【Abstract】ObjectiveTo investigate the effects of rhGH on hypoalbuminemia in cirrhotic rats after partial hepatectomy. MethodsThirty rats were randomly divided into normal control group (n=6), liver cirrhosis group (LC group, n=6), liver cirrhosis and hepatectomy group (LCH group,n=6), PN (parenteral nutrition) group (n=6， given PN after hepatectomy) and rhGH+PN group (n=6,given rhGH and PN after hepatectomy). Liver function and blood glucose were measured. The expression of ALB mRNA was detected by RTPCR. Liver Ki67 immunohistochemistry was studied. ResultsCompared with PN group, serum ALP was lower; serum ALB and blood glucose were higher in rhGH+PN group. The expression of hepatic ALB mRNA was higher, and hepatic Ki67 labeling index was higher as well in this group. ConclusionrhGH can improve hypoalbuminemia after partial hepatectomy in cirrhotic rats with partial hepatectomy.
Objective To explore the cause, diagnosis, and treatment methods of portal vein thrombosis （PVT） after splenectomy. Methods The clinical data of 29 patients who were got splenectomy because of portal hypertension or traumatic splenic rupture from August 2002 to August 2008 in our hospital were analyzed retrospectively. Results Tweenty-seven patients with PVT were treated successfully, whose thrombi were absorbed completely or partially. One case died of peritonitis，septic shock，and multiple organ failure. One case died of hematemesis, hepatic coma，and multiple organ failure. Tweenty-four patients were followed up, the follow-up time was 0.5 to 3 years, the average was 2 years. Two cases died of massive hemorrhage, 1 case died of hepatic encephalopathy，and 1 case died of liver failure. Two cases occurred deep venous thrombosis in one year after treatment, and the remaining patients had no recurrence of venous thrombosis. Conclusions PVT have some connection with the raise of blood platelet and the hemodynamic changes of the portal vein system after splenectomy. Standardization of operation, early diagnosis, early line anticoagulant，and antiplatelet adhesion therapy are effective way to prevent and treat PVT.
42 Wistar rats were divided into three groups at random, liver cirrhosis (LC), portal vein stricture (PVS) and sham operation (SO) group. The changes of barrier capability of gastric mucosa in portal hypertensive rats were observed. The results demonstrated: the splanchnic blood flow of the portal hypertensive rats increased, as compared with the normal control group (Ｐ＜0.001), but actually gastric mucosa was under the condition of ischemia. Mucosa of gastric wall glycoprotein and PGE2 of gastric mucosa decreased, as compared with the normal control (Ｐ＜0.01); and more seriously decreased in cirrhotic portal hypertensive rats, there was no significant difference about amount of the basal acid secretion (BAS) among the three groups, but the amount of H＋ backdiffusion (H＋BD) was obviously increased, as compared with the normal control group (Ｐ＜0.001). The amount of H＋BD of cirrhotic portal hypertensive rats was the highest among this three groups. The results suggest that the barrier capability of gastric mucosa with portal hypertension is lower than that of the normal control group and much lower with cirrhotic portal hypertensive rats. The portal hypertensive gastropathy is associated with the lower capability of defense of gastric mucosa. The condition of liver function contributes to the change of barrier capability of gastric mucosa.
ObjectivesTo systematically review the risk factors of hepatocellular carcinoma (HCC) in patients with hepatic B surface antigen (HBsAg).MethodsScopus, EMbase, PubMed, and The Cochrane Library databases were systematically searched for relevant studies on HCC after HBsAg seroclearance from inception to October 31st, 2017. Two reviewers independently screened literature, extracted the data, and evaluated the risk of bias in the included studies. Meta-analysis was then conducted using R 3.5.3 software.ResultsA total of 28 studies involving 105 411 patients were included. Among 105 411 patients with chronic hepatitis B (CHB), 7 656 patients occurred spontaneously HBsAg seroclearance, while 1 248 patients had HBsAg seroclearance after interferon or nucleoside analogue therapy. The rate of HBsAg seroclearance was 6.77%. Meta-analysis showed that risk factors for HCC after serum HBsAg conversion included cirrhosis (OR=6.43, 95%CI 3.56 to 11.60, P<0.001), male (OR=2.72, 95%CI 1.66 to 4.46,P<0.001), and age ≥50 years at HBsAg seroclearance (OR=3.71, 95%CI 2.17 to 6.35,P<0.001).ConclusionsPatients with CHB after HBsAg seroclearance are still at risk of developing HCC. Therefore, periodic surveillance is recommended, especially for male patients, patients with cirrhosis, and patients who experience HBsAg seroclearance when over 50.
Two hundred and thirty patients with solid hepatic space-occupying lesions (SHSOL), on whom hepatic resection was performed in Zhongshan hospital, were analyzed. We found that liver cirrhosis could be a diagnostic marker of hepatocellular carcinoma in patients with SHSOL, for which the sensitivity being 85.2%, the specificity 96.3%, and the positive predictive value 98.7%.
Objective To study the effect and feasibility of gradual oral diethylnitrosamine (DENA) induced liver cirrhotic model in rats under avoirdupois monitoring. Methods Fifty Wistar rats (6 weeks old) were divided into 3 groups: normal control group （n=10）, traditional DENA induction group (receiving traditional oral DENA treatment, n=20）, gradual DENA induction group (receiving gradual oral DENA treatment under avoirdupois monitoring, n=20). The weight, mortality and liver cirrhosis formation were observed. Results After 4 weeks of inducing cirrhosis, the weight of traditional DENA induction group 〔(234.9±27.1) g〕 was significantly lower than that of normal control group 〔(264.8±33.7) g, P＜0.05〕. After 8 weeks of inducing cirrhosis, the weight of traditional DENA induction group 〔(251.5±34.3) g〕 was significantly lower than that of normal control group 〔(303.2±49.4) g， P＜0.01〕 and gradual DENA induction group 〔(277.5±27.6) g， P＜0.05〕. However, the difference between normal control group and gradual DENA induction group was not remarkable (P＞0.05). The mortality in traditional DENA induction group (35%) was significantly higher than that in normal control group (0) and gradual DENA induction group (0)， P＜0.05. But the rate of cirrhosis formation both in traditional DENA induction group and gradual DENA induction group was 100%. Conclusion Oral DENA induced cirrhotic model in rats is a simple, reproducible and reliable technique. Gradual oral technique, in which DENA is given under avoirdupois monitoring, can improve rat’s security and reduce mortality.
Objective To study the value of the clinical application of stereography and measurement of liver volume in cirrhotic patients with portal hypertension. Methods By use of the personal computer and the software of threedimensional reconstruction and measurement system of liver faultage photograph, the liver volume in vivo was successfully measured and the threedimensional image of the liver rebuilt in 46 posthepatitic cirrhotics who were selected for orthotopic liver transplantation and in 30 noncirrhotic controls, and comparison with the reference volume of recipient liver was obtained by means of water deplacement after transplantation. Results The liver volume of cirrhotic patients with portal hypertension measured by software and water deplacement was (983.33±206.11) cm3, and (904.93±209.56) cm3 respectively. Comparison by means of linear regression analysis between volume measurement on threedimensional reconstruction software and reference volume showed a nearly ideal correlation coefficient(r=0.969,P＜0.01), the average error was 8.66%.The average of liver volume in controls was (1287.00±96.18) cm3, and was positively correlated to the height，weight and body surface area (r=0.845,0.833,0.932 respectively,P＜0.01)，and was different from that of cirrhotics. Liver volume of cirrhoitic patients with portal hypertension was related to their ChildPugh classification. The liver volume of patients in Child C group was significantly smaller than that of patients of Child B group, and was significantly correlated with Alb （r=0.496, P＜0.01） and TBIL（r=-0.493, P＜0.01）,PT(r=-0.517, P＜0.01), but was not significantly correlated with ALT（r=0.206，Pgt;0.05）,portal pressure（r=-0.093，P=0.539） and portosystemic shunt index (r=0.044，P=0.769). Conclusion The volume measurement of the liver by the threedimensional software is relatively accurate. Liver volume of cirrhotic patients with portal hypertension was significantly related to their liver function,and can reflect the liver reserve function.
The wister rats with cirrhotic portal hypertension induced by carbon tetrachloride/ethanal were divided into four groups;①distal splenocaval shunt(DSCS);②portal azygous devascularization (PAD);③mesocaval shunt side to side (MCS);and ④the conrol. Oral glucose toleronce test (OGTT), and glucagon loading test (GLT) were performed on them. The results revealed that the hepatic reserve function of the rats with DSCS and PAD had significant difference as compared with the control (Ｐ＜0.05), but that of the rat with MCS had no significant difference as compared with the control (Ｐ＞0.05).The present study indicates that the hepatic reserve function of rats with DSCS and PAD is better than that of the rats with MCS.
To investigate the change of the portal venous pressure (PVP), conjugated glycocholic acid (CGA) and pancreatic glucagon (PG) concentration in rats peripheral and portal venous blood in the course of experimental liver cirrhosis induced with carbon tetrachloride and to investigate the mentioned changes after portalazygous devascularization. The authors found that in the early stage of cirrhosis the PVP and the concentration of CGA and PG in peripheral venous blood were increased markedly, CGA in portal vein was decreased and PG in portal vein was increased in early stage of liver cirrhosis.With the extent of liver cirrhosis the indexes above changed more markedly. After portalazygous devascularization the concentration of CGA in peripheral vein in the cirrhotic rats was increased but PVP, the concentration of CGA in portal vein and PG in peripheral and portal vein did not change.There was no change in nornal rats. The results suggest that the variation in CGA in peripheral vein can accurately reflect the degree of damage to liver cells, thus making the diagnosis of liver cirrhosis earlier and judging the degree and prognosis of liver cirrhosis.The concentration of PG in portal venous and peripheral vein relate to PVP in liver cirrhosis.Portalazygous devascularization can maintain PVP and PG in portal vein and do not affect liver function of the control rats but it can damage liver cell in cirrhotic rats.
Objective To review the value of imaging assessment of stem cell transplantation in treatment for liver cirrhosis.Methods The related literatures in recent years were collected,and the applications of different radiological techniques and strategies of stem cell transplantation in treatment for liver cirrhosis were summarized.Results Stem cell transplantation in treatment for liver cirrhosis was feasible and effective. Radiological assessment could supply the prompt and accurate information for clinic to choose the proper therapeutic method.The curative effect could also be accurately assessed by radiological techniques.Conclusion Radiological examination is important for the assessment of stem cell transplantation in treatment for liver cirrhosis.