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VIRAL COINFECTIONS IN PATIENTS WITH CHRONIC HEPATITIS B: THEIR PREVALENCE AND CLINICAL SIGNIFICANCE 慢性乙型肝炎病毒合并感染的流行及临床意义
Pub Date : 2020-01-01 DOI: 10.25298/2616-5546-2020-4-2-171-176
D. V. Tserashkou, V. Mitsura, E. Voropaev, O. Osipkina
Background. Hepatitis B virus (HBV) infection remains a global public health problem. Objective – to analyze the prevalence of viral coinfections with human immunodefciency virus (HIV), hepatitis C virus (HCV), hepatitis delta virus (HDV), TT-viruses and SENV in patients with chronic hepatitis B (CHB) and to assess their influence on liver disease severity. Material and methods. The observational cross-sectional study included 287 patients with chronic hepatitis B virus (HBV) – those with monoinfection and coinfected with HIV, HCV, HDV. Routine hematological and biochemical tests were performed, serum HBV DNA level as well as liver fbrosis stage were measured. Blood samples from 62 patients for Torque teno virus (TTV), Torque teno mini virus, Torque teno midi virus, SENV (D and H genotypes) DNAs were examined by polymerase chain reaction. Results. Among patients with CHB the prevalence of coinfection HBV + HIV is 6.6%, HBV + HCV – 6.3%, HBV + HDV – 3.8% and HBV + HDV + HCV – 1.7%. CHB patients coinfected with HIV, HCV, HDV had more pronounced biochemical differences and higher proportion of liver cirrhosis vs. HBV-monoinfected ones. The detection rate of TT viruses and their various combinations in patients with CHB is 91.9%, SENV – 66.1%. Conclusion. Coinfection with HIV, HCV, HDV in CHB patients is associated with more severe forms of chronic liver disease as compared to HBV-monoinfection. TT viruses and SENV are widespread and don’t affect the severity of liver disease in patients with CHB.
背景。乙型肝炎病毒(HBV)感染仍然是一个全球公共卫生问题。目的:分析慢性乙型肝炎(CHB)患者与人类免疫缺陷病毒(HIV)、丙型肝炎病毒(HCV)、丁型肝炎病毒(HDV)、tt病毒和SENV病毒共感染的流行情况,并评估它们对肝脏疾病严重程度的影响。材料和方法。这项观察性横断面研究包括287例慢性乙型肝炎病毒(HBV)患者,包括单感染和合并感染HIV、HCV、HDV的患者。进行常规血液学、生化检查,测定血清HBV DNA水平及肝纤维化分期。采用聚合酶链反应法检测62例患者血液中转矩丁诺病毒(TTV)、转矩丁诺迷你病毒(Torque teno mini virus)、转矩丁诺midi病毒(Torque teno midi virus)、转矩丁诺病毒(SENV) (D和H基因型)dna。结果。在慢性乙型肝炎患者中,HBV + HIV合并感染的患病率为6.6%,HBV + HCV - 6.3%, HBV + HDV - 3.8%, HBV + HDV + HCV - 1.7%。合并HIV、HCV、HDV感染的CHB患者与单hbv感染的CHB患者生化差异更明显,肝硬化比例更高。TT病毒及其各种组合在CHB患者中的检出率为91.9%,SENV - 66.1%。结论。慢性乙型肝炎患者同时感染HIV、HCV、HDV与更严重形式的慢性肝病相关。TT病毒和SENV广泛存在,并不影响慢性乙型肝炎患者肝脏疾病的严重程度。
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引用次数: 0
TRANSLOCATION OF INTESTINAL MICROFLORA IN CIRRHOSIS 肝硬化患者肠道菌群的易位
Pub Date : 2020-01-01 DOI: 10.25298/2616-5546-2020-4-2-143-150
D. Haurylenka, N. Silivontchik
Background. Understanding of intestinal bacteria-host interaction physiology as well as bacterial translocation characteristics at the initial stages and in advanced cirrhosis emphasizes the importance of approaches minimizing the migration of microorganisms and their components from the intestinal lumen. Objective – to provide a brief review of publications highlighting the problem of bacterial intestinal translocation as the main mechanism for the development of bacterial infections and pro-inflammatory status in patients with liver cirrhosis. Material and methods. We performed the study and analysis of English- and Russian-language articles over the past 30 years contained in the following databases: PubMed, Cochrane Collaboration, UpToDate. The key words were: «intestinal microflora translocation», «bacterial translocation», «translocation markers». Results. Contemporary views on changes of the intestinal barrier and those of innate and adaptive immunity systems in liver diseases are considered. Data on possibility and signifcance of detecting bacterial translocation are presented.Current methods used for gut microbiome analysis as well as some areas for future research are discussed. Conclusion. A validated marker/markers is required to study bacterial translocation in cirrhosis.
背景。了解肠道细菌-宿主相互作用生理学以及早期和晚期肝硬化的细菌易位特征,强调了减少微生物及其成分从肠腔迁移的方法的重要性。目的-简要回顾强调细菌性肠易位问题是肝硬化患者发生细菌感染和促炎状态的主要机制的出版物。材料和方法。我们对以下数据库中过去30年的英语和俄语文章进行了研究和分析:PubMed, Cochrane Collaboration, UpToDate。关键词:“肠道菌群易位”、“细菌易位”、“易位标记”。结果。在肝脏疾病的肠道屏障的变化和那些先天和适应性免疫系统的当代观点被考虑。介绍了检测细菌易位的可能性和意义。讨论了目前用于肠道微生物组分析的方法以及未来研究的一些领域。结论。研究肝硬化中的细菌易位需要一个或多个有效的标记物。
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引用次数: 0
THE INTRODUCTION OF THE PHOTOSENSITIZER “FOTOLON” INTO THE COMMON BILE DUCT: INFLUENCE ON EXPERIMENTAL ANIMALS 光敏剂“fotolon”进入胆总管:对实验动物的影响
Pub Date : 2020-01-01 DOI: 10.25298/2616-5546-2020-4-2-189-195
R. Shyla
Background. Photodynamic therapy of liver diseases involves the introduction of photosensitizers into the common bile duct. Objective – to evaluate the effect on animals of under pressure introduction of the photosensitizer “Photolon” into the common bile duct. Material and methods. The control group was injected with physiological solution under pressure, the experimental one – with “Photolon”. The vital signs of the animals, the laboratory data were studied, a histological examination of the liver and duct was carried out. Results. The blood parameters of the experimental animals and their postoperative condition were not statistically different from those of the control group (p≤0.05). The liver and common bile duct had normal histological structure. Conclusions. The under pressure introduction of the photosensitizer “Photolon” into the common bile duct causes no morphological changes in the liver tissues and common bile duct and has no toxic effect on animals.
背景。肝脏疾病的光动力治疗包括将光敏剂引入总胆管。目的:评价胆总管加压注入光敏剂“Photolon”对动物的影响。材料和方法。对照组在压力下注射生理溶液,实验组注射“Photolon”。对实验动物的生命体征、实验室数据进行了研究,并对肝脏和胆管进行了组织学检查。结果。实验动物的血液参数及术后情况与对照组比较,差异无统计学意义(p≤0.05)。肝脏及胆总管组织学结构正常。结论。在压力下将光敏剂“Photolon”引入胆总管,对肝组织和胆总管无形态学改变,对动物无毒性作用。
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引用次数: 1
THE ROLE OF INTESTINAL MICROBIOTA IN THE PATHOGENESIS OF SEPSIS PROGRESSION 肠道菌群在脓毒症发病机制中的作用
Pub Date : 2020-01-01 DOI: 10.25298/2616-5546-2020-4-2-155-159
R. Yakubtsevich, A. V. Lemesh
Background. Sepsis is a global public health problem and is associated with high mortality rates in all countries. According to recent views, sepsis is defned as life-threatening organ dysfunction caused by an unregulated response of the host to infection. Objective. To analyze the results of scientifc studies confrming the key role of intestinal dysbiosis in the pathophysiology of sepsis. Material and methods. A qualitative analysis of 34 Russian-language and English-language sources concerning the role of the intestinal microbiota in the onset of sepsis was carried out. Results. It has been established that intestinal microbiota plays an important role in the etiology, pathogenesis and treatment of sepsis and its disbalance can trigger the development of sepsis of various etiologies, mainly gram-negative. Conclusions. The analysis of the literature indicates that bacterial translocation can be natural provided that the immune system functions properly. Intestinal microbiota plays one of the leading roles in the development of sepsis. The use of probiotics and transplantation of intestinal microbiota contribute greatly to the treatment and prevention of sepsis in ICU patients.
背景。败血症是一个全球性的公共卫生问题,在所有国家都与高死亡率有关。根据最近的观点,败血症被定义为由宿主对感染的不调节反应引起的危及生命的器官功能障碍。目标。分析证实肠道生态失调在脓毒症病理生理中的关键作用的科学研究结果。材料和方法。对34例俄语和英语资料进行了定性分析,内容涉及肠道微生物群在脓毒症发病中的作用。结果。肠道菌群在脓毒症的病因、发病机制和治疗中起着重要作用,其失衡可引发以革兰氏阴性为主的多种病因脓毒症的发生。结论。文献分析表明,只要免疫系统功能正常,细菌易位是自然发生的。肠道菌群在脓毒症的发展中起着主导作用之一。益生菌的应用和肠道菌群的移植对ICU患者脓毒症的治疗和预防有重要的作用。
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引用次数: 0
THE ROLE OF THE GUT-LIVER AXIS IN LIVER CIRRHOSIS PATHOGENESIS AND COMPLICATIONS 肝肠轴在肝硬化发病及并发症中的作用
Pub Date : 2020-01-01 DOI: 10.25298/2616-5546-2020-4-2-151-154
V. A. Savarina, V. Mitsura
Background. Liver cirrhosis is a severe disease that can provoke hepatocellular carcinoma. It is known that such patients have increased intestinal permeability causing the translocation of living bacteria and bacterial products through the inferior vena cava system into the liver, that leads to a cascade of immune and molecular events. Objective – to establish the role of the gut-liver axis in the pathogenesis and outcomes of liver cirrhosis. Material and methods. We performed a PubMed search of publications over the last 10 years, using the keywords ‘intestinal permeability’, ‘cirrhosis’. Results. Increased intestinal permeability and bacterial translocation are of great importance in the development of liver cirrhosis. In turn, the progression of the disease further enhances the transfer of bacteria from the intestine into the inferior vena cava system. The severity of this process is proportional to the stage of cirrhosis and correlates with the prognosis of the disease. Conclusion. Increased intestinal permeability, altered gut microbiota and bacterial translocation contribute to liver damage and fbrosis up to the development of liver cirrhosis and its complications. Further research is required to determine if modulation of the gut microbiota can affect the course of liver disease.
背景。肝硬化是一种可引起肝细胞癌的严重疾病。已知这类患者的肠道通透性增加,导致活细菌和细菌产物通过下腔静脉系统进入肝脏,从而导致一系列免疫和分子事件。目的:探讨肝肠轴在肝硬化发病机制及预后中的作用。材料和方法。我们使用关键词“肠通透性”、“肝硬化”对过去10年的出版物进行了PubMed搜索。结果。肠道通透性增加和细菌易位在肝硬化的发展中起重要作用。反过来,疾病的进展进一步加强了细菌从肠道转移到下腔静脉系统。这一过程的严重程度与肝硬化的阶段成正比,并与疾病的预后相关。结论。肠道通透性增加、肠道微生物群改变和细菌易位可导致肝损伤和纤维化,直至肝硬化及其并发症的发生。需要进一步的研究来确定肠道微生物群的调节是否会影响肝病的病程。
{"title":"THE ROLE OF THE GUT-LIVER AXIS IN LIVER CIRRHOSIS PATHOGENESIS AND COMPLICATIONS","authors":"V. A. Savarina, V. Mitsura","doi":"10.25298/2616-5546-2020-4-2-151-154","DOIUrl":"https://doi.org/10.25298/2616-5546-2020-4-2-151-154","url":null,"abstract":"Background. Liver cirrhosis is a severe disease that can provoke hepatocellular carcinoma. It is known that such patients have increased intestinal permeability causing the translocation of living bacteria and bacterial products through the inferior vena cava system into the liver, that leads to a cascade of immune and molecular events. Objective – to establish the role of the gut-liver axis in the pathogenesis and outcomes of liver cirrhosis. Material and methods. We performed a PubMed search of publications over the last 10 years, using the keywords ‘intestinal permeability’, ‘cirrhosis’. Results. Increased intestinal permeability and bacterial translocation are of great importance in the development of liver cirrhosis. In turn, the progression of the disease further enhances the transfer of bacteria from the intestine into the inferior vena cava system. The severity of this process is proportional to the stage of cirrhosis and correlates with the prognosis of the disease. Conclusion. Increased intestinal permeability, altered gut microbiota and bacterial translocation contribute to liver damage and fbrosis up to the development of liver cirrhosis and its complications. Further research is required to determine if modulation of the gut microbiota can affect the course of liver disease.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69172769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PROSPECTS FOR THE USE OF DRUGS BASED ON BACTERIAL LIPOPOLYSACCHARIDES IN HEPATOLOGY 基于细菌脂多糖的药物在肝病学中的应用前景
Pub Date : 2020-01-01 DOI: 10.25298/2616-5546-2020-4-2-160-164
S. A. Chernyak
Background. The study of new properties of bacterial lipopolysaccharides (BLPS), not related to their intoxication activity, is of great interest. Objective – to describe the mechanisms of BLPS action and to assess their effcacy. Material and methods. We performed a literature review of 32 sources published during the period from 1962 to 2020. Results. It was found out that in addition to the immunomodulatory effect, BLPS are capable of exerting anti-inflammatory, antitumor, radioprotective effects and stimulating tissue regeneration as well. A wide range of BLPS therapeutic effects has been established in diseases of the hepatobiliary system, as evidenced by experimental and clinical studies. BLPS administration shortens the manifestation stage of acute hepatitis, promotes quick normalization of functional liver tests and restoration of morphological changes in the liver. Conclusion. The presence of hepatoprotective and antifbrotic properties in BLPS encourages their wider use in clinical practice of hepatologists.
背景。细菌脂多糖(BLPS)与中毒活性无关的新性质的研究引起了人们的极大兴趣。目的:描述BLPS的作用机制并评价其疗效。材料和方法。我们对1962年至2020年期间发表的32篇文献进行了综述。结果。研究发现,BLPS除具有免疫调节作用外,还具有抗炎、抗肿瘤、防辐射、促进组织再生等作用。经实验和临床研究证实,BLPS在肝胆系统疾病中具有广泛的治疗作用。给药BLPS可缩短急性肝炎的表现期,促进肝功能检查的快速正常化和肝脏形态改变的恢复。结论。BLPS的肝保护和抗纤维化特性促使其在肝病学家的临床实践中得到更广泛的应用。
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引用次数: 0
CHRONIC HEPATITIS C IN THE RUSSIAN FEDERATION AFTER STARTING THE HCV ELIMINATION PROGRAM 俄罗斯联邦在启动HCV消除计划后的慢性丙型肝炎
Pub Date : 2020-01-01 DOI: 10.25298/2616-5546-2020-4-2-165-170
A. A. Dzemova, R. Ganchenko, G. Trifonova, E. Esaulenko
Background. Five years have passed since the adoption of the strategy for the elimination of viral hepatitis. It is necessary to take stock of the frst results. Objective – to assess the dynamics of the epidemic process of CHC and the clinical manifestations of the disease during the period of 2015-2019. Material and methods. The article analyzes the data from the state statistical reporting of infectious diseases in the Russian Federation (RF), from the reference-center for the monitoring of viral hepatitis, from statistical tables compiled at Methodological and Research Center for Epidemiological Surveillance of Viral Hepatitis under Pasteur Institute of Epidemiology and Microbiology. The data from the Federal register of patients with viral hepatitis were used. The article analyzes our own experience of observing 555 patients with HCV at different stages of the disease. Results. In 2015–2019, CHC incidence in the RF decreased by 20% (30,90/0000- in 2019, 38,00/0000– in 2015). The total number of people with CHC is increasing (in 2015 – 562 622 people, in 2019 – 635372). It is estimated that only 20% of those infected are under surveillance. The death rate from CHC remains high. The proportion of patients with an advanced stage of CHC is about 20%. The proportion of decompensated cirrhosis decreased by 8%. In recent years, government funding for the treatment has increased, but only about 8% of all registered CHC patients are covered by the therapy. Conclusions. In the RF the WHO strategy targets have not been achieved by 2020. That’s why it’s important to develop a strategy to counter the spread of HCV for the period up to 2030.
背景。自通过消除病毒性肝炎战略以来,已经过去了五年。有必要对最初的结果进行评估。目的:了解2015-2019年CHC流行动态及临床表现。材料和方法。本文分析了俄罗斯联邦传染病国家统计报告的数据、病毒性肝炎监测参考中心的数据、巴斯德流行病学和微生物学研究所病毒性肝炎流行病学监测方法和研究中心编制的统计表。数据来自病毒性肝炎患者联邦登记册。本文分析了我们对555例不同阶段HCV患者的观察经验。结果。2015 - 2019年,RF的CHC发病率下降了20%(2019年为30,90/0000,2015年为38,000 /0000)。CHC的总人数正在增加(2015年为562 622人,2019年为635372人)。据估计,只有20%的感染者受到监测。CHC的死亡率仍然很高。晚期CHC患者比例约为20%。失代偿性肝硬化比例下降8%。近年来,政府对这种治疗的资助有所增加,但在所有登记的CHC患者中,只有约8%的人接受了这种治疗。结论。在RF中,世卫组织的战略目标到2020年尚未实现。这就是为什么必须制定一项战略,在2030年之前遏制丙型肝炎病毒的传播。
{"title":"CHRONIC HEPATITIS C IN THE RUSSIAN FEDERATION AFTER STARTING THE HCV ELIMINATION PROGRAM","authors":"A. A. Dzemova, R. Ganchenko, G. Trifonova, E. Esaulenko","doi":"10.25298/2616-5546-2020-4-2-165-170","DOIUrl":"https://doi.org/10.25298/2616-5546-2020-4-2-165-170","url":null,"abstract":"Background. Five years have passed since the adoption of the strategy for the elimination of viral hepatitis. It is necessary to take stock of the frst results. Objective – to assess the dynamics of the epidemic process of CHC and the clinical manifestations of the disease during the period of 2015-2019. Material and methods. The article analyzes the data from the state statistical reporting of infectious diseases in the Russian Federation (RF), from the reference-center for the monitoring of viral hepatitis, from statistical tables compiled at Methodological and Research Center for Epidemiological Surveillance of Viral Hepatitis under Pasteur Institute of Epidemiology and Microbiology. The data from the Federal register of patients with viral hepatitis were used. The article analyzes our own experience of observing 555 patients with HCV at different stages of the disease. Results. In 2015–2019, CHC incidence in the RF decreased by 20% (30,90/0000- in 2019, 38,00/0000– in 2015). The total number of people with CHC is increasing (in 2015 – 562 622 people, in 2019 – 635372). It is estimated that only 20% of those infected are under surveillance. The death rate from CHC remains high. The proportion of patients with an advanced stage of CHC is about 20%. The proportion of decompensated cirrhosis decreased by 8%. In recent years, government funding for the treatment has increased, but only about 8% of all registered CHC patients are covered by the therapy. Conclusions. In the RF the WHO strategy targets have not been achieved by 2020. That’s why it’s important to develop a strategy to counter the spread of HCV for the period up to 2030.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69173033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
THE CONTENT OF RETINOL AND α-TOCOPHEROL IN EXPERIMENTAL LIVER FIBROSIS IN RATS 实验性肝纤维化大鼠视黄醇和α-生育酚的含量
Pub Date : 2020-01-01 DOI: 10.25298/2616-5546-2020-4-2-196-200
I. A. Kondratovich, Y. Novogrodskaya, V. Andreev, R. Kravchuk, A. Ostrovskaya, I. E. Gulyai, S. Shalesnaya, M. Kurbat, V. Tsyrkunov
Background. The content of retinol and α-tocopherol in the human body affects the development and progression of chronic liver diseases and is associated with the functioning of perisinusoidal lipocytes (HSC) and the state of biological membranes. Objective – to evaluate the content of retinol and α-tocopherol in blood plasma and liver tissue in the dynamics of experimental liver fbrosis in rats. Material and methods. Modeling of liver fbrosis / cirrhosis was carried out on sexually mature male rats by intraperitoneal administration of thioacetamide (TAA) solution at a dose of 200 mg / kg every other day for 4 and 12 weeks. The control group of animals received an equal volume of saline. The concentration of α-tocopherol and retinol was determined by S.L. Taylor’s method. Results. In rat liver preparations, 4 weeks after administration of TAA solution to animals, signs of FII-III stage of fbrosis were observed. According to electron microscopy, HSCs were in a transitional state and acquired a more elongated shape; the number of lipid inclusions in their cytoplasm decreased. The administration of TAA for 12 weeks led to the formation of liver cirrhosis in rats, with characteristic macro- and microscopic changes. On light microscopy, the number of HSCs decreased in rat liver preparations 3 months after administration of TAA; activated HSCs were encountered, which acquired an elongated shape and lost lipid inclusions. The content of retinol in the 2nd group of animals (with liver fbrosis stage II-III) was 2.2 times higher than in the control group, and 1.8 times higher than in the 3rd group with liver cirrhosis (p < 0.05). The content of retinol in the liver tissue after 4 weeks of TAA administration decreased by 11.7%, after 12 weeks - by 1.5 times. The level of α-tocopherol in the liver at the stage of fbrosis FII-III decreased by 21% compared with the control group, at the stage of cirrhosis - by 2 times. Conclusion. The use of thioacetamide in rats for 1 and 3 months leads to the development of liver fbrosis and cirrhosis. A decrease in the content of retinol and α-tocopherol in the liver occurs with the progression of liver fbrosis /cirrhosis. The high content of retinol and α-tocopherol in plasma at the stage of liver fbrosis FII-III is due to degranulation (activation) of HSC.
背景。人体内视黄醇和α-生育酚的含量影响慢性肝病的发生进展,并与肝周脂细胞(HSC)功能和生物膜状态有关。目的:探讨大鼠实验性肝纤维化过程中血浆和肝组织中视黄醇和α-生育酚含量的变化。材料和方法。性成熟雄性大鼠以200 mg / kg /隔日腹腔注射硫乙酰胺(TAA)溶液,连续4周和12周建立肝纤维化/肝硬化模型。对照组动物给予等量生理盐水。采用泰勒法测定α-生育酚和视黄醇的含量。结果。在大鼠肝脏制剂中,TAA溶液给予动物4周后,观察到FII-III期纤维化迹象。电镜观察,造血干细胞处于过渡状态,呈细长状;细胞质中脂质包涵体的数量减少。TAA给药12周导致大鼠肝硬化的形成,并出现特征性的宏观和微观变化。光镜下,TAA给药3个月后,大鼠肝脏制剂中hsc数量减少;遇到活化的hsc,其获得拉长的形状并失去脂质内含物。第二组(肝纤维化II-III期)动物的视黄醇含量是对照组的2.2倍,是肝硬化第三组的1.8倍(p < 0.05)。TAA给药4周后肝组织中视黄醇含量下降11.7%,12周后下降1.5倍。FII-III期肝脏α-生育酚水平较对照组下降21%,肝硬化期α-生育酚水平较对照组下降2倍。结论。大鼠使用硫代乙酰胺1和3个月可导致肝纤维化和肝硬化。随着肝纤维化/肝硬化的进展,肝脏中视黄醇和α-生育酚含量降低。肝纤维化FII-III期血浆中视黄醇和α-生育酚含量高是由于HSC的脱颗粒(活化)所致。
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引用次数: 0
THE COMBINATION OF LADD’S SYNDROME WITH CONGENITAL HYPERTROPHIC PYLORIC STENOSIS ladd综合征合并先天性肥厚性幽门狭窄
Pub Date : 2020-01-01 DOI: 10.25298/2616-5546-2020-4-2-212-216
V. V. Navasad, V. I. Kavalchuk, E. A. Navasad
Background. The combination of the two congenital pathological conditions – compression of the duodenum by embryonic cords of the peritoneum and congenital inversion of the small intestine and right half of the colon due to incomplete bowel rotation – was described in detail by W. E. Ladd in 1932, thus the pathology is known as “Ladd’s syndrome” (LS). Congenital pyloric stenosis belongs to a group of severe birth defects. The disease is based on a congenital violation of the morphological structures of the pyloric sphincter of the stomach due to hypertrophy of the circular muscle layer and interstitial tissue leading to pyloric stenosis and impaired patency in this part of the gastrointestinal tract. Objective. Demonstration of diagnostics and treatment peculiarities of a rare case of a combined pathology of the gastrointestinal tract in a newborn. Material and methods. The data from clinical observation of the patient M., 3 days old, who was treated in the neonatal Department of the Grodno regional children’s clinical hospital (GODKB) since December 2018 till March 2019. Results. The child was found to have a combination of Ladd’s syndrome with congenital hypertrophic pyloric stenosis. Successful correction of the birth defects was performed. Conclusion. We have presented a case report that hasn’t been yet described in literature. Despite the diffculties in diagnostics, the patient was discharged with recovery. The follow-up examination in 2020 revealed no abnormalities in the child’s development.
背景。1932年,w.e.l add详细描述了这两种先天性病理情况的结合,即腹膜的胚胎索压迫十二指肠,以及小肠和结肠右半部分因肠道旋转不完全而内翻,因此这种病理被称为“Ladd综合征”(LS)。先天性幽门狭窄属于一组严重的先天缺陷。这种疾病是基于先天性的幽门括约肌形态结构的破坏,这是由于环形肌层和间质组织的肥大导致幽门狭窄和胃肠道这部分的通畅受损。目标。一个罕见病例的诊断和治疗特点的综合病理在新生儿胃肠道的示范。材料和方法。患者M.,出生3天,自2018年12月至2019年3月在格罗德诺地区儿童临床医院(GODKB)新生儿科接受治疗。结果。孩子被发现有Ladd综合征合并先天性肥厚性幽门狭窄。成功地矫正了出生缺陷。结论。我们提出了一个尚未在文献中描述的病例报告。尽管诊断困难,但患者出院后恢复了健康。2020年的随访检查显示,孩子的发育没有异常。
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引用次数: 2
THE ROLE OF ENDOGENOUS INTOXICATION IN THE REGULATION OF BCL-2 GENE EXPRESSION IN THE DYNAMICS OF EXPERIMENTAL SUBHEPATIC OBSTRUCTIVE JAUNDICE 内源性中毒对实验性肝下梗阻性黄疸bcl-2基因表达调控的作用
Pub Date : 2019-12-17 DOI: 10.25298/2616-5546-2019-3-2-178-183
O. A. Drichits, L. S. Kizyukevich, А. V. Kapytski, I. L. Kizyukevich
Background. Antiapoptotic gene Bcl-2 blocks cell death, prolongs cell survival in many cellular systems, protects against various cytotoxic effects. Objective – to evaluate the role of endogenous intoxication in the regulation of Bcl-2 antiapoptotic gene expression in the dynamics of experimental subhepatic obstructive jaundice. Material and methods. The subhepatic obstructive jaundice (duration: 1, 3, 5 and 10 days) was simulated in rats by bandaging the common bile duct at the liver gate. Sham operated animals were used as a control group. The concentration of total bile acids, total bilirubin and urea as well as the activity of ALT and AST were determined in blood serum of experimental and control rats. Total RNA was isolated from 1 ml of whole blood. The level of Bcl2 gene expression was performed by real-time PCR (PCR-RT). Results. Over a 10 day-experiment the concentration of total bile acids in blood serum of jaundiced animals has increased 38-74 times (p<0.001), the level of bilirubin - 11.7-18 times (p<0.001), aminotransferase activity and urea concentration have increased significantly. All this leads to endotoxemia, producing a cytotoxic effect on the tissues of the internal environment of the body and is accompanied by enhanced relative level of expression of the antiapoptotic gene Bcl-2. Conclusion. A 10-day-subhepatic obstructive jaundice (the degree of its severity depends on the duration of cholestasis) leads to the development of biliary endogenous intoxication, accompanied by enhanced relative level of expression of the Bcl-2 antiapoptotic gene, that in its turn blocks the development of apoptosis.
背景。抗凋亡基因Bcl-2在许多细胞系统中阻断细胞死亡,延长细胞存活,防止各种细胞毒性作用。目的:探讨内源性中毒对实验性肝下阻塞性黄疸Bcl-2抗凋亡基因表达的调控作用。材料和方法。采用肝门处胆总管包扎法模拟大鼠肝下梗阻性黄疸(持续时间1、3、5、10天)。以假手术动物为对照组。测定实验组和对照组大鼠血清中总胆汁酸、总胆红素、尿素浓度及ALT、AST活性。从1 ml全血中分离总RNA。实时荧光定量PCR (PCR- rt)检测Bcl2基因表达水平。结果。在10 d的试验中,黄疸动物血清中总胆汁酸浓度增加了38 ~ 74倍(p<0.001),胆红素水平增加了11.7 ~ 18倍(p<0.001),转氨酶活性和尿素浓度显著增加。所有这些导致内毒素血症,对机体内环境组织产生细胞毒性作用,并伴随抗凋亡基因Bcl-2的相对表达水平增强。结论。为期10天的肝下梗阻性黄疸(其严重程度取决于胆汁淤积的持续时间)导致胆道内源性中毒的发展,并伴有Bcl-2抗凋亡基因的相对表达水平增强,进而阻断细胞凋亡的发展。
{"title":"THE ROLE OF ENDOGENOUS INTOXICATION IN THE REGULATION OF BCL-2 GENE EXPRESSION IN THE DYNAMICS OF EXPERIMENTAL SUBHEPATIC OBSTRUCTIVE JAUNDICE","authors":"O. A. Drichits, L. S. Kizyukevich, А. V. Kapytski, I. L. Kizyukevich","doi":"10.25298/2616-5546-2019-3-2-178-183","DOIUrl":"https://doi.org/10.25298/2616-5546-2019-3-2-178-183","url":null,"abstract":"Background. Antiapoptotic gene Bcl-2 blocks cell death, prolongs cell survival in many cellular systems, protects against various cytotoxic effects. Objective – to evaluate the role of endogenous intoxication in the regulation of Bcl-2 antiapoptotic gene expression in the dynamics of experimental subhepatic obstructive jaundice. Material and methods. The subhepatic obstructive jaundice (duration: 1, 3, 5 and 10 days) was simulated in rats by bandaging the common bile duct at the liver gate. Sham operated animals were used as a control group. The concentration of total bile acids, total bilirubin and urea as well as the activity of ALT and AST were determined in blood serum of experimental and control rats. Total RNA was isolated from 1 ml of whole blood. The level of Bcl2 gene expression was performed by real-time PCR (PCR-RT). Results. Over a 10 day-experiment the concentration of total bile acids in blood serum of jaundiced animals has increased 38-74 times (p<0.001), the level of bilirubin - 11.7-18 times (p<0.001), aminotransferase activity and urea concentration have increased significantly. All this leads to endotoxemia, producing a cytotoxic effect on the tissues of the internal environment of the body and is accompanied by enhanced relative level of expression of the antiapoptotic gene Bcl-2. Conclusion. A 10-day-subhepatic obstructive jaundice (the degree of its severity depends on the duration of cholestasis) leads to the development of biliary endogenous intoxication, accompanied by enhanced relative level of expression of the Bcl-2 antiapoptotic gene, that in its turn blocks the development of apoptosis.","PeriodicalId":34878,"journal":{"name":"Gepatologiia i gastroenterologiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45114039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Gepatologiia i gastroenterologiia
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