Hepatocellular carcinoma(HCC)occurs commonly and with increasing frequency in developing countries,where it also carries an especially grave prognosis.The major risk factor for HCC in these regions is chronic hepatiti...Hepatocellular carcinoma(HCC)occurs commonly and with increasing frequency in developing countries,where it also carries an especially grave prognosis.The major risk factor for HCC in these regions is chronic hepatitis B virus(HBV)infection,although dietary exposure to aflatoxin B1 also plays an important etio-logical role.Prevention of HCC in developing regions is unlikely in the foreseeable future.Although an effec-tive vaccine against HBV is available,the percentage of babies born in developing countries that receive the full course of immunization remains low.Moreover,the usually long interval between infection with HBV and the development of HCC means that 30 to 50 years will elapse before the full effect of the vaccine will be realized.Practical measures to prevent aflatoxin B1 ex-posure are not in place.Serumα-fetoprotein levels are a useful pointer to the diagnosis of HCC in low-income countries,but definitive diagnosis is hampered both by the lack of the sophisticated imaging equipment now available in developed countries and by obstacles to obtaining histological proof.In the majority of patients in low-income regions,the tumor is inoperable by the time the patient presents.Hepatic resection is seldom possible in sub-Saharan Africa,although the tumor is successfully resected in a larger number of patients in China.Liver transplantation for HCC is rarely performed in either region.Sophisticated new radiotherapy tech-niques are not available in developing countries.The beneficial effects of the multikinase inhibitor,sorafenib,are encouraging,although financial considerations may restrict its use in low-income countries.展开更多
目的:探讨在肝移植患者血清中S-100β蛋白的变化和原因.方法:本院临床肝功终末期进行肝移植的患者5例,检测术前,无肝期末,供肝移植后1,24,48h血中S-100β和IL-1β的浓度(双抗体夹心-ELAISA法);监测术前,阻断前,无肝期10、30、60min,肝...目的:探讨在肝移植患者血清中S-100β蛋白的变化和原因.方法:本院临床肝功终末期进行肝移植的患者5例,检测术前,无肝期末,供肝移植后1,24,48h血中S-100β和IL-1β的浓度(双抗体夹心-ELAISA法);监测术前,阻断前,无肝期10、30、60min,肝脏再灌注后10、90min及术毕的HR、MAP、CO、CVP和血气分析.结果:S100-β术前均在正常范围,新肝期1h明显增高(0.437±0.148 vs mg/L 0.132±0.061 mg/L),至24h(0.480±0.340 mg/L)仍高于术前水平,48h降至无肝期末水平(0.239±0.09 mg/L).IL-1β于新肝期24h升至最高水平(63.7±21.9 ng/L vs 32.2±19.1 ng/L),其后降低:腔静脉阻断后30 min经药物调整MAP维持在正常水平,HR仍高于阻断前,CO明显降低(5.4±2.42 L/min vs 9.9±2.33 L/min):再灌注后最初10 min CO仍旧低于术前水平(6.7±1.81 L/min),经治疗逐渐恢复至术前水平;血中二氧化碳分压在新肝早期明显升高,无肝期末及新肝早期虽然应用了碳酸氢钠注射液但pH值仍降低,呈酸血症,术毕前恢复正常;离子经过调整基本均在正常范围.相关分析发现S-100β的变化与CO和IL-1β无明显相关(r=-0.327,r=0.248,P>0.05).结论:肝移植患者术后血清中S-100β蛋白的增加是血脑屏障通透性增加所致,与IL-1β和CO的变化无明显关系.展开更多
Summary: To investigate the changes in neurological symptoms and signs, as well as serum copper, serum ceruloplasmin after hepatic transplantation in patients with Wilson’s disease, neurological symptoms and signs, s...Summary: To investigate the changes in neurological symptoms and signs, as well as serum copper, serum ceruloplasmin after hepatic transplantation in patients with Wilson’s disease, neurological symptoms and signs, serum copper, serum ceruloplasmin before and after hepatic transplantation in 18 patients with Wilson’s disease were observed, and those changes were followed up in 20 non-operative controls treated with penicillamine. Our results showed that the neurological symptoms and signs, serum copper and serum ceruloplasmin were improved in the operative group but deteriorated in the non-operative control group. Our study showed that hepatic transplantation is better than penicillamine in the treatment of Wilson’s disease.展开更多
文摘Hepatocellular carcinoma(HCC)occurs commonly and with increasing frequency in developing countries,where it also carries an especially grave prognosis.The major risk factor for HCC in these regions is chronic hepatitis B virus(HBV)infection,although dietary exposure to aflatoxin B1 also plays an important etio-logical role.Prevention of HCC in developing regions is unlikely in the foreseeable future.Although an effec-tive vaccine against HBV is available,the percentage of babies born in developing countries that receive the full course of immunization remains low.Moreover,the usually long interval between infection with HBV and the development of HCC means that 30 to 50 years will elapse before the full effect of the vaccine will be realized.Practical measures to prevent aflatoxin B1 ex-posure are not in place.Serumα-fetoprotein levels are a useful pointer to the diagnosis of HCC in low-income countries,but definitive diagnosis is hampered both by the lack of the sophisticated imaging equipment now available in developed countries and by obstacles to obtaining histological proof.In the majority of patients in low-income regions,the tumor is inoperable by the time the patient presents.Hepatic resection is seldom possible in sub-Saharan Africa,although the tumor is successfully resected in a larger number of patients in China.Liver transplantation for HCC is rarely performed in either region.Sophisticated new radiotherapy tech-niques are not available in developing countries.The beneficial effects of the multikinase inhibitor,sorafenib,are encouraging,although financial considerations may restrict its use in low-income countries.
文摘目的:探讨在肝移植患者血清中S-100β蛋白的变化和原因.方法:本院临床肝功终末期进行肝移植的患者5例,检测术前,无肝期末,供肝移植后1,24,48h血中S-100β和IL-1β的浓度(双抗体夹心-ELAISA法);监测术前,阻断前,无肝期10、30、60min,肝脏再灌注后10、90min及术毕的HR、MAP、CO、CVP和血气分析.结果:S100-β术前均在正常范围,新肝期1h明显增高(0.437±0.148 vs mg/L 0.132±0.061 mg/L),至24h(0.480±0.340 mg/L)仍高于术前水平,48h降至无肝期末水平(0.239±0.09 mg/L).IL-1β于新肝期24h升至最高水平(63.7±21.9 ng/L vs 32.2±19.1 ng/L),其后降低:腔静脉阻断后30 min经药物调整MAP维持在正常水平,HR仍高于阻断前,CO明显降低(5.4±2.42 L/min vs 9.9±2.33 L/min):再灌注后最初10 min CO仍旧低于术前水平(6.7±1.81 L/min),经治疗逐渐恢复至术前水平;血中二氧化碳分压在新肝早期明显升高,无肝期末及新肝早期虽然应用了碳酸氢钠注射液但pH值仍降低,呈酸血症,术毕前恢复正常;离子经过调整基本均在正常范围.相关分析发现S-100β的变化与CO和IL-1β无明显相关(r=-0.327,r=0.248,P>0.05).结论:肝移植患者术后血清中S-100β蛋白的增加是血脑屏障通透性增加所致,与IL-1β和CO的变化无明显关系.
文摘Summary: To investigate the changes in neurological symptoms and signs, as well as serum copper, serum ceruloplasmin after hepatic transplantation in patients with Wilson’s disease, neurological symptoms and signs, serum copper, serum ceruloplasmin before and after hepatic transplantation in 18 patients with Wilson’s disease were observed, and those changes were followed up in 20 non-operative controls treated with penicillamine. Our results showed that the neurological symptoms and signs, serum copper and serum ceruloplasmin were improved in the operative group but deteriorated in the non-operative control group. Our study showed that hepatic transplantation is better than penicillamine in the treatment of Wilson’s disease.
