divided into normal group,model group and Shenxi Dan group.Except for the normal group,the rats in the other groups were given intraperitoneal injection of D-galactosamine (GalN) and intravenous injection of lipopolysaccharide (LPS) to induce endotoxic shock.The changes in mean arterial pressure (MAP) during the entire process were monitored.Serum samples and liver and lung tissues were collected after infusion for 0 h,2 h,6 h,respectively,and then the amount of whole blood cells,serum contents of total bilirubin (TB),lactate dehydrogenase (LDH),aspartate aminotransferase (AST),and alanine aminotransferase (ALT) were detected.Meanwhile,the pathological changes in lung and liver tissues after hematoxylin-eosin (HE) staining were observed under light microscope.Results Compared with the model group,the decrease degree of the blood pressure was mild,platelet count(plt) was not decreased obviously,while the increase of serum TB,LDH,AST,ALT contents was significantly inferior,and inflammatory pathological changes of lung and liver tissues significantly were much relieved in Shenxi Dan group.Conclusion Shenxi Dan can improve lung and liver function of endotoxic shock rats,reduce the pathological damage,and improve microcirculation,which is helpful to clinical treatment of endotoxic shock.

Association between high expression of intrahepatic programmed death-1 and liver inflammation in patients with autoimmune hepatitis / 中华肝脏病杂志

Objective@#To investigate the expression of programmed death-1 (PD-1) in liver tissue and its association with liver pathology in patients with autoimmune hepatitis (AIH).@*Methods@#A total of 54 AIH patients (38 in the active stage and 16 in the remission stage) were enrolled, and 9 healthy volunteers were enrolled as control group. Immunohistochemistry combined with quantitative image analysis was used to measure the expression of PD-1 in liver tissue. The t-test, rank sum test, one-way analysis of variance, least significant difference t-test, Mann-Whitney U test, and Pearson relation analysis were used for statistical analysis of different types of data.@*Results@#The AIH group had a significantly higher positive rate of PD-1 in liver tissue than the control group (13.57%±6.84% vs 2.22%±0.66%, P < 0.01), and the patients in the active stage of AIH had a significantly higher positive rate of PD-1 in liver tissue than those in the remission stage (16.53%±7.72% vs 6.56%±3.16%, P < 0.01). The positive rate of PD-1 in liver tissue was 6.56%±3.16% in G0 group, 14.33%±5.08% in G1-2 group, and 19.23%±5.41% in G3-4 group (P < 0.01), but there was no significant difference in the positive rate of PD-1 between S0, S1-2, and S3-4 groups (P > 0.05). In AIH patients, the positive rate of PD-1 in liver tissue was positively correlated with the levels of total bilirubin, alanine aminotransferase, aspartate aminotransferase, and IgG (r = 0.665, 0.721, 0.711, and 0.813, all P < 0.01).@*Conclusion@#AIH patients have regulated PD-1 expression in liver tissue, which is closely associated with liver inflammation and is not associated with fibrosis degree, suggesting that PD-1 is involved in the development and progression of inflammation in AIH patients.

Report of cysticercosis in sheep of Ballesta, Bolivar, Colombia / Reporte de cisticercosis en ovinos faenados en el corregimiento de Ballesta, Bolívar, Colombia / Relatório cisticercose em ovinos abatidos na aldeia de Ballesta, Bolívar, Colombia

Sheep are the intermediate hosts of Cysticercus tenuicollis, the metacestode of Taenia hydatigena. Cysticercosis produces economic losses associated with loss of condition and offal condemnation at slaughter. The aim of this study was to determine the prevalence of C. tenuicollis cysts in sheep, the most common sites and the histology of livers affected by this parasite in Bolivar, Colombia. This study included 23 sheep (4 females and 19 males) and it was carried out between August and November 2015. The prevalence of C. tenuicollis cysts was 39.13% (9/23). Fifty six percent (5/9) of the animals had body condition (BC: scale of 1 to 5) of 2; 22% (2/9) 3, and 22% (2/9) 4. A single cyst was found in 78% (7/9) of the animals, and 22% (2/9) had two cysts. Cysts were located in the rumen serosa: 44% (4/9); abomasal serosa: 22% (2/9); liver: 22% (2/9); bladder serosa 22% (2/9); and diaphragm: 11% (1/9). The C. tenuicollis metacestodes belonged to the species Taenia hydatigena. Lesions in the liver of all affected animals consisted of severe infiltration of eosinophils, lymphocytes and plasma cells. Also present were areas of periportal fibrosis. In conclusion, cysticercosis damages the liver of sheep and potentially have a deleterious effect on the productivity of the flock. This is the first report describing post-mortem diagnosis of Cysticercus tenuicollis infection in sheep in Colombia.

Los ovinos son los hospederos intermediaros de Taenia hydatigena y su forma de presentación es el Cysticercus tenuicollis. Produce pérdidas económicas asociadas a la disminución de peso y al decomiso de los órganos afectados. El objetivo de este estudio fue determinar la prevalencia de quistes por cisticercos en canales de ovejas, hacer la clasificación taxonómica, describir las localizaciones más frecuentes, estudiar la histología de la hepatitis por cisticerco en ovinos destinados al beneficio provenientes del corregimiento de Ballesta, Bolívar y poblaciones aledañas, Colombia. Se estudiaron 23 ovinos (4 hembras y 19 machos) entre agosto y noviembre de 2015. La prevalencia puntual fue del 39.13% (9/23). El 56% de los animales (5/9) tenían condición corporal (C.C) 2; el 22% (2/9) C.C 3, y el 22% (2/9) C.C 4. El 78% de los animales (7/9) presentaron un solo quiste, y el 22% (2/9), dos quistes. Los quistes se localizaron en la serosa del rumen: 44% (4/9); serosa del abomaso: 22% (2/9); hígado: 22% (2/9); vejiga: 22% (2/9); y diafragma: 11% (1/9). El metacéstodo identificado fue Cysticercus tenuicollis perteneciente al estado larval de la tenia Taenia hidatigena. Las lesiones diagnosticadas en hígado fueron infiltrado severo de eosinófilos, linfocitos y células plasmáticas; fibrosis hepática y colangiohepatitis mixta multifocal. En conclusión, la cisticercosis afecta el hígado de los ovinos y tiene un efecto potencialmente perjudicial sobre la productividad del rebaño. Este es el primer informe que describe en ovejas el diagnóstico post mortem de la infección por C. tenuicollis en Colombia.

Os carneiros sã o os anfitriões de intermediários Taenia hydatigena e sua apresentaçã o é a Cysticercus tenuicollis. Ela produz prejuízos económicos associados com reduçã o de peso e a apreensã o dos órgã os afetados. O objetivo deste estudo foi determinar a prevalência de cistos cisticercos em canais de ovelhas, tornar a classificaçã o taxonô mica, descrever os locais mais comuns, estudar a histologia dos cisticercos hepatite em ovinos destinados a beneficiar da populações circundante de Ballesta, Bolívar, Colômbia. Forum estudados 23 ovelhas (4 mulheres e 19 homens) entre agosto e novembro de 2015. A prevalência pontual foi 39,13% (9/23). 56% dos animais (5/9) tinha condiçã o corporal (C.C.) 2; 22% (09/02) 3 CC, e 22% (2/9) CC 4. 78% dos animais (7/9) tinha um único cisto, e 22% (09/02), dois cistos. Cistos foram localizados na serosa do rúmen: 44% (4/9); abomaso serosa: 22% (09/02); hepática: 22% (2/9); bexiga: 22% (09/02); e diafragma: 11% (09/01). O metacestóide foi identificado Cysticercus tenuicollis pertencentes ao estágio larval da tênia Taenia hydatigena. As lesões hepáticas graves foram diagnosticados infiltrados de eosinófilos, linfócitos e células de plasma; fibrose hepática e colangiohepatitis misturado multifocal. Em conclusã o, cisticercose afecta o fígado de carneiro e tem um efeito potencialmente nocivo sobre a produtividade do rebanho. Este é o primeiro relatório que descreve no diagnóstico postmortem ovelhas de infecçã o por C. tenuicollis na Colô mbia..

Effect of Tonifying Kidney Therapy on Pathology of Chronic Hepatitis B Virus Carriers / 中国中医药信息杂志

Objective To study the effects of tonifying kidney therapy on pathology in chronic hepatitis B virus carriers.MethodsWith the multi-center, randomized, double-blinded and placebo-controlled methods, 600 cases of chronic hepatitis B virus carriers were divided intoBushen Qingtou group,Bushen Jianpi group and control group, 200 cases in each group, and were treated withBushen Qingtou prescription,Bushen Jianpi prescription and placebo prescription respectively for 52 weeks. The pathological changes of the liver biopsy were observed by liver biopsy examination before and after treatment. Inflammatory active degree and fibrosis were scored with Knodell HAI and Ishak.Results The number of decreasing more than 2 points on Knodell HAI inBushen Qingtou group,Bushen Jianpi group and control group was 21, 18, and 6 respectively (P0.05). The number of decreasing more than 1 points on Ishak in Bushen Qingtou group,Bushen Jianpi group, and control group was 13, 12, and 9 respectively (P>0.05); the number of increasing more than 1 points on Ishak inBushen Qingtou group,Bushen Jianpi group and control group was 8, 3, and 11 respectively, with statistical significance betweenBushen Jianpi group and controlled group (P0.05), which meantBushenJianpi prescription could prevent the deterioration of liver tissue fibrosis more significantly than placebo prescription did. ConclusionTonifying kidney therapy, includingBushen Qingtou prescription andBushen Jianpi prescription, can inhibit the inflammatory activity and slow down the fibrosis progression of the chronic HBV carriers.

Effect of Yirui Capsules on Serum Inflammatory Cytokines and Hepatic Alpha-7 Nicotinic Acetylcholine Receptor Expression in Hyperlipidemia Rats / 广州中医药大学学报

Objective To study the relationship between the inflammatory cytokine levels and the expression of hepatic alpha-7 nicotinic acetylcholine receptor (α7 nAChR) in hyperlipidemia rats and to investigate the intervention effect of Yirui Capsules ( mainly composed of Radix Salviae Miltiorrhizae, Fructus Crataegi, Rhizoma Alismatis, etc). Methods Fifty male SD rats were randomly divided into blank control group ( fed with conventional diet, N=10) and high-fat diet group (fed with high-fat diet, N=40). After feeding for 14 d, the forty rats in high-fat diet group were further randomly divided into model control group, and low-, middle-, and high-dose Yirui Capsules groups (140, 280, 560 mg/kg, respectively), 10 rats in each group and the treatment lasting 30 days. And then, the serum levels of lipids were detected, C-reactive protein (CRP) and tumor necrosis factor (TNF) -α in the serum were detected by enzyme-linked immunosorbent assay ( ELISA) , and the expression of hepatic α7 nAChR was analyzed by immunohistochemical staining and reverse transcription-polymerase chain reaction (RT-PCR) . Results Yirui Capsules in different dosages could improve serum lipid levels in hyperlipidemia rats to various degrees. The contents of serum inflammatory cytokines CRP and TNF-α and the mRNA expression of hepatic α7nAChR were increased in the model control group as compared with those in the blank control group ( P<0.01). The contents of inflammatory cytokines CRP, TNF-αand the mRNA expression of hepatic α7nAChR were decreased in the three Yirui Capsules groups as compared with those in the model control group ( P<0.01). The results of immunohistochemical staining for α7nAChR expression were consistent with RT-PCR results. Conclusion The expression of hepatic α7nAChR is increased in hyperlipidemia rats. Yirui capsules are effective on decreasing inflammatory cytokine levels, improving lipid metabolism, and down-regulating α7nAChR expression.

Experimental Study of Yougui Pills on Related Factors of SREBP Pathway in Kidney Yang Deficiency and Hyperlipidemia Rats / 广州中医药大学学报

Objective To observe the effects of Yougui Pills (YP) intervention on SREBP pathway related factors of sterol regulatory element binding protein-1c ( SREBP-1c) , cholesteryl ester transfer protein ( CETP) and fatty acid synthase ( FAS) protein and gene expression in kidney yang deficiency hyperlipidemia rat model. Methods Sixty SD rats were divided into normal control group, model group (in the dosage of 2.43 g/kg), and YP group. Rat model of kidney yang deficiency hyperlipidemia was induced with intramuscular injection of hydrocortisone. Normal control group and model group were given normal saline, and YP group was given YP suspension intragastrically. After treatment, the hepatic pathomorphology of rats in the three groups was examined, and the contents of serum lipids were examined. Hepatic SREBP-1c, CETP and FAS protein expression was detected by Western-blotting method, and their mRNA expression was detected by real-time polymerase chain reaction ( RT-PCR) . Results Compared with the normal control group, serum triglyceride ( TG ) , total cholesterol ( TC ) , low-density lipoprotein cholesterol ( LDL-C ) contents were significantly increased (P<0.01), high-density lipoprotein cholesterol (HDL-C) was significantly decreased (P<0.01), and hepatic pathomorphological changes of hyperlipoidemia were obvious in the model group. Compared with the model group, TG, TC, LDL-C contents were significantly decreased ( P<0.01) , and HDL-C was significantly increased (P<0.01) in YP group. Model group had higher SREBP-1c, CETP and FAS mRNA and protein expression than the normal control group ( P<0.05) , while YP group had lower SREBP-1c, CETP and FAS mRNA and protein expression than the model group ( P<0.05) . Conclusion YP can decrease the blood lipid levels probably by down-regulating the expression levels of SREBP-1c, CETP and FAS gene and protein related to the the SREBP pathway in rats of kidney yang deficiency hyperlipidemia induced by intramuscular injection of hydrocortisone.

Histological Injury and Its Risk Factors of HBeAg-negative Chronic Hepatitis B Virus-infected Patients with Persistently Normal Alanine Aminotransferase Levels / 医学研究杂志

Objective To investigate the histological injury as well as the risk factors for the course of HBeAg-negative chronic hep-atitis B virus( HBV)-infected patients with persistently normal alanine aminotransferase ( ALT) levels ( PNAL) . Methods Ninty four patients of HBeAg-negative chronic HBV-infected with PNAL were performed liver puncturing. The ALT, HBV markers, and liver histo-logical changes were detected. The gender, age, family history, HBV-DNA and HBsAg levels were compared between different patients with liver inflammation and fibrosis. And the Logistic model was used during the analysis of independent risk factor. Results Among 94 cases, patients with inflammatory necrosis classification≥G2 accounted for 74. 5%, fibrosis grading≥S2 accounted for 27. 7%. Patients in the group of inflammatory necrosis classification≥G2 was older than the group of < G2, and the ALT level of≥G2 group was higher, as well as a higher HBV-DNA. What is more,Patients in the group of inflammatory necrosis classification ≥G2 were mainly male, and were associated with a family history of hepatitis B. Patients in the group of fibrosis stage ≥S2 was older than < S2 group, and the ALT level of fibrosis stage ≥S2 group was higher. And those patients were often associated with a family history of hepatitis B, but there was no significant difference among the HBV-DNA level and gender constitution. HBV-DNA and family history were the independent risk fac-tors of liver inflammation necrosis≥G2, and family history was the only independent risk factor of fibrosis stage≥S2. Conclusion The patients of HBeAg-negative chronic HBV-infected with PNAL, regardless of the ALT and HBV-DNA, must have a liver biopsy. The pa-tients with high level of HBV-DNA and with a family history of hepatitis B should be performed liver puncturing accordingly.

Study of Dicliptera Chinensis Polysaccharide in Counteracting Liver Injury Induced by Antituberculosis Drugs / 广州中医药大学学报

Objective To study the therapeutic effect and mechanism of Dicliptera chinensis polysaccharide ( DCP) on liver injury induced by antituberculosis drugs. Methods Sixty mice were randomly divided into six groups, namely normal control group, model group, glucurolactone group (in the dosage of 200 mg·kg-1·d-1), and high-, middle- and low-dose DCP groups ( in the dosage of 600, 400, 200 mg·kg-1·d-1, respectively). Except for the normal control group, the rats in the other groups were given intragastric administration of isoniazid and rifampicin ( 100 mg/kg) to induce liver injury model, and were simultaneously treated with corresponding agents, once a day. On the experiment day 30, the blood and liver tissue were sampled. The serum levels of alanine aminotransferase ( ALT) , aspartate aminotransferase ( AST) , alkaline phosphatase ( AKP) and microsomal nitric oxide ( NO) were detected by biochemical method. The contents of tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) in liver tissue were determined by enzyme-linked immunosorbent assay ( ELISA) , and the hepatic histopathology was observed after HE staining. Results In DCP groups, the hepatic pathological changes of the mice were improved, the number of the inflammatory cells was reduced, and the activities of serum ALT, AST and AKP as well as the contents of hepatic TNF-α, IL-6 and NO were reduced ( P<0.05 or P<0.01 compared with those in the model group). Conclusion Dicliptera chinensis polysaccharide is effective for liver injury induced by antituberculosis drug, and the mechanism may be associated with its anti-inflammatory action.

Associations of peripheral CD4+CD25+CD127low/-regulatory T cells with viral load and liver pathology in hepatitis B virus carriers / 中华临床感染病杂志

Objective To investigate the associations of peripheral CD4+ CD25 + CD127low/-regulatory T cells (Treg) with HBV viral load and liver pathology in hepatitis B virus (HBV) carriers.Methods Forty six chronic HBV carriers admitted in the first hospital of Jiaxing during October 2012 and February 2014,and 23 healthy subjects (controls) were enrolled in the study.CD4+ CD25 + CD127low/-Treg in peripheral blood of the two groups were detected by flow cytometry.Ultrasound-guided liver biopsies were performed in chronic HBV carriers and HBV DNA load was determined by real-time PCR method.Independent samples t test was used for the comparison between groups,and Spearman rank correlation or Pearson linear correlation analyses were performed.Results The frequency of the peripheral CD4+ CD25+CD127low/-Treg in 46 HBV carriers was (5.11 ±1.47)％,which was significantly higher than that in healthy controls [(3.46 ± 1.23) ％,t =4.629,P ＜ 0.01].The HBV DNA load in HBV carriers was (6.21 ±1.98)lg copies/mL,which was positively correlated with the CD4+ CD25+ CD127low/-Treg level (r =0.405,P ＜ 0.01).Among 46 HBV carriers,21 (45.65％) were of inflammation grade 2 or above,and 16 (34.78％) were of fibrosis stage 2 or above.Peripheral CD4+ CD25+ CD127low/-Treg level was negatively correlated with inflammation and fibrosis in HBV carriers (r =-0.343 and-0.452,P ＜ 0.05).Conclusion CD4 + CD25 + CD127low/-Treg may be associated with the chronicity of HBV infection and the degree of liver damage.

Clinical value of liver biopsy for infantile hepatitis syndrome / 中华实用儿科临床杂志

Objective To investigate the value of ultrasound-guided liver biopsy for infantile hepatitis syndrome regarding diagnosis,treatment and prognosis.Methods Fifty children with infantile hepatitis syndrome hospitalized in Guiyang Maternal and Child Hospital during Aug.2010 to May 2012 were involved in this study.Ultrasoundguided liver biopsies were performed to evaluate the inflammation grade and fibrosis stage.Immunohistochemical staining was used for pathogen diagnosis.The clinical outcomes were followed-up.Results Thirty-four cases (68％)were CMV infection,6 cases(12％) were vanishing bile duct syndrome,4 cases(8％) were chronic intrauterine infection,4 cases(8％) were congenital anomaly of bilirubin metabolism,and 2 cases (4％) were obstructive cholangitis.All 50 cases showed mild inflammation at portal area(G1-G2 grade).All 50 cases exhibited liver fibrosis.Sixteen cases were S1 stage,20 cases were S2 stage,8 cases were S3 stage and 6 cases were S4 stage.Pathogen analysis:all 50 cases showed intrahepatic cholestasis:38 cases were diffuse cholestasis,and 12 cases were moderate cholestasis.Treatment:all cases were treated using 2-week heteropathy; antivirus was used for CMV infected cases,thus 39 cases were finally cured,9 cases were relieved,and 2 cases were ineffective.Conclusion Liver biopsy is valuable for diagnosis,treatment and prognosis infantile hepatitis syndrome.

Hepatic hyperplasia and damages induces by zearalenone Fusarium mycotoxins in BALB/c mice / Hiperplasia e danos hepáticos induzidos por micotoxinas do gênero Fusarium-zearalenone em camundongos BAB/c

CONTEXT: Zearalenone is a mycoestrogen and considered a mycotoxin. OBJECTIVE: To establish whether zearalenone produced hepatotoxicity via oral administration. METHODS: Zearalenone was orally administered at a dose of 50 mg, 100 mg and 200 mg ZEN/body weight/daily, respectively, for 14 days to three groups of BALB/c mice. Diagnostic modalities used to evaluate hepatic damage and impaired hepatic function pre- and post zearalenone administration included hepatic marker enzyme activity, pentobarbital sleeping time, cytochrome P-450 activities and histopathologic evaluation of liver. RESULTS: Significant histopathologic changes viz. sinusoidal congestion, cytoplasmic vacuolization, hepatocellular necrosis and neutrophil infiltration were observed after evaluating of liver section from each group after accumulated zearalenone exposure. Further, zearalenone exposure increased activities of alanine transaminase, aspartate transaminase and lipid peroxides whereas activities of tissue glutathione and cytochrome P450 were decreased as compared to control mice. Zearalenone also increased the sleeping time and decreased sleeping latency after pentobarbital through intraperitoneal route as compared to control mice which indicates that the impairment of hepatic metabolizing enzymes by zearalenone. CONCLUSION: Zearalenone is a potential hepatotoxin by oral route.

CONTEXTO: Zearalenone é um micoestrógeno e considerado como micotoxina. OBJETIVO: Avaliar se o Zearalenone produz hepatotoxicidade por administração via oral. MÉTODOS: Zearalenone foi administrada por via oral em doses de 50 µg, 100 µg e 200 µg/peso corporal/dia/14 dias, respectivamente, para três grupos de camundongos BAB/C. Modalidades diagnósticas usadas para avaliar o dano hepático e comprometimento da função hepática pré- e pós-administração de Zearalenone incluíram atividade enzimática de marcadores hepáticos, tempo de sono por pentobarbital, atividade do citocromo P-450 e avaliação histopatológica hepática. RESULTADOS: Alterações histopatológicas significantes como congestão sinusoidal, vacuolização citoplasmática, necrose hepatocelular e infiltração neutrofílica foram observadas após avaliação histológica de cada grupo após exposição acumulada de Zearalenone. Além disto, a exposição à Zearalenone incrementou a atividade das enzimas alanina transaminase e aspartato transaminase e peróxidos lipídicos, ao passo que as atividades teciduais de glutationa e citocromo P-450 diminuiram, quando comparadas com camundongos-controle. Zearalenone também aumentou o tempo de sono e diminuiu a latência do sono após a administração de pentobarbital por via intra-abdominal, quando comparados com camundongos-controle, o que indica o comprometimento das enzimas do metabolismo hepático por ela. CONCLUSÃO: Zearalenone é uma potente hepatotoxina quando administrada por via oral.

Avaliação da intoxicação aguda induzida por atrazina em espécie da ictiofauna do pantanal mato-grossense, pacu (Piaractus mesopotamicus), com o emprego de biomarcadores morfológicos / Morphological biomarkers for assessing acute toxicity of atrazine in pacu (Piaractus mesopotamicus) fingerlings, a freshwater species from the Brazilian pantanal wetland

Atrazina é um herbicida muito usado em agricultura intensiva e encontrado com alta freqüência em recursos hídricos na região do Pantanal Mato-grossense. Assim, devido aos riscos que a atrazina pode trazer à ictiofauna da região, foi proposta deste trabalho determinar a CL50 da atrazina em alevinos de pacu (Piaractus mesopotamicus). A determinação da CL50 em 96 h em sistema estático, realizada em duplicata, foi conduzida em aquários de vidro com 8 peixes cada, de peso médio de 5,06±0,31g, avaliando-se as seguintes concentrações nominais de atrazina: 0; 13,2; 17,6; 22,0; 26,4; 30,8; 35,2; 39,6 mg L-1, realizando-se também análise comportamental e análise anatomopatológica. Experimento de intoxicação aguda foi realizado em duplicata, nas mesmas condições do anterior, com a concentração da CL50 obtida (28,58 mg L-1), sendo empregados 6 exemplares de peso médio 6,68±0,36g. Amostras hepáticas e mesonéfricas foram colhidas e processadas para análise de microscopia de luz (ML), realizando-se nestas amostras análise semi-quantitativa das alterações encontradas, e para análise de microscopia eletrônica de transmissão (MET). Quanto à avaliação comportamental, foram observados nos grupos tratados: o escurecimento da pigmentação da pele, várias alterações na intensidade do movimento, perda de equilíbrio e presença da ação de boquejamento. Na avaliação anatomopatológica, foram observadas nos grupos tratados: dilatação da região ventral, exoftalmia, protrusão labial, hiperemia no opérculo e em todas as nadadeiras, presença de ar e/ou água no estômago e ascite sanguinolenta...

Exposure to atrazine caused darkening of the skin, alterations in the intensity of movements, loss of balance and an increase in the frequency of gasping. Anatomopathological assessment revealed dilation of the ventral region, exophthalmia, lip protrusion, skin hyperemia in the opercular region and in all fins, the presence of air and/or water in the stomach, and bloody ascites after the herbicide exposition. The histopathological analysis revealed the typical hepatic and renal morphology for the specie, in control group. Several histopathological changes were observed in exposed fish, but the changes most significant were: in liver, the presence of hyaline inclusions in the cytoplasm of hepatocytes, and proximal tubule (PT) degeneration in the kidney. The ultrastructure showed that the atrazine caused several membrane alterations suggestive of oxidative stress and lipid peroxidation...

Hemangiosarcoma hepático con metástasis a útero en un felino. Reporte de un caso / Hemangiosarcoma hepático com metástases a útero em um gato. Reporte de um caso / Hepatic haemangiosarcoma with metastasis in uterus in a feline. Case report

El hemangiosarcoma (HSA) es un tumor maligno del endotelio vascular. En gatos esta neoplasia es rara, pues solo un 2% de los diagnósticos de tumores malignos corresponde a HSA hepático. En este informe se presenta el caso de un paciente felino con dilatación abdominal, un mes de evolución, dolor abdominal y anorexia con duración de 3 días. En la necropsia se halló: hidrotórax, dilatación cardiaca derecha, hígado con moteado blanco o amarillo claro de 1 a 2 mm de diámetro y zonas necróticas multifocales de color rojo oscuro sobre la superficie. En útero se encontró dilatación del cuerno izquierdo con múltiples masas sólidas con contenido sanguinolento. Microscópicamente se diagnosticó un HSA hepático con metástasis en útero.

The Haemangiosarcoma (HSA) is a malignant tumor of the vascular endothelium. It is a rare neoplasic in cats, just a 2% are reported from all the malignant tumors presented this species and is highly metastasic. The hepatic HSA embraces from 0 to 6-12% of the primary hepatic neoplasics. In this report a case of a feline patient which was suffering from one month of evolution abdominal dilatation, and tree day abdominal pain and anorexia is presented. During necropsy hydrothorax, right cardiac dilatation, liver with white or light yellow mottled appearance on cut surfaces of 1-2 mm of diameter and necrotic multifocal zones with dark red color and in the uterus, dilatation of the left horn with multiples solid masses with bloody content were found. The case was microscopically diagnosed as a hepatic HSA with metastasis to the uterus.

O hemangiossarcoma (HSA) é um tumor maligno endotelial vascular. Em gatos esta neoplasia é rara, pois só 2% dos diagnósticos de tumores malignos correspondem a HSA do fígado. Este relatório apresenta o caso de um paciente felino com inchaço abdominal, um mês de evolução, dor abdominal e anorexia de três dias de evolução. A autópsia foi encontrada: hidrotórax, dilatação cardíaca direita, fígado manchado com branca ou amarela, de 1 a 2 mm de diâmetro e áreas necrótica multifocales vermelhas escuras na superfície. Em útero foi encontrada dilatação do corno esquerdo com múltiplas massas sólidas com conteúdo sangrento. Microscopicamente foi diagnosticado HSA hepático com metástases no útero.

Protective Effect of Phyllanthus Compound Ⅱon Experimental Hepatic Damage in Mice / 广州中医药大学学报

【Objective】To observe the protective effect of Phyllanthus Compound Ⅱ(PCⅡ) on experimental hepatic damage in mice.【Methods】Sixty NIH mice were randomized into 5 groups: normal control group,model group,high-,moderate-and low-dose PCⅡ(110,55,and 27.5 g/kg respectively) groups,bifendate(150 mg/kg) group.Mice models of acute hepatic damage were induced with concanavalin A(Con A) and D-galactosamine(D-GalN)respectively.Serum levels of alanine transferase(ALT) and aspartate transferase(AST),and superoxide dismustase(SOD) activity were examined.The pathological changes of hepatic tissue were also observed.【Results】 PCⅡmarkedly decreased serum ALT and AST levels,and decreased hepatic SOD activity(P0.05 compared with bifendate group).The hepatic pathological changes were improved in PCⅡ groups.【Conclusion】PCⅡ exerts a better protective effect on mice hepatic damage induced by Con A and D-GalN,and its protective mechanism may be related with the inhibition of lipoperoxidation damage.

The expression of toll-like receptor 4 in the endotoxin-induced acute hepatic injury / 中华传染病杂志

Objective In order to explore the role of Toll like receptors 4(TLR4) in recognizing endotoxin and initiating inflammatory response, the expression of TLR4 of the liver in D galactosamine(D Gal) and endotoxin induced acute hepatic injury was analyzed. Methods The BALB/C mice with acute hepatic injury were induced with the combination of D Gal(900 mg/kg)and lipopolysaccharide (LPS, 10 ?g/kg) by intraperitoneal administration. To evaluate the hepatic injury, serum transaminase (ALT and AST) and plasma TNF ? were determined and the mortality was observed at the various time point following intraperitoneal injection with D Gal/LPS. The level of TLR4 mRNA was measured by semiquantitative RT PCR. Also the protein expression of TLR4 in the liver was detected by immunohistochemistry. The data was analyzed by the SAS software. Results After 4 hours of intraperitoneal injection of D Gal/LPS, the serum transaminase and plasma TNF ? levels were apparently elevated. The treatedmouse began to die at 7 hours. The mortality reached up to 80% at 10 hours. TLR4 mRNA were expressed at low level in normal mice liver, while it was significantly increased and maintained at higher level following intraperitoneal injection with D Gal/LPS (compare to 0 h time point, P