Advance in study on hepatoprotective effects and its mechanism of polysaccharides / 中国中药杂志

Liver damage is the pathologic status in the liver system, which can lead to cirrhosis, fibrosis and cancer of the liver. So to search for effective drugs on prevention and treatment of anti-hepatic lesion have already attracted broad concern in the world. Polysaccharides widely exist in plants, microorganisms and animals, and have high efficiency but low toxicity properties. Therefore, polysaccharides had been the hotspot in the research field of liver-protecting medicines, and had undergone great progresses. In this study, the hepatoprotective effects and its mechanism of polysaccharides were summarized and reviewed, and the market prospects of development and application were prospected. The research result indicated that polysaccharides derived from plants, microorganisms, animals which had significant effects on liver protection. Results also showed that polysaccharides showed the protective effect on chemical liver injury by anti-oxidation, alleviating calcium overload, adjusting the function of mitochondria, and the protective effect on immune liver injury by regulating cytokine secretion, blocking the complement system activity, inhibiting inflammatory mediator expression, suppressing hepatocyte apoptosis. Polysaccharides had rich resource, diverse bio-effects, abundance approaches and multitarget. Therefore, there is huge potential for developing polysaccharides as novel hepatoprotective medicine candidates.

Effect of Gypenosides on Lipid Peroxidation in Rats with Type 2 Diabetes Mellitus Complicated by Nonalcoholic Fatty Liver Disease / 医药导报

Objective To obserVe the effect of gyPenoside on liPid Peroxidation and hePatic lesion in rats with tyPe 2 diabetes mellitus and nonalcohol fatty liVer disease. Methods Totally,65 SPF male SD rats were randomly diVided into blank control grouP (grouP N),NAFLD model grouP (grouP NM),and NAFLD with T2DM model grouP. The NAFLD with T2DM model grouP was further diVided into three subgrouPs:JH grouP,Perfused with 1 g·kg-1 ·d-1 GPS;JL grouP,Perfused with 0. 5 g·kg-1 ·d-1 GPS;model control grouP,Perfused with the same Volume of water. Blood sugar,triglycerides ( TG) ,total cholesterol ( TC) ,alanine aminotransferase ( ALT) ,asPart aminotransferase ( AST) ,adePonectin ( ADP) in the Plasma were measured. TG, malondialdehyde (MDA),and suPeroxide dismutase (SOD) in the liVer tissue were also tested. Results ADP leVel was (7. 46±1. 12),(3. 58±0. 98),(4. 89±1. 02),(4. 79±1. 01) and (4. 13±0. 89) ng·mL-1 in N,M,NM,JH and JL grouPs, resPectiVely. The ADP leVel was significantly higher in grouP JH and JL than in grouP M (P<0. 01),and significantly higher in grouP JH than in grouP JL (P<0. 05). MDA leVel was (2. 98±0. 09),(4. 22±0. 11),(3. 66±0. 10),(3. 72±0. 11),(3. 99±0. 13) nmol·mL_1 in N,M,NM,JH and JL grouPs,resPectiVely. The MDA leVel was significantly lower in grouP JH and JL than in grouP M (P<0. 01),and significantly lower in grouP JH than in grouP JL (P<0. 05). SOD leVel was (240. 8±17. 4), (149. 9±20. 6),(181. 6±19. 4),(209. 8±19. 2),(189. 4±18. 9) U·mL_1 in N,M,NM,JH,and JL grouPs,resPectiVely. SOD leVel was significantly higher in grouP JH and JL than in grouP M (P<0. 01),and significantly higher in grouP JH than in grouP JL (P<0. 05). TG leVel was (28. 98±1. 68),(214. 46±5. 44),(198. 46±6. 98),(142. 87±6. 64) and (164. 92±7. 56) mg·g-1 in N,M,NM,JH and JL grouPs,resPectiVely. TG leVel was significantly lower in grouP JH and JL than in grouP M ( P<0. 01),and significantly lower in grouP JH than in grouP JL (P<0. 05). ALT and AST were significantly lower in grouP JH and JL than in grouP M (P<0. 01),and significantly lower in grouP JH than in grouP JL (P<0. 05). Conclusion The liPid Peroxidation in the liVer of rats with T2DM comPlicated with NAFLD can be reduced by gyPenoside,and hePatic lesion may be alleViated through inhibition of liPid Peroxidation.

The MR imaging diagnosis of liver diseases using gadoxetic acid: Emphasis on hepatobiliary phase

Hepatocyte specific contrast agents including gadoxetic acid and gadobenate dimeglumine are very useful to diagnose various benign and malignant focal hepatic lesions and even helpful to estimate hepatic functional reservoir. The far delayed phase image referred to as the hepatobiliary phase makes the sensitivity of detection for malignant focal hepatic lesions increased, but specificity of malignant diseases, including hepatocellular carcinoma, metastasis and cholangiocarcinoma, characterization remained to be undetermined.

Relatively Increased Number of Liver Foxp3+ Regulatory T Cells against Hepatic Lesions in Murine Lupus / 华中科技大学学报（医学）（英德文版）

Systemic lupus erythematosus (SLE) is a multiple organ autoimmune disorder,including theliver,but the possible reason in impairment in the liver is still unclear.Our present study assessed alterations of transcription factor Foxp3+ regulatory T cells (Tregs) and several other immune molecules [programmed cell death 1 and its ligand (PD1 and PD-L1),and interleukin 10 (IL-10) and transform growth factor β (TGF-β)] in the liver and other major organs of lupus-prone BXSB mice by flow cytometry,real-time quantitative reverse trinscription PCR,and enzyme-linked immunosorbent assay.Results showed that both frequency and number of Foxp3+ Tregs were dramatically reduced in the thymus,spleen and kidney of the BXSB mice (P＜0.05),but those in the liver were kept in nearly normal range,when compared to negative control C57BL/6 mice.In comparison to control mice,the mRNA levels of Foxp3,PD1 and PD-L1 were significantly decreased in the kidneys of BXSB mice (P＜0.05),but there was no significant difference in the livers of the BXSB mice (P＞0.05).Protein levels of IL-10 and TGF-β in serum showed no significant difference between BXSB and C57BL/6 mice,but were significantly increased in the kidneys and livers of BXSB mice as compared with those in C57BL/6 mice (P＜0.05).These results suggest that reduced Foxp3+ Tregs are involved in the pathogenesis of SLE in BXSB mice,and relatively higher number of these cells in the livers than in the other target organs could constitute a protective mechanism against hepatic lesions in lupus-prone mice,which may provide insights into development of new therapeutic approaches in SLE patients.

Laparoscopic Liver Resection: A Single Center Experience

BACKGROUND: An increasing number of small prospective studies have been published, since the first report of laparoscopic liver resection by Gagner et al. in 1992. They have shown encouraging results for the feasibility and safety of the procedure. This paper provides a retrospective analysis of a single center's experience with elective laparoscopic liver resections. METHODS: We did a retrospective study on laparoscopic liver resections performed from July 2005 to April 2009, undertaken in 34 patients with preoperative diagnosis of a benign lesion (7 cases, 20.6%), hepatocellular carcinoma in absence of complicated cirrhosis (18 cases, 52.9%), or liver metastasis (9 cases, 26.4%). The mean tumor size was 2.63+/-1.57 cm (range 0.55-7.5) RESULTS: We carried out 15 wedge resections (44.1%), 3 right hemi-hepatectomies (8.8%), 4 left hemi-hepatectomies (11.8%), 5 liver segmentectomies (14.7%), 7 left lateral sectionectomies (20.6%). The average duration of an operation was 175.00+/-129.12 minutes. There were 6 patients (15%) in which a conversion to laparotomy was required none of the conversions occurred under emergency situations. Intraoperative transfusion was required for 5 patients (14.7%). Postoperative complications developed in 2 patients (5.8%) (1 intraabdominal abscess, 1 bile leakage). There were no deaths and no reoperations for complications. The mean postoperative hospital stay was 9.9 days. CONCLUSION: Our experience shows that laparoscopic liver resections, including major hepatectomies, are feasible and safe. Nonetheless, a prospective randomization study with a greater number of cases and longer follow-up is needed before laparoscopic liver resection can be regarded as the gold-standard approach for hepatic lesions.

Efficacy of Reduced Glutathioue plus Xiangdan Injection for Anti-Tuberculosis Drug-induced Hepatic Lesion / 中国药房

OBJECTIVE:To observe the therapeutic efficacy of reduced glutathioue plus Xiangdan injection for anti-tuberculosis drug-induced hepatic lesion. METHODS:A total of 75 patients with anti-tuberculosis drug-induced hepatic lesion were randomly divided into two groups:38 cases (trial group) were assigned to receive reduced glutathioue (1.2 g) that was added into normal saline(250 mL) by iv gtt q.d plus Xiangdan injection (20 mL) that was added into 10% glucose injection (250 mL) q.d by iv gtt;37 cases(control group)received potassium magnesium injection (20 mL)which was added into 10% glucose injection(250 mL) q.d by iv gtt. After treatment for 4 weeks,the liver function parameters and the total effective rates in two groups were measured. RESULTS:Compared with control group,the liver function had a significantly better improvement in trial group (P

Three Therapeutic Schemes in the Prevention of Antitumor Drug-induced Hepatic Lesion:Cost-minimization Analyses / 中国药房

0.05).CONCLUSION:Group C is the preferable one among the three groups.

The protecting effects of matrine on chemotherapy related hepatic lesion,a retrospective clinical analysis / 中国基层医药

Objective To evaluate the protecting effects of matrine on chemotherapy related hepatic lesion and its possible mechanism.Methods The positive rate and severity of hepatic lesion were compared between pa- tients being treated with or without matrine during chemotherapy processes.Furthermore,the difference of liver pro- tecting effect of this Chinese medicine between hepatitis B virus(HBV)infection chemotherapy patients and disinfec- tion patients were also analyzed.Results Both the rate of hepatic lesion and level of ALT in matrine treated group were much lower than those in untreated group in chemotherapy patients.The rate of hepatic lesion and level of ALT in HBV infection patients were higher than those in HBV disinfection patients in untreated group,while the signifi- cant difference of these two parameters between HBV infection patients and disinfection patients were disappeared in matrine treated group.Conclusion Matrine has hepatic protecting effect in chemotherapy related liver lesion.

Economic Evaluation on 6 Therapeutic Schemes for Hepatic Lesion Induced by Chemotherapeutic Drugs / 中国药房

OBJECTIVE:To evaluate the economic efficacy of 6 therapeutic schemes for hepatic lesions induced by chemotherapeutic drugs. METHODS: A total of 269 malignant tumor patients complicating hepatic lesion because of using of chemotherapeutic drugs were randomly divided into 6 groups (A, B, C, D, E and F) to be treated with Reduced Glutathione Sodium for Injection, Diammonium Glycyrrhizinate Injection, Compound Glycyrrhizin Injection, Polyene Phosphatidylcholine Injection, Compound Diisopropylamine Dichloroacetate Injection, Compound Ammonium Glycyrrhetate Injection, respectively. The curative effects were recorded and the cost-effectiveness analysis was conducted. RESULTS: In A, B, C, D, E and F groups, the effective rates were 91.67%, 75.00%, 86.05%, 84.78%, 87.50% and 85.42%, respectively, the costs were 798.28 yuan, 311.08 yuan, 859.88 yuan, 918.68 yuan, 1 092.28 yuan and 1 319.08 yuan, respectively, and the cost-effectiveness ratios were: 870.82, 414.77, 999.28, 1 083.60, 1 248.32 and 1 544.23, respectively. The incremental cost-effectiveness ratios for A, C, D, E, F groups as against group B were 2 922.62, 4 966.52, 6 212.68, 6 249.60 and 9 673.70, respectively. CONCLUSION: Group A was proved to be the safe, effective and economical therapeutic scheme for hepatic lesions induced by chemotherapeutic drugs.

Experience of Clinical Pharmaceutical Care Carried Out in Respiratory Department / 中国药房

OBJECTIVE:To discuss the role of clinical pharmacists in providing pharmaceutical care in respiratory department.METHODS:The clinical pharmaceutical care provided by clinical pharmacists in respiratory department was analyzed and summarized.RESULTS & CONCLUSION:The pharmaceutical care carried out in respiratory department can help reduce the incidence of medication errors.

Verapamil modulates LPS-induced cytokines production via inhibiting NF-?B activation in the liver of rats / 肠外与肠内营养

Objective:To investigate the effect of verapamil on the endotoxin-induced cytokine production and nuclear factor kappa B(NF-?B) activation in the liver. Methods:Fifty six adult male Sprague-Dawley rats were randomly divided into seven groups: group A: saline;group B:endotoxin(10 mg/kg,intraperitoneally,i.p.);group C,D,E,F:endotoxin(10 mg/kg) after treatment with verapamil(1,2.5,5,10 mg/kg i.p.respectively),and group G:verapamil alone(10 mg/kg).Tumor necrosis factor(TNF-?),interleukin-6(IL-6), interleukin-10(IL-10) and NF-?B in the liver tissues and the serum levels of ALT and AST were investigated at 1 h afer LPS injection. Results:Endotoxin stimulated production of TNF-?,IL-6 and IL-10,and activated NF?B in the liver.Verapamil attenuated acute liver injury,down-regulated endotoxin-induced pro-inflammatory cytokine production,up-regulated ant-inflammatory cytokines production and inhibited NF-?B activation in the liver in a dose-dependent manner.Conclusion:Verapamil can attenuate acute liver injury by down-regulating the production of TNF-?,IL-6 and up-regulating IL-10 in the liver in a dose-dependent manner,possibly via inhibition of NF-?B.

Value of Enhancement Patterns for Characterization of Focal Hepatic Lesions / 中国普外基础与临床杂志

Objective To investigate the diagnostic value of the enhancement patterns for characterizing various focal hepatic lesions (FHL). Methods Forty-seven patients (50 lesions) were included into the study. The morphologic features and the dynamic enhancement patterns of FHL were observed in the early arterial phase, late arterial phase and portal venous phase.The degree of FHL enhancement was analyzed by calculating the contrast-to-noise ratio. Results 70% of the HCCs presented “fast-filling and rapid-washout” feature; 67% of the cholangiocarcinomas showed slight enhancement in arterial phase, and 33.3% had delayed enhancement on portal venous phase; All hemangiomas presented peripheral nodular enhancement in arterial phase, which then demonstrating centropedal “push-on” enhancement in portal venous phase; Hepatic abscesses mainly presented a slightly enhanced rim around the lesion with fibrous septa inside and an edematous zone outside. Conclusion The enhancement pattern and the dynamic evolution of FHL enhancement had a great diagnostic value for different FHL by using MRI 3D-VIBE sequence.

Diagnostic Value of Contrast-Enhanced Volumetric Interpolated Breath-Hold Examination MR Sequence in Focal Hepatic Lesions / 中国普外基础与临床杂志

Objective To investigate the diagnostic value of a fast gradient-echo(GRE) three-dimensional contrast-enhanced volumetric interpolated breath-hold examination(3D-VIBE) MR sequence in evaluating focal liver lesions.Methods Conventional spin-echo T2W,2D GRE T1W plain scan and Gd-enhanced 3D-VIBE multi-phasic(early arterial,late arterial and portal venous phases) acquisitions were prospectively performed for 51 consecutive patients suspected of having focal liver lesions on CT or ultrasound imaging.Native T2W and 2D GRE T1W were acquired first,then 3D-VIBE fast scanning at early arterial,late arterial and portal venous phases respectively.The SNR and CNR of the liver lesions on plain scan and the enhancement patterns on contrast-enhanced 3D-VIBE images were carefully observed with correlation of the clinical and surgical pathological findings.Results There exited certain differences in SNR,CNR,and the enhancement patterns of different kinds of focal hepatic lesions in plain scan and Gd-enhanced multi-phasic 3D-VIBE acquisitions.Conclusion 3D-VIBE MR sequence is helpful in the detection and characterization of focal liver lesions.

Efficacy of Reduced Glutathione Against Hepatic Lesion Induced by Antituberculotic Agents / 中国药房

OBJECTIVE:To observe the efficacy of the reduced glutathione against hepatic lesion induced by antituberculotic agents.METHODS:A total of 226 patients with pulmonary tuberculosis undergoing short- course chemotherapy were randomly assigned to receive antituberculotic agents plus reduced glutathione throughout the course(treatment group,n = 114 cases) or to receive Inosine plus Glucurolactone(control group,n = 112).The patients were followed for 3～6 months with the incidence of hepatic lesion compared between the two groups.RESULTS:There were significant differences between the treatment group and the control group in the incidence of hepatic lesion,6 cases(5.3%) in treatment group vs.29 cases (25.9%) in the control group(P

A Case of Early Gastric Carcinoma Combined with Hypereosinophilic Multiple Liver Abscesses / 대한소화기내시경학회지

Eosinophilia is defined as the presence of more than 500 eosinophil/mL of blood and is common in the clinical condition such as parasite infestation, drug, allergy, hypereosinophilic syndrome, and malignant diseases. Determining the cause of eosinophilia may be one of the most frustrating endeavors in clinical medicine. Hepatic infiltration of eosinophils and microabscess formation are observed in many disorders. Gastric cancer and intestinal malignancies show frequent liver metastasis and blood eosinophilia. Several cases of an early gastric carcinoma (EGC) with metastasis of the liver have been reported. When multiple intrahepatic lesions of suspicious malignancy appear in radiologic study, clinicians must differentiate malignancy from benign diseases. A case is herein reported of a 56- year-old male patient with synchronously developed, multiple low density hepatic lesions with early gastric carcinoma. He was managed with systemic chemotherapy at another hospital, because he was diagnosed with distant metastasis of early gastric carcinoma. Upon operating these lesions were proved to be EGC combined with hypereosinophilic multiple liver abscesses. This case is herein reported with a review of relevant literatures.

Grading of schistosomiasis patients' hepatic lesions by ultrasonography and analysis of portal vein and splenic vein haemodynamics / 中国血吸虫病防治杂志

Objective To study the relationship between the grading of schistosomiasis japonica hepatic lesions by B-ultrasonography and the portal vein and splenic vein haemodynamics. Methods The grades of 125 schistosomiasis patients’ hepatic lesions were determined by Doppler ultrasonography according to the method recommended by WHO/TDR. The portal vein and splenic vein inner diameters and blood flow velocity were examined and the portal vein and splenic vein volumes of blood flow were calculated in the patients above mentioned and 51 normal persons. Results The inner diameters, blood flow velocity and volumes of blood flow of portal vein and splenic vein in the patients were significantly different from those in the normal persons, and also there were significant differences among the patients with different degrees of fibrosis. Conclusions The changes of schistosomiasis patients’ portal vein haemodynamics is connect with the liver parenchyma characteristics. The step up of the ratio of blood flow volume of splenic vein with the portal vein is breakdown with the aggravate of the hepatic lesion.