Résumé
Objective To discuss and analyze the reliability and validity of the application Chinese version of Caregiver Grief Scale (CGS) on caregivers of patients with advanced hepatocarcinoma. Methods To translate the original English scale into Chinese and adapt it to the culture of China, forming a Chinese CGS. Totally 330 patients were selected with advanced hepatocarcinoma who were hospitalized in a gradeⅢ, class A hospital by the convenient sampling method. They were carried out exploratory factor analysis and confirmatory factor analysis respectively. Results For Chinese CGS, the critical value of every purpose has statistical significance (P < 0.05) by comparison. Exploratory factor analysis showed:KMO value was 0.923;Bartlett's sphericity test value was 794.31;cumulative variance contribution rate was 67.532%;four common factors can be extracted. Confirmatory factor analysis showed that the structural model of the scale was good: χ2/d?=1.11<3.0,goodness of fit index=0.995,root mean square error of approximation=0.021,adjusted goodness-of-fit index=0.968,normed fit index=0.973, comparative fit index=0.957,Tucker-Lewis index=0.993,incremental fit index=0.943. Each correlation coefficient of the scale has statistical significance and expert validity is between 0.832 and 0.973. Reliability analysis shows that the total Cronbach'sαof the scale was 0.908;Cronbach'sαcoefficient of every dimension was between 0.896 and 0.913; Guttman's split-half reliability was 0.917; test-retest reliability was 0.831. ROC curve showed that when the total score of the scale ≥24.5, specificity and sensitivity were good. Conclusions Chinese version of CGS has good reliability and validity, which is suitable for preliminary screening grief emotion of caregivers of patients with advanced hepatocarcinoma.
Résumé
Objective To investigate the protective effects of extract of Periplaneta americana (APA) against carbon tetrachloride (CCl4)-induced hepatic fibrosis in rats. Methods Seventy SD rats were divided into five groups:normal con-trol group (C), model control group (M), extract of APA 1 group (APA1), extract of APA 2 group (APA2) and reduced glutathi-one group (R). The liver fibrosis model was induced by injecting 40%CCl4-olive solution subcutaneously for seven weeks in M, APA1, APA 2 and R groups. Drugs were given at the same time. Rats were killed at 7-week (C, M, APA1 and R groups), and were killed at 9-week (APA2 group). The serum values of transaminase (ALT, AST), albumin (ALB), hyaluronic acid (HA) and laminin (LN), and hepatic inflammation and fibrosis were detected respectively. The expressions of apoptotic relat-ed gene Bcl-2 and Bax protein in central veins and portal areas of hepatic lobules were detected by immunohistochemical method. Results Rats showed poor nutritional status, and significantly increased transaminase, HA and LN in M group, but the serum level of ALB was significantly lower than that in C group. There was extensive necrosis of liver cells, obviously fi-brosis or cirrhosis in model rats’liver tissues. The serum contents of ALT, AST, HA and LN were significantly decreased, the serum level of ALB were significantly increased in APA1,APA2 and R groups (P<0.05). There were complete hepatic lobule and no obvious fibrous tissue hyperplasia in liver biopsy of APA1 and R groups. The values of Bcl-2/Bax proteins in central vein of liver tissues were significantly higher in APA1,APA2 and R groups than those of M group (P<0.05), but the ratio of Bcl-2/Bax was lower in periportal area of liver tissues (P<0.05). There were significantly higher body weight and ALB levels in APA1 group than those in R group (P<0.05). The level of transaminase was slightly higher in APA1 group than that of R group. The degeneration of liver cells was found mostly in R group. Conclusion The extract of Periplaneta americana has a role in protecting liver cells, inhibiting the progression of hepatic fibrosis, and improving the nutritional sta-tus of trial rats.
Résumé
Objective To investigate the incidence,influencing factors and clinical features of ischemic hepatitis.Methods Changes of serum transaminase and lactate dehydrogenase in patients with shock and respiratory failure were recorded in our hospital.Ischemic hepatitis was identified according to diagnosis guidelines,and its incidence was counted.Clinical data of patients with ischemic hepatitis were recorded.Results There were 53 cases diagnosed as ischemic hepatitis in 317 severe patients,including hemorrhagic shock,heart failure,respiratory failure,et al.The incidence was high in elderly patients aged over 70 years and male.Levels of alanine aminotransferase (ALT),AST and lactic dehydrogenase (LDH) were significantly increased 1-3 days after shock and respiratory failure,then reached to peak value 1-5 days [averaged (3.35±0.89) days] after shock and respiratory failure.Serum ALT was 869-4354 U/L,AST was 773-4833U/L and LDH was 1021-2662 U/L.Total bilirubin level was increased in 16 cases and the total bilirubin was 14-54 μmol/L.AST was declined to a point within 2 times the upper limit of normal range after 9-16 days,averaged (13± 1.6) days.Elevated transaminase level had no correlation with sex,age and pre-existing liver diseases.The time of enzyme changes had no correlation with sex but age and liver diseases.Patients aged ≥ 70 years had later AST peak and the recovery time was longer than younger patients (P＜0.01).Conclusions Ischemic hepatitis occurs mainly in men and elderly people.But advanced age and underlying liver diseases can affect the recovery time of transaminase in patients with ischemic hepatitis.