维生素B2联合蓝光照射对新生儿黄疸康复进程及肝脏功能的影响研究

Study on the Effects of Vitamin B2 Combined with Blue Light Irradiation on the Recovery Process and Liver Function in Neonatal Jaundice

:-
 
目的:探讨维生素B2(VB2)联合蓝光照射对新生儿黄疸康复进程及肝脏功能的影响。方法:选取2024年5月—2025年10月收治的150例黄疸患儿,应用随机数字表法分为常规组和试验组,每组75例。常规组接受蓝光照射治疗,试验组在常规组基础上口服VB2治疗。比较两组患儿的氧化应激反应[谷胱甘肽过氧化物酶(GSH-Px),8羟基脱氧鸟苷(8-OHdG)、晚期蛋白氧化产物(AOPP)、超氧阴离子(O2-)]、肝脏微循环[血管性血友病因子(vWF)、可溶性血栓调节蛋白(sTM)、肝动脉阻力指数(HA-RI)、门静脉血流速度(PVV)]、胆红素排泄[总胆红素(TBil)、间接胆红素(IBil)]、肝脏功能[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)]、康复进程[光疗时间、胆红素恢复正常时间、黄疸消退时间、住院康复时间]及治疗安全性。结果:治疗后,试验组的GSH-Px高于常规组,8-OHdG、AOPP、O2-均低于常规组(P<0.05);试验组的vWF、sTM、HA-RI均低于常规组,PVV高于常规组(P<0.05)。试验组的TBil、IBil、ALT、AST分别为(80.52±5.47)μmol/L、(68.52±5.49)μmol/L、(30.25±5.48)U/L、(32.14±5.22)U/L,均低于常规组[(85.19±6.44)μmol/L、(74.37±6.52)μmol/L、(35.29±6.17)U/L、(38.55±6.48)U/L],差异有统计学意义(P<0.05)。试验组的光疗时间、胆红素恢复正常时间、黄疸消退时间、住院康复时间分别为(3.05±0.33)d、(4.22±1.39)d、(5.41±1.27)d、(5.12±0.49)d,均低于常规组[(3.68±0.36)d、(5.36±1.45)d、(6.28±1.33)d、(6.51±0.54)d],差异有统计学意义(P<0.05)。试验组的不良反应发生率与常规组比较,差异无统计学意义(P>0.05)。结论:VB2联合蓝光照射可减轻黄疸患儿的氧化应激反应并改善肝脏微循环,对促进胆红素排泄、改善肝脏功能均有积极影响,在促进患儿康复同时未显著增加治疗风险。其安全性较高,可进一步推广。
Objective: To investigate the effects of vitamin B2 (VB2) combined with blue light irradiation on the recovery process and liver function of neonatal jaundice. Method: 150 children with jaundice admitted from May 2024 to October 2025 were selected and randomly divided into a control group and an experimental group using a random number table method, with 75 cases in each group. The conventional group received blue light irradiation treatment, while the experimental group received oral VB2 treatment on the basis of the conventional group. Compare the oxidative stress response of two groups of children [glutathione peroxidase (GSH Px) higher than the control group, 8-hydroxydeoxyguanosine (8-OHdG), advanced protein oxidation products (AOPP), superoxide anion (O2-)], liver microcirculation [von Willebrand factor (vWF), soluble thrombomodulin (sTM), hepatic artery resistance index (HA-RI), portal vein blood flow velocity (PVV)], bilirubin excretion [total bilirubin (TBil), indirect bilirubin (IBil)], liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST)], rehabilitation process [phototherapy time, bilirubin recovery time to normal, jaundice regression time]. Hospitalization rehabilitation time and treatment safety. Result: After treatment, the GSH Px levels in the experimental group were higher than those in the control group, while 8-OHdG, AOPP, and O2- levels were lower than those in the control group (P<0.05); The vWF, sTM, and HA-RI of the experimental group were lower than those of the control group, while PVV was higher than that of the control group (P<0.05). The TBil, IBil, ALT, and AST of the experimental group were (80.52 ± 5.47) μ mol/L, (68.52 ± 5.49) μ mol/L, (30.25 ± 5.48) U/L, and (32.14 ± 5.22) U/L, respectively, which were lower than those of the conventional group [(85.19 ± 6.44) μ mol/L, (74.37 ± 6.52) μ mol/L, (35.29 ± 6.17) U/L, (38.55 ± 6.48) U/L], and the difference was statistically significant (P<0.05). The phototherapy time, bilirubin recovery time, jaundice resolution time, and hospital rehabilitation time of the experimental group were (3.05 ± 0.33) days, (4.22 ± 1.39) days, (5.41 ± 1.27) days, and (5.12 ± 0.49) days, respectively, which were lower than those of the conventional group [(3.68 ± 0.36) days, (5.36 ± 1.45) days, (6.28 ± 1.33) days, and (6.51 ± 0.54) days], and the difference was statistically significant (P<0.05). The incidence of adverse reactions in the experimental group was not significantly different from that in the control group (P>0.05). Conclusion: VB2 combined with blue light irradiation can alleviate oxidative stress response and improve liver microcirculation in children with jaundice. It has a positive effect on promoting bilirubin excretion and improving liver function, and does not significantly increase treatment risk while promoting the recovery of children. It has high safety and can be further promoted.
论著

CircRNA-0003340在2型糖尿病大鼠肝脏组织中的表达及意义

CircRNA-0003340 expression and significance in the liver of T2DM rats

:7-13
 
目的 观察2型糖尿病大鼠肝脏组织中circRNA-0003340的表达,并探讨与糖尿病的关系。方法 选取健康雄性SD大鼠30只,随机分为2组,正常对照组(NC组,n=10)与2型糖尿病组(T2DM组,n=20),检测FPG、FINs、HbA1c、TC、TG、HDL-C、LDL-C、AST、ALT;行腹腔注射糖耐量实验和胰岛素耐量实验,计算胰岛素抵抗指数(HOMA-IR);HE染色观察胰岛细胞形态;RT-PCR检测大鼠肝脏组织circRNA-000334的表达量。结果 与NC组比较,T2DM组的AST、ALT、FPG、HAb1c、FINs、HOMA-IR、TG、TC、LDL-C均升高(P<0.05),HDL-C降低(P<0.05)。circRNA-0003340在T2DM组肝脏组织中的表达较NC组肝脏组织中的表达是下调的,差异有统计学意义(P<0.05)。Sperman相关分析示大鼠肝脏组织中circRNA-0003340表达水平与FPG、TG及TC呈负相关(P<0.05)。结论 circRNA-003340的表达水平可能与T2DM大鼠的糖脂代谢密切相关,circRNA-003340在肝脏组织中的表达水平下调可能参与T2DM的发生发展。
Objective To observe the expression of circRNA-0003340 in the liver tissue of type 2 diabetes mellitus (T2DM)rats and to explore its relationship with diabetes.Methods A total of 30 healthy male SD rats were randomly divided into two groups,normal control group(NC group,n=10)and T2DM group(n=20),and fasting plasma glucose(FPG),fasting insulins(FINS),glycated hemoglobin(HbA1c),total cholesterol(TC),triglyceride (TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),aspartate aminotransferase(AST),alanine aminotransferase(ALT)levels were detected.Intraperitoneal glucose tolerance test and insulin tolerance test were performed to calculate the insulin resistance index(HOMA-IR),HE staining was used to observe islet cell morphology,the expression of circRNA-000334 in rat liver tissue was detected by RT-PCR.Results Compared with the NC group,the T2DM group had increased AST,ALT,FPG,HAb1c,FINs,HOMA-IR,TG,TC,LDL-C(P<0.05)and decreased HDL-C(P<0.05).The expression of circRNA-0003340 in liver tissue in T2DM group was down-regulated compared with that in NC group,with statistically significant difference(P<0.05).Sperman correlation analysis showed that the expression level of circ-0003340 in rat liver tissue was negatively correlated with FPG,TG and TC(P<0.05).Conclusions The expression level of circRNA-003340 may be closely related to the glycolipid metabolism of T2DM rats,and the downward regulation of the circRNA-003340 expression level in liver tissues may be involved in the occurrence and development of T2DM.
论著

微泡超声空化在增强微波消融对肝脏肿瘤的热消融效应中的价值

Valuable study of microbubble ultrasound cavitation enhanced microwave ablation for liver cancer

:43-48
 
目的 通过研究微泡超声空化增强微波消融对兔VX2肿瘤的热消融效应来探究其在肿瘤治疗中的价值。方法 24只肝脏移植瘤兔随机分为空白对照组、单纯超声空化治疗组、单纯微波消融治疗组、超声空化联合微波消融治疗组4组。利用增强超声显示每组治疗前后肿瘤的大小、形状和轮廓并通过温度针来检测治疗区域的局部温度。结果 联合治疗组血流灌注缺损最严重,微波消融组和联合治疗组缺损体积分别为1.53±0.20和1.68±0.43(P=0.117);微波消融组以及联合治疗组消融治疗时温度达平台时间分别为(21.7±5.0)s和(10.3±5.0)s(P<0.01),最高温度(℃)分别为100.9±5.0和134.1±6.0(P<0.01)。结论 MWA联合MEUS治疗肝癌可使治疗区局部温度急剧升高至峰值温度,有望提高肝癌治疗效果。
Objective To investigate the thermal ablation effect of microbubble ultrasound cavitation combined with microwave ablation on rabbit VX2 tumors. Methods Twenty-four rabbits with liver transplantation tumors were randomly divided into four groups: blank control group, ultrasound-only cavitation treatment group, microwave-only ablation treatment group, and ultrasound-cavitation combined with microwave ablation treatment group. Enhanced ultrasound was used to show the size, shape and contour of the tumor before and after treatment in each group, and the local temperature of the treatment area was detected by a temperature needle. Results The blood flow perfusion defect was the most severe in the combined treatment group. The defect volume of the microwave ablation group and the combined treatment group were 1.53±0.20 and 1.68±0.43 (P=0.117). The temperature reached the plateau time in the microwave ablation group and the combined treatment group. It was (21.7±5.0)s and (10.3±5.0)s (P<0.01), and the highest temperature (℃) was 100.9±5.0 and 134.1±6.0 (P<0.01). Conclusion MWA combined with MEUS for liver cancer can sharply increase the local temperature in the treatment area to the peak temperature, which is expected to improve the treatment effect of liver cancer.
临床诊疗

ADMIRE重建技术在肝脏CT扫描中的应用价值探讨

The application value of iterative reconstruction ADMIRE Technology in liver CT scan

:113-116
 
目的 探讨FORCE CT实时迭代ADMIRE重建技术在肝脏CT扫描中的应用价值。方法 临床疑肝病患者50例,行FORCE CT肝脏平扫后,分别采用FBP重建和ADMIRE-1~5级重建,比较6组图像的平均CT值、噪声、SNR、CNR及图像质量的主观评分及诊断效能等。结果 比较6组图像显示,肝实质平均CT值无统计学差异(P>0.05);噪声、SNR、CNR及主观评分间均有差异(P<0.05),ADMIRE-5重建噪声最小、SNR、CNR最大。图像主观评分ADMIRE-1和ADMIRE-5图像评分低于FBP,ADMIRE-2~4高于FBP,绝对评分最高为ADMIRE-3重建,但六种重建图像对病变诊断效能一致。结论 肝脏CT平扫结合FORCE CT 实时迭代ADMIRE重建技术能有效降低图像噪声及提高图像质量,具有潜在降低扫描剂量的作用。
Objective: To discuss the value of ADMIRE reconstruction technique in the liver plain CT scan by the comparison of displays to the liver separately by ADMIRE and traditional FBP reconstructions after DSCT scan. Methods: 48 patients who were clinically doubted to have hepatic lesions were scanned by DSCT in liver, then six groups of images for FBP and ADMIRE 1-5 on the average CT value, noise, signal to noise ratio ( SNR ), contrast to noise ratio (CNR) and subjective scoring on image quality were compared. Results: 6 groups of images were compared,and the average CT value of liver parenchyma has no statistical differences (P>0.05);The differences were statistically significant (P<0.05)on noise, SNR, CNR and subjective scoring,ADMIRE5 reconstruction has the least noise and the largest SNR and CNR.For the images of ADMIRE1 and ADMIRE5, the image subjective scoring is lower than that by FBP; for the images of ADMIRE2 and ADMIRE4, the image subjective scoring is higher than that by FBP; and ADMIRE-3 has the highest score.But for the rate of lesion detection, all the images were the same. Conclusion: ADMIRE reconstruction strength 3 makes the best image quality.ADMIRE reconstruction can decrease noise and improve SNR and CNR,as well as have a potential effect decreasing the scan dose.
论著

高龄肝脏与低龄肝脏生理差异的实验性研究

Experimental of physiological differences between elderly and younger livers in rats

:7-12
 
目的 探讨生理情况下高龄肝脏与低龄肝脏的区别,寻找可以区分高龄肝脏与低龄肝脏的指标。方法 取6周龄SD大鼠和9月龄以上退役SD大鼠各5只,采用超声弹性成像检测肝脏硬度、全自动生化检测仪检测血清学指标、H&E染色观察肝脏形态结构、Sirius Red染色及Masson染色检测胶原纤维的沉积、免疫组化SP法检测TGF-β1、p16INK4a、SMP-30蛋白的表达。结果 高龄组和低龄组之间血清学指标、胶原纤维沉积及TGF-β蛋白、p16INK4a蛋白的表达无差异;超声弹性成像检测低龄组Vs值为(1.21±0.09)m/s,高龄组为(1.32±0.05)m/s(P=0.033);SMP-30蛋白低龄组IOD值为138244.988±51286.257,高龄组为116240.170±35017.936(P=0.007)。结论 高龄大鼠与低龄大鼠肝脏的硬度及SMP-30蛋白的表达存在差异,随着年龄的增加肝脏硬度增大,SMP-30蛋白表达下降。肝脏硬度与SMP-30蛋白可作为区分高龄肝脏与低龄肝脏的指标。
Objective To investigate the differences between elderly and younger liver. Methods In accordance with the age of the SD rats into two groups: younger group (Group Y, 6 weeks, n=5) and elderly group (Group O, 40 weeks or more, n=5). Data were compared by using ultrasound elasticity imaging to detect liver stiffness, automatic biochemical detector to gauge serum indexes, H&E staining to observe the liver morphological structure, Sirius Red staining and Masson staining to assay the collagen fibers deposition, Immunohistochemistry to identify the expression of TGF-β1, p16INK4a and SMP-30 protein. Results Serum indexes, collagen deposition, TGF-β1 and p16INK4a protein expression were no statistically significant difference between two groups. The Vs value was (1.21±0.09) m/s in Group Y and (1.32±0.05) m/s in Group O (P=0.033). and the IOD value of SMP-30 protein between Group Y and Group O were 138244.988±51286.257 and 116240.170±35017.936 (P=0.007). Conclusion The degree of liver stiffnessnd and SMP-30 protein in elderly and younger liver are different.Increased the degree of liver stiffness and decreased the expression of SMP-30 protein in the elderly SD rats. Liver stiffness and SMP-30 protein could be used as indicators to distinguish between elderly and younger liver.
论著

肝脏脂肪变性对肝脏手术安全性及预后的影响研究

Study of liver steatosis on surgery safety and prognosis

:18-21
 
目的 探讨肝脏脂肪变性对肝脏切除手术安全性及预后的影响。方法 选取2012年1月—2014年12月在我院接受肝切除术治疗的肝癌患者172例,根据HE染色结果,172例患者中无脂肪变性106例(对照组),轻度脂肪变性42例(轻度组),中重度脂肪 24例(中重度组),比较各组患者基本资料(性别、年龄等)、手术情况、生化指标、术后并发症、住院时间等。结果 三组患者体重指数(BMI)差异有统计学意义(P<0.05),中重度组BMI最高,为(26.94±3.14)kg/m2;中重度组患者手术时间、术中出血量、输注红细胞和肝门阻断时间分别为(182.39±42.17)min、(553.07±50.22)mL、(1.18±0.34)U和(20.15±6.07)min,均高于其他两组(P<0.05);中重度组患者重度并发症发生率为45.83%,高于对照组和轻度组的9.43%和9.52%(P<0.05);中重度组住院时间和ICU时间分别为(23.06±7.30)d和(3.71±1.03)d,高于其他两组(P<0.05)。结论 轻度肝脏脂肪变性对手术基本无影响,而中重度脂肪变性会增加手术时间和出血、重度并发症发生较多,不利于手术的安全性以及预后。
Objective To explore the effect of liver steatosis on liver resection safety and the prognosis. Methods Selected from January 2012 to December 2014 in our hospital liver resection of 172 cases of liver cancer patients, according to the results of HE staining, 172 patients without fatty degeneration in 106 cases (control group), 42 cases of mild steatosis (mild steatosis group), 24 cases of severe fatty (moderate and severe steatosis group),observed each group patients the clinical characteristics, surgery situation, biochemical index, postoperative complications, hospitalization time, etc. Results Body mass index(BMI)of patients in the three groups difference was statistically significant (P<0.05), moderate and severe steatosis group had the highest BMI (26.94±3.14)kg/m2; in moderate and severe steatosis group, surgery time, intraoperative bleeding volume, infusion of red blood cells and hepatic portal occlusion time were (182.39±42.17) min, (553.07±50.22) ml, (1.18±0.34) U and (20.15±6.07) min. They were significantly higher than that of the control group and mild steatosis group (P<0.05); moderate and severe steatosis patients with severe complication rate was 45.83%,significantly higher than that in the control group and the mild steatosis 9.43% and 9.52%. The difference was statistically significant (P<0.05); In moderate and severe steatosis group, hospitalization time and ICU were (23.06±7.30) d and(3.71±1.03) d, significantly higher than that in the control group and the mild steatosis group(P<0.05). Conclusion Mild liver steatosis have no effect on the surgery, severe liver steatosis may increase the surgery time and bleeding, severe complications occurred more, is not conducive to the safety of the surgery and prognosis.
学术前沿

胆管结扎诱导的梗阻性胆汁淤积对大鼠肝脏肝细胞影响的初步探究

Preliminary study of bile duct ligation induced obstructive cholestasis in rat hepatocytes

:1165-1174
 
目的 初步探究胆管结扎诱导的梗阻性胆汁淤积对大鼠肝细胞的影响。方法 10只Lewis大鼠随机分为对照组和胆汁淤积组,每组各5只,胆汁淤积组采用胆管结扎2周诱导梗阻性胆汁淤积大鼠模型。苏木精-伊红染色和苯胺蓝染色比较组织病理变化,使用生化分析比较两组小鼠肝功能情况。采用改良的两步胶原酶灌注分离原代肝细胞,通过RT-qPCR检测两组小鼠肝细胞标志基因、细胞增殖标志基因以及胆管细胞标志基因的表达情况。结果 与对照组相比,胆汁淤积组肝脏表现为明显的肝组织紊乱和纤维胶原蛋白沉积以及肝功能的损害。胆汁淤积组较对照组的原代肝细胞更高表达细胞增殖标志基因:细胞增殖标志物(Ki67)基因,叉头盒M1蛋白(Foxm1)基因,增殖细胞核抗原(Pcna)基因和肝细胞生长因子(HGF)基因(P<0.05);胆汁淤积组的原代肝细胞表达更低水平的肝细胞标志基因:白蛋白(Alb)基因,多药耐药相关蛋白2(Mrp2)基因,胆盐输出泵(Bsep)基因和肝细胞连环蛋白1(Catenin1)基因(P<0.05),同时表达更高水平的胆管细胞标志基因:细胞角蛋白7(Ck7)基因,细胞角蛋白 19(Ck19)基因,胆管细胞多药耐药性蛋白1(Mdr1)基因和胆管细胞囊性纤维化跨膜传导调节因子(Cftr)基因(P<0.05)以及肝祖细胞标志基因:上皮细胞黏附分子(Epcam)基因和Y染色体性别决定区-盒转录因子9(Sox9)基因(P<0.05)。结论 胆汁淤积可诱导肝细胞向胆管细胞特性转化的可塑性。
Objective To explore the effect of bile duct ligation induced obstructive cholestasis on rat hepatocytes. Methods Ten Lewis rats were randomly divided into control group and cholestasis group, and the cholestasis was induced by bile duct ligation for 2 weeks. The histopathological changes were compared by H&E and aniline blue staining and the liver function was compared by biochemical analysis. Primary hepatocytes were isolated by modified two-step collagenase perfusion, and the expressions of hepatocyte marker genes, cell proliferation marker genes and cholangiocyte marker genes were detected by RT-qPCR. Results Compared with the control group,the liver of the cholestatic group showed obvious disordered histopathology, deposition of fibrous collagen and impaired liver function. Compared with the control group, the primary hepatocytes in the cholestasis group expressed higher cell proliferation-related genes(Ki67,Foxm1,Pcna and HGF)(P<0. 05). Primary hepatocytes in the cholestasis group expressed lower levels of hepatocyte marker genes(Alb,Mrp2,Bsep and Catenin1)(P<0. 05),and higher levels of cholangiocyte marker genes(Ck7,Ck19,Mdr1 and Cftr)(P<0. 05)and higher levels of the hepatic progenitor cell marker genes(Epcam and Sox9)(P<0. 05). Conclusions Cholestasis induces rat hepatocyte plasticity in the transformation into bile duct properties.
出版者信息








《广州医药》公众号