[Changes in serotonin and noradrenaline in hepatic encephalopathy as a result of liver failure in rat].

OBJECTIVE: To investigate the changes in serotonin (5-HT) and noradrenaline (NA) in hepatic encephalopathy as a result of acute and chronic liver failure in rat. METHODS: One hundred and ten Sprague-Dawley (SD) rats were randomly divided into groups of normal control (n=20), experimental group of acute liver failure (ALF) encephalopathy (n=45), and experimental group of chronic liver failure (CLF) encephalopathy (n=45). Two dosages of thioacetamide (TAA) of 500 mg/kg were gavaged with an interval of 24 hours to reproduce ALF model. To reproduce CLF model rats were fed with 0.03% TAA in drinking water for 10 weeks, and 50% of TAA dosage was added or withheld according to the change in weekly body weight measurement. Animals were sacrificed and venous blood specimens were obtained after successful replication of model, and 5-HT, NA, ammonia, parameters of liver function were determined, and liver and brain were studied pathologically. RESULTS: The experiment showed that the liver functions of rats in groups ALF encephalopathy and CLF encephalopathy deteriorated seriously, changes in alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), albumen (ALB), ALB/globulin (A/G), and blood ammonia were observed(P<0.05 or P<0.01). The clinical manifestations, liver and brain pathologies were identical to those of ALF and CLF encephalopathy. The values of 5-HT were increased in groups ALF encephalopathy and CLF encephalopathy [(16.06+/-1.08) micromol/L and (15.32+/-1.48) micromol/L] compared with the normal group [(2.75+/-0.26) micromol/L, both P<0.01], while the value of NA decreased in the group of CLF encephalopathy [(94.0+/-2.13) pmol/L vs.(121.2+/-14.8) pmol/L,P<0.05]. CONCLUSION: The levels of 5-HT are elevated in the groups of ALF encephalopathy and CLF encephalopathy. The content of NA decreases remarkably in CLF encephalopathy.

[Influence of plasma replacement on the hepatic failure with infection].

OBJECTIVE: To investigate the influence of artificial liver support system on severe hepatic failure with infection, 37 cases of severe hepatic failure and 80 cases times of plasma replacement were analyzed. METHODS: The volume of plasma replacement was 2,000-2,600 ml/time. Japanese Plasauto-iQ Blood Purifying Device was used. Blood samples were observed before and after plasma replacement to determine liver function and prothrombin time. PBMCs were isolated and cultured, and the supernatants were collected to determine the levels of interleukin-10 (IL-10), IL-12 and gamma-interferon (gamma-IFN). RESULTS: Before plasma replacement, 32 cases of 80 case times had infection, 5 cases of them had fever, the temperature was 37.5-38.0 centigrade. Four cases of them were fungus infection, 1 case was lung infection. After plasma replacement, liver function was improved, temperature was normal infection was controlled. The levels of IL-10, IL-12 and gamma-IFN in supernatants before and after plasma replacement were significantly higher than normal control, and the IL-10 level after plasma replacement was markedly higher than that before plasma replacement. The levels of IL-12 and gamma-IFN after plasma replacement were higher than plasma replacement, but they didn't reached statistic difference. CONCLUSION: Plasma replacement might be helpful to control infection and therefore to stabilized the hepatic failure.