目的：分析血脂正常者发生脂肪肝的危险因素及其临床特征。方法：回顾性分析137例血脂正常的脂肪肝（血脂正常脂肪肝组）和137例血脂正常的非脂肪肝（对照组）病人的临床资料，对肥胖等相关因素进行Logistic回归分析，并比较血脂正常脂肪肝组和高脂血症脂肪肝组病人的临床特征、肝功能改变差异。结果：血脂正常患者发生脂肪肝的独立相关危险因素为嗜酒、肥胖、2型糖尿病、空腹血糖升高、高尿酸血症，其比数比（odds nate，OR）分别为27.49、26.95、3.14、1.60和1.00。血脂正常脂肪肝组患者的γ-谷氨酰转移酶(27.7%)和球蛋白(5.8%)升高及A/G异常（13.1%）的比例均显著低于高脂血症脂肪肝组，后者相应为38.8%、12.3%和23.9%，均为P<O.05。结论：嗜酒、肥胖、2型糖尿病、空腹血糖升高和高尿酸血症是血脂正常者发生脂肪肝的独立相关危险因素。血脂正常脂肪肝组患者的肝功能损害较高脂血症脂肪肝组患者为轻。

临床流行病学研究表明，非甾体类抗炎药（NSAIDs）可降低消化系肿瘤的发病率，其作用机制可能与环氧合酶-2（COX-2）表达降低，抑制凋亡相关蛋白Bcl-2的表达有关[1]。本研究在检测胰腺癌COX-2蛋白表达率的基础上，观察特异性与非特异性COX-2抑制剂对细胞生长活力及凋亡的影响，探讨COX-2抑制剂NSAIDs对胰腺癌辅助治疗的可行 性，为胰腺癌防治探索新途径。

背景与目的：非甾体类抗炎药物（nonsteroidal anti-inflammatory drugs, NSAIDs）可以预防或降低消化系统肿瘤的发病率，提示环氧合酶-2（cyclooxygenase-2, COX-2）的表达与消化系统肿瘤的发生、发展密切相关。本研究通过检测胰腺癌组织中COX-2的表达，探讨COX-2与bcl-2表达的关系，及其在胰腺癌发生、发展过程中的作用。方法：胰腺癌等组织COX-2和bcl-2的表达采用ABC免疫组化分析；评价两者表达及其与患者临床病理特征的关系。结果：胰腺癌组织COX-2和bcl-2的表达阳性率分别为73.3%和66.7%，阳性率明显高于胰腺良性病变组织和正常胰腺组 织，两者呈高度正相关，相关系数г=0.470(P<0.01)。但COX-2表达率与患者临床病理特征无关(P>0.05)。结论：胰腺癌组织中COX-2表达增强，COX-2表达与bcl-2表达有协同效应，两者共同参与胰腺癌细胞凋亡的调控。

观察重组人白细胞介素2（γ-IL2）体外诱导的腹腔巨噬细胞，在YPC3抗人胰腺癌单克隆抗体（YPC3mAb）介导下,通过抗体依赖性细胞介导的细胞毒性（ADCC）机制对胰腺癌细胞的杀伤作用。4h51Cr释放实验表明，在YPC3mAb作用下，活化腹腔巨噬细胞对Capan-2人胰腺癌细胞的杀伤活力明显增强，比单用巨噬细胞杀伤活力约提高70.0%，而对照1-F/7抗登革热病毒单抗无明显影响。γ-IL2作用的腹腔巨噬细胞和脾淋巴细胞具有类似的ADCC杀伤效应。结果提示，γ-IL2和YPC3mAb联合腹腔注射，可能为胰腺癌的局部治疗提供一个新方法。

Monoclonal antibodies specific to tumor cells may be a useful tool for the diagnosis and treatment of carcinomas. In this study, YPC3 mAb, a specific monoclonal antibody against the human pancreatic carcinoma cell line Capan-2, was labeled directly with 99mTc after being pretreated with 2-mercaptoethanol. The radiolabeling efficiency was found to be high (88%-95%) and the immunoreactivity retained, as assessed by immunohistochemistry and enzyme-linked immunosorbent assay. The biodistribution of 99mTc-YPC3 mAb in nude mice bearing Capan-2 pancreatic carcinoma xenografts was studied and compared with that of labeled mouse immunoglobulin G (99mTc-nmIgG). The xenograft uptake values per gram of tissue 6h and 24h after injection of 99mTc-YPC3 mAb were found to be, respectively, 4.72%ID/g and 8.42%ID/g, and the tumor/blood ratios 1.16 and 2.24. At 6h and 24h after injection of 99mTc-nmIgG, the uptakes were 2.89%ID/g and 1.80%ID/g, and the tumor/blood ratios 0.84 and 1.02 respectively. External imaging by single-proton emission computed tomography, 24h after injection of 99mTc-YPC3 mAb, revealed clear scintigraphic visualization of Capan-2 xenografts, whereas injection of 99mTc-nmIgG did not. This study suggests that 99mTc labeling of monoclonal antibody YPC3 might be of practical value in localization diagnosis of human pancreatic carcinoma.

[目的]探讨非肥胖者发生脂肪肝的危险因素及其临床特点。[方法]非肥胖脂肪肝发病危险因素的筛选采用Logistic回归分析方法，比较非肥胖与肥胖脂肪肝组间血脂、肝功能等生化指标的差异。[结果]嗜酒（OR：37.583），2型糖 尿病（OR：5.731），TG（OR：5.007），LDL-C（OR：1.724）和空腹血糖（OR：1.618）与非肥胖脂肪肝的发病成正相关。非肥胖脂肪肝患者的LDL-C（62.1%）和UA（17.8%）升高及AST/ALT<1（48.5%）的发生率显著低于肥胖脂肪肝患者。[结论]嗜酒、2型糖尿病、高脂血症和空腹血糖升高是非肥胖患者发生脂肪肝独立的相关危险因素。非肥胖脂肪肝较肥胖脂肪肝有较小比例的血脂、尿酸异常改变和较少的AST/ALT<1的发生率。

[目的]比较酒精性脂肪肝和非酒精性脂肪肝的临床特点。[方法]收集28例酒精性脂肪肝和301例非酒精性脂肪肝的资料，并进行对比分析。[结果]酒精性脂肪肝组几乎均为男性，其肥胖（21.4%）、2型糖尿病（14.3%）、高脂血症 (10.7%）和高血压的发病率（7.1%）显著低于非酒精性脂肪肝组（分别为59.5%、53.5%、64.1%和47.8%）。酒精性脂肪肝组的血清甘油三酯（TG）、胆固醇（CHOL）、低密度脂蛋白胆固醇（LDL-c）、载脂蛋白B（Apo B）和空腹血糖（FPG）的异常率低于非酒精性脂肪肝组，而高密度脂蛋白胆固醇（HDL.c）、天门冬氨酸氨基转移酶（AST）、AST/ALT（≥2）和直接胆红素（DB）的异常率则高于该组。[结论]酒精性脂肪肝好发于男性，肥胖、2型糖尿病、高脂血症和高血压的发生率显著低于非酒精性脂肪肝病人；其肝功能损害较非酒精性脂肪肝更明显。

AIM: There is still no accepted conclusion regarding the clinical features and related risk factors of patients with fatty liver. The large-scale clinical studies have not carried out yet in Guangzhou area. The aim of the present study was to investigate the clinical features and related risk factors of patients with fatty liver in Guangzhou area. METHODS: A total of 413 cases with fatty liver were enrolled in the study from January 1998 to May 2002. Retrospective case-control study was used to evaluate the clinical features and related risk factors of fatty liver with logistic regression. RESULTS: Obesity (OR: 21.204), alcohol abuse (OR: 18.601), type 2 diabetes mellitus (OR: 4.461), serum triglyceride (TG) (OR: 3.916), serum low-density lipoprotein cholesterol (LDL-C) (OR: 1.840) and fasting plasma glucose (FPG) (OR: 1.535) were positively correlated to the formation of the fatty liver. The levels of serum alanine aminotransferase (ALT) and gammaglutamyltransferase (GGT) increased mildly in the patients with fatty liver and were often less than 2-fold of the normal limit. The higher abnormalities of aspartate aminotransferase (AST) levels (42.9%) with AST/ALT more than 2(17.9%) were found in patients with alcoholic fatty liver (AFL) than those with nonalcoholic fatty liver (NAFL) (16.9% and 5.0% respectively). The elevation of serum TG, cholesterol (CHOL), LDL-C was more common in patients with NAFL than with AFL. CONCLUSION: Obesity, alcohol abuse, type 2 diabetes mellitus and hyperlipidemia may be independent risk factors of fatty liver. The mildly abnormal hepatic functions can be found in patients with fatty liver. More obvious damages of liver function with AST/ALT usually more than 2 were noted in patients with AFL.