| Objective:1.Observe the expression of miR-21 in the serum of healthy people,LC patients and ACLF patients and the effect of detoxification and stasis removal on the serum miR-21 expression of ACLF patients.2.The expression of miR-21,HDAC2,HDAC7 and IL-17 in the liver tissue of ACF rats was observed,and the effect of detoxification and stasis Ⅱ in upregulating miR-21 in inhibiting ACLF inflammation and necrosis was revealed.Methods:1.Clinical research:(1)Fifteen healthy patients,15 LC patients,and 15 ACLF patients who met the criteria were included,which were divided into normal group,cirrhosis group,and ACLF group,and the expression level of serum miR-21 in each group was detected by PCR.(2)60 patients with ACLF who met the criteria were randomly divided into control group and treatment group,the control group was given comprehensive treatment by Western medicine,and the treatment group was added with detoxification and stasis Ⅱ on the basis of the control group,and the observation period was 8 weeks.By observing miR-21,ALT,AST,TBiL,ALB,PTA,mortality and TCM syndrome scores in the control group and treatment group,the effect and clinical efficacy of detoxification and stasis Ⅱ on miR-21 in ACF patients were evaluated.2.Experimental research:The 30 experimental rats were divided into sclerosis group(LC group),model group(Model group),traditional Chinese medicine group(JDYH group),each group used CCL4 for cirrhosis molding,pathology suggested rat cirrhosis,Model group and JDHY group gave D-GaLN combined with LPS for acute attack,JDHY group was given detoxification and stasis Ⅱ gavage 5 days before acute attack,and Model group was gavaged with the same amount of distilled water.After successful molding,HE staining and Masson staining were given to detect liver histopathology in rats.PCR detected miR-21 content in rat liver tissue;WB detected the content of IL-17 in rat liver tissue;Elisa detected the contents of HDAC2 and HDAC7 and serum ALT and AST in rat liver tissue.Fully automated analyzer for TBiL content.Results:1.Clinical research:(1)Compared with healthy patients,the serum miR-21 level of LC and ACLF patients was significantly reduced(P<0.05);compared with LC patients,the serum miR-21 level of ACLF patients was reduced,and the difference was statistically significant(P<0.05).(2)After 8 weeks of treatment,the serum miR-21 levels of the control group and the treatment group increased(P<0.05),the levels of ALT,AST and TBiL decreased(P<0.05),the levels of ALB and PTA increased(P<0.05),the scores of TCM symptoms improved(P<0.05),and the treatment group improved better than the control group(P<0.05),and the control group improved their miR-21,ALT,AST,TBiL,PTA and TCM syndrome scores better than those in the control group(P<0.05).There was no significant difference in the degree of ALB improvement in the treatment group(P>0.05),the total effective rate of the treatment group(60.71%)was higher than that of the control group(34.48%),and the mortality rate of the treatment group(21.43%)was lower than that of the control group(48.28%).2.Experimental research:(1)Masson staining in LC group showed the formation of scarring bands of collagen fibers in liver tissue samples,the regular honeycomb structure of normal liver lobules was segmented to form pseudolobules,Masson staining and HE staining in Model group showed a large number of hepatocyte necrosis,the structure of liver lobules was changed and blurred,the hepatocyte nucleus was deformed,the liver cord was irregular,and the inflammatory cell infiltration was obvious.The pathological results of liver histopathology in rats in the JDHY group showed that some liver cells were necrosis,the degree of structural destruction of liver lobules was different,some liver cells were swollen and degenerated,and some inflammatory cells were infiltrate,compared with the Model group,the pathological changes of liver in the JDHY group were milder.(2)Compared with the LC group,the miR-21 level of liver tissue in the Model group decreased(P<0.05),and compared with the Model group,the miR-21 level in liver tissue in the JDHY group was increased,and the difference was statistically significant(P<0.05).(3)Compared with the LC group,the levels of HDAC2 and HDAC7 in the model group were increased(P<0.05),and compared with the model group,the levels of HDAC2 and HDAC7 in the liver tissue of the JDHY group were reduced,and the difference was statistically significant(P<0.05).(4)Compared with the LC group,the IL-17 level of liver tissue in the Model group was increased with a statistically significant difference(P<0.05),and compared with the Model group,the level of IL-17 in liver tissue in the JDHY group was reduced and the difference was statistically significant(P<0.05).(5)Compared with the LC group,the levels of AST,ALT and TBiL in the Model group were increased and the difference was statistically significant(P<0.05);compared with the Model group,the levels of AST,ALT and TBiL in the JDHY group were reduced and the difference was statistically significant(P<0.05).Conclusion(s):(1)miR-21 is poorly expressed in the serum of ACLF patients,and is negatively correlated with AST,ALT,TBiL,and positively correlated with PTA,and miR-21 has the effect of antagonizing ACLF.Detoxification and stasis removal Ⅱ can increase the serum miR-21 level of ACLF patients,improve liver function,coagulation function,TCM syndrome score,reduce mortality,and improve clinical efficacy.(2)The expression of miR-21 in the liver tissue of ACLF rats was reduced,which was negatively correlated with HDAC2,HDAC7 and IL-17 in liver tissue,and the expression of miR-21 could be upregulated by detoxification and stasis Ⅱ,inhibiting the inflammatory response of ACLF rats and antagonizing ACLF. |
