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Based on the service of stranded patients in D Hospital, this study aimed to explore the multiple needs of stranded patients and construct an intervention mode from the ecosystem perspective. Using the method of case study, taking the service of stranded patients in hospital D as an example, 49 case records and verbatim interviews with stakeholders were analyzed. The discharge and resettlement of stranded patients faces multiple obstacles from individuals, families, medical and social systems. This study constructed the social work intervention model from the ecosystem perspective: information collection and needs assessment, empowerment of individual system, reconstruction of family support system, coordination of medical system and linking social support system. The intervention process achieved efficient effects. Social work intervention of stranded patients should pay attention to patients’ psychosocial needs and improve awareness of system difficulties; mobilize the multi-system support network and deliver services in combination with case management method; conduct social advocacy for the breakthrough of law and policy.
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Atherosclerosis is the main cause of cardiovascular diseases, while Carotid intima-media thickness is a biomarker of subclinical atherosclerosis. Numerous studies have confirmed that exercise can slow down or even reverse the formation and progression of carotid Intima-Media thickness. This paper provides a review of the effects of different exercise modalities, intensities, and populations on the vascular structure to provide a reference for the prevention of atherosclerosis with exercise.
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OBJECTIVE To investigate the effects of matrine (MT) on steatosis Chang Liver cell model induced by oleic acid (OA) and its possible mechanism. METHODS Chang Liver cells were divided into blank group, model group and MT low-dose, medium-dose group and high-dose groups (0.1, 0.5, 1.0 mmol/L). Except for blank group, the other groups were treated with 1.0 mmol/L OA for 24 h to establish steatosis model, and MT groups were given corresponding concentrations of drugs for 24 h. The activities of steatosis Chang Liver cells were observed; the morphologies of intracellular lipid droplets were observed and lipid content was also determined. The contents of liver function indexes [alanine transaminase (ALT), aspartate transaminase (AST), total bilirubin (TBIL), alkaline phosphatase (ALP)], as well as mRNA and protein expressions of farnesoid X receptor (FXR), cytochrome P450 7A1 (CYP7A1) and fibroblast growth factor 19 (FGF19) were all detected. RESULTS OA and MT had no significant effect on the activity of Chang Liver cells. After OA treatment, orange lipid droplets formed in cytoplasm; compared with blank group, relative lipid content and the levels of liver function indexes were increased significantly, while the mRNA and protein expressions of FXR, CYP7A1 and FGF19 were down-regulated significantly (P<0.05). After treatment of low, medium and high concentrations of MT, above indexes were all reversed significantly (P<0.05). CONCLUSIONS MT could significantly improve the lipid content and liver function indexes of steatosis Chang Liver cells induced by OA though regulating FXR/CYP7A1/ FGF19 signaling pathway.
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The retention of emergency patients is a common problem faced by hospitals worldwide. In addition to medical problems, social, family, economic and other problems will also cause patients to stay in the emergency department. It not only brings challenges to patients’ own disease treatment and hospital operation and management, but also brings ethical dilemmas. Taking the service cases of medical social workers who involved in stranded patients in Shanghai E Hospital as an example, this paper analyzed 20 service records and interviews with social workers receiving cases, and combed the ethical dilemmas faced by medical social workers in the process of involving in emergency stranded patients. It was found that medical social workers faced many ethical dilemmas in the process of involving in emergency stranded patients, such as interpersonal relations and relevant legal regulations, the right to life and health and the right to informed consent, the self-determination of case owners and the allocation of medical resources. In this regard, it is suggested to solve the problem of patient retention by advocating the improvement of relevant systems and policies, building cooperative teams to smooth referral channels, strengthening education, and promoting family shared decision-making.
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Nonobstructive azoospermia (NOA) is a severe condition in infertile men, and increasing numbers of causative genes have been identified during the last few decades. Although certain causative genes can explain the presence of NOA in some patients, a proportion of NOA patients remain to be addressed. This study aimed to investigate potential high-risk genes associated with spermatogenesis in idiopathic NOA patients by whole-exome sequencing. Whole-exome sequencing was performed in 46 male patients diagnosed with NOA. First, screening was performed for 119 genes known to be related to male infertility. Next, further screening was performed to determine potential high-risk causative genes for NOA by comparisons with 68 healthy male controls. Finally, risk genes with high/specific expression in the testes were selected and their expression fluctuations during spermatogenesis were graphed. The frequency of cystic fibrosis transmembrane conductance regulator (CFTR) gene pathogenic variant carriers was higher in the NOA patients compared with the healthy controls. Potential risk genes that may be causes of NOA were identified, including seven genes that were highly/specifically expressed in the testes. Four risk genes previously reported to be involved in spermatogenesis (MutS homolog 5 [MSH5], cilia- and flagella-associated protein 54 [CFAP54], MAP7 domain containing 3 [MAP7D3], and coiled-coil domain containing 33 [CCDC33]) and three novel risk genes (coiled-coil domain containing 168 [CCDC168], chromosome 16 open reading frame 96 [C16orf96], and serine protease 48 [PRSS48]) were identified to be highly or specifically expressed in the testes and significantly different in the 46 NOA patients compared with 68 healthy controls. This study on clinical NOA patients provides further evidence for the four previously reported risk genes. The present findings pave the way for further functional investigations and provide candidate risk genes for genetic diagnosis of NOA.
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Humans , Male , Azoospermia/pathology , East Asian People , Exome Sequencing , Mutation , Proteins/geneticsABSTRACT
Objective To explore the association between triglyceride glucose(TyG)index and TyG-body mass index(TyG-BMI)and the prevalence of metabolic associated fatty liver disease(MAFLD)in the elderly men.Methods Totally 2290 elderly men were selected from January to December in 2021 in the Second Medical Center of Chinese PLA General Hospital,and divided into MAFLD group(n=1322)and non-MAFLD group(n=968).Multivariate logistic regression was used to analyze the association between TyG index,TyG-BMI and MAFLD.The receiver operating characteristic(ROC)curve was drawn to explore the predictive value of TyG index and TyG-BMI with MAFLD in the elderly men.Results Two thousand two hundred and ninety elderly men were(74.3±10.1)years old,and an average BMI of(24.63±2.70)kg/m2.BMI,γ-glutamyl transaminase(γ-GT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatinine(Scr),thyroid stimulating hormone(TSH),free triiodothyronine(FT3),the rate of smoking and drinking,and the prevalence of hypertension,diabetes,hyperuricemia,high triglyceride(TG),low high density lipoprotein cholesterol(HDL-C),hyperuricemia,thyroid nodules and cholelithiasis were all significantly higher in non-MAFLD group than those in MAFLD group(P<0.05),while the age of MAFLD group was lower than that of non-MAFLD group(P=0.003).Multivariate logistic regression analysis showed that the risk of MAFLD in patients of TyG quartile groups Q2,Q3,Q4 was 1.667(95%CI 1.257-2.236,P<0.001),2.004(95%CI 1.482-2.710,P<0.001)and 5.420(95%CI 3.266-8.995,P<0.001)times higher than that of TyG Q1,respectively.The risk of MAFLD in patients of TyG-BMI Q2,Q3,Q4 was 2.215(95%CI 1.549-3.167,P<0.001),2.809(95%CI 1.723-4.580,P<0.001)and 2.513(95%CI 1.253-5.040,P=0.009)times higher than that of TyG-BMI Q1,respectively.The ROC curve showed that areas under the curve(AUC)of MAFLD predicted by TyG index and TyG-BMI were 0.717(95%CI 0.696-0.738)and 0.840(95%CI 0.823-0.856),and the best cut-off values were 8.63 and 205.20,respectively.Moreover,the ROC curve showed that AUC of MAFLD in the elderly men without hyperlipidemia or diabetes predicted by TyG index and TyG-BMI were 0.653(95%CI 0.622-0.684)and 0.840(95%CI 0.818-0.862),and the best cut-off values were 8.42 and 202.66,respectively.In addition,AUC,accuracy,specificity,sensitivity,positive predictive value and negative predictive value predicted by TyG-BMI were higher than those by TyG index.Conclusions TyG index and TyG-BMI are significantly associated with MAFLD in the elderly men.Both TyG index and TyG-BMI have certain predictive value for the prevalence of MAFLD in the elderly men,and TyG-BMI may be better.
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Metabolism-associated fatty liver disease(MAFLD),formerly known as non-alcoholic fatty liver disease(NAFLD),is one of the most popular chronic liver diseases in the world,and has become one of the main causes of liver cirrhosis,end-stage liver disease,and primary liver cancer.In recent years,the prevalence of MAFLD has gradually increased in China,the Asia Pacific region,and even globally,increasing the medical and socio-economic burden.The exploration of the epidemiology and risk factors of this disease at home and abroad has also gradually increased.Meanwhile,due to the scarcity of MAFLD treatment drugs,their drug treatment has become a hot issue that needs to be urgently addressed in clinical practice.In recent years,there has been an increase in the number of drugs entering the clinical trial stage.Based on this,the current epidemiological status,risk factors,diagnostic criteria,and treatment research progress of MAFLD have been reviewed in order to provide new ideas and directions for the clinical diagnosis,treatment,and scientific research of MAFLD.
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Objective:To investigate the current situation of medical social worker supervision in Shanghai, for reference to promote the high-quality development of medical social work.Methods:From June to July 2022, a questionnaire survey was conducted on the in-service medical social workers in all medical institutions with medical social work departments or posts in Shanghai. The questionnaire mainly included demographic information, current status of supervision implementation, and effectiveness of supervision. The data were analyzed descriptively with t test for comparison between groups and the Pearson test was for correlation analysis. Results:A total of 99 medical social workers were included in this study, 65 had received supervision, and medical institutions where 58 people located had established the supervision system. The average scores of actual and expected supervisory support received by medical social workers were 3.71 and 4.20 respectively, and the mean burnout level score was 32.91. The effect of establishing a supervision institutions on burnout was statistically significant ( P<0.05) and actual access to supervision support was negatively associated with burnout ( P<0.05). Conclusions:The overall situation of medical social work supervision in Shanghai was positive, but the demand for supervision was not fully satisfied; Supervision had a positive impact on reducing the burnout level. It is suggested that medical social work should further strengthen the cultivation of supervisory talents, promote the construction of supervisory systems, and improve the quality of supervision.
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ObjectiveTo systematically review the effect of high-intensity interval training (HIIT) on executive function for healthy children and adolescents, and delineate the factors related to the intervention outcome. MethodsLiterature about the effect of HIIT on executive functions for healthy children and adolescent was retrieved from Web of Science, PubMed, Cochrane, Embase, Google Scholar, and CNKI, up to July 31st, 2023. The methodological quality was evaluated using the Physiotherapy Evidence Database (PEDro) scale, and relevant data were systematically reviewed. ResultsFifteen researches were included, from nine countries, comprising 13 randomized controlled trials with the scores of PEDro scale from five to eight, involving 17 021 participants aged six to 18 years. They were published mainly from 2016 to 2023. The primary factors related to the intervention outcome were the age of participants, HIIT intervention programs, and work-to-rest ratio. HIIT significantly improved working memory and inhibitory control in healthy children, while it was limited for adolescents. ConclusionHIIT can significantly improve inhibitory control and working memory in healthy children. Key factors related to the intervention outcomes include the age of participants and the specifics of the HIIT program, etc.
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Based on the service of stranded patients in D Hospital, this study aimed to explore the multiple needs of stranded patients and construct an intervention mode from the ecosystem perspective. Using the method of case study, taking the service of stranded patients in hospital D as an example, 49 case records and verbatim interviews with stakeholders were analyzed. The discharge and resettlement of stranded patients faces multiple obstacles from individuals, families, medical and social systems. This study constructed the social work intervention model from the ecosystem perspective: information collection and needs assessment, empowerment of individual system, reconstruction of family support system, coordination of medical system and linking social support system. The intervention process achieved efficient effects. Social work intervention of stranded patients should pay attention to patients’ psychosocial needs and improve awareness of system difficulties; mobilize the multi-system support network and deliver services in combination with case management method; conduct social advocacy for the breakthrough of law and policy.
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AIM: To study the effect and mechanism of Delicaflavone on migration and invasion of gefitinib-resistant lung cancer cell line PC-9/GR. METHODS: MTT assay was used to detect cell viability. Transwell and scratch assays were used to detect cell invasion and migration abilities. Western blotting was used to detect the expressions of MMP-9, MMP-2, E-cadherin, N-cadherin, Vimentin and PI3K/Akt/mTOR pathway-related proteins in PC-9/GR cells. RESULTS: Compared with control group, 20 mg/L Delicaflavone could significantly inhibit the viability of PC-9/GR cells for 24 h (P<0.05), while Delicaflavone below 10 mg/L had no significant effect on cell proliferation. The number of invasive cells and migrated cells were decreased significantly by Delicaflavone in a concentration-dependent way (P<0.05 and P<0.01). Delicaflavone could concentration-dependently reduce the expression of MMP-9, MMP-2, N-cadherin, vimentin (P<0.01), meanwhile up-regulate the expression of E-cadherin (P<0.01). In addition, Delicaflavone also decreased the expression of p-PI3K, p-Akt and p-mTOR in a concentration-dependent manner (P<0.01). CONCLUSION: Delicaflavone can inhibit the migration and invasion of PC-9/GR cells by regulating epithelial-mesenchymal transition via PI3K/Akt/mTOR pathway.
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Natural deep eutectic solvent (NDES) is a kind of deep eutectic solvents (DESs) which is composed of natural substances with good biocompatibility. Those substances can function as hydrogen bond donor and acceptor, such as choline, amino acids, sugars, etc. NDES have been widely used in many fields due to their advantages of low cost, easy preparation and environmental friendliness. It is especially suitable for the pharmaceutical industry because of its good biocompatibility and safety for use. In this paper, we firstly review the molecular simulation methods for current design of DESs from the formation principle. And then, the materials and preparation of NDES are reviewed and the physicochemical properties are further described. Finally, we review the current application of NDES in pharmaceutics including increasing drug solubility, promoting drug permeability and enhancing oral drug absorption, and meanwhile their future applications in pharmaceutics were also prospected.
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AIM: To construct and identify the mammary gland cell-specific conditional knockout of SENP7 by the Cre-loxP system. METHODS: The homozygous SENP7
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AIM: To investigate the mechanism of the involvement of SUMO-ylated Androgen receptor (AR) in tamoxifen resistance and the role of SUMO inhibitor ginkgolic acid in resistance. METHODS: Real-Time PCR was used to detect AR mRNA levels in parental cells MCF-7W and drug-resistant cells MCF-7R, AR protein levels and SUMO levels in MCF-7W and MCF-7R cells was performed by western blot, and CB/IP was applied to detect AR interacts with SUMOE3 ligase PIAS1 and HSP27 in MCF-7R cell chromatin, the transcriptional activity of SUMO AR was also evaluated by the fluorescent reporter gene experiment, the CCK-8 method and the trypan blue exclusion method were used to detect cell viability and cell viability respectively. RESULTS: The mRNA and protein expression levels of AR in MCF-7R cells were significantly higher than those in MCF-7W cells (P<0.05), and there was highly SUMOylated AR in MCF-7R cells. Further research found that there had an obvious interaction between AR and SUMO E3 ligase PIAS1 and HSP27, that was, the SUMOylated AR was modified by E3 ligase. Moreover, androgen R1881 could enhance the transcriptional activity of the SUMOylated AR in a concentration-dependent manner. Compared with ginkgo acid alone, 10 μmol/L of ginkgolic acid combined with 10 μmol/L of enzalutamide treated MCF-7R cells for 3 days, the cell number was significantly reduced, and the number of cell death increased significantly (P<0.05). CONCLUSION: The resistance mechanism of tamoxifen may be due to the enhanced AR transcription and activity increased by the hyperactive SUMOylated AR, SUMO inhibitor ginkgolic acid combined with AR antagonist enzalutamide can be a new strategy for the treatment of tamoxifen resistance.
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Objective:To identify and quantify spatiotemporal and kinematic gait parameters in a group of early-stage Parkinson′s disease (PD) patients compared with healthy subjects.Methods:Eight patients with PD (PD group, Hoehn-Yahr stage≤2.5) and seven age-matched healthy subjects (control group) were enrolled from the Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between May 2017 and August 2018 for the study. The spatiotemporal and kinematic gait parameters were obtained by Vicon 3D optical motion analysis system under three conditions: single-task walking, dual-task walking and turning. The linear mixed model was used to compare the gait parameters between the two groups and analyze the interactive effects.Results:Arm swing amplitude in the PD group was lower than that in the control group ((0.63±0.15) m vs (0.89±0.27) m in single-task walking, (0.64±0.16) m vs (0.99±0.22) m in dual-task walking, β=-0.353, 95% CI -0.558--0.148, P=0.002). The PD group showed significantly higher arm swing asymmetry than the control group (12.48%±5.48% vs 6.96%±4.39% in single-task walking, 17.13%±4.05% vs 7.67%±5.23% in dual-task walking, β=8.992, 95% CI 4.148-13.836, P=0.001). A notable interactive effect of groups and task factors in arm swing asymmetry was found. The arm swing asymmetry of the PD group increased more than the control group in dual-task walking than in single-task walking (β=3.916, 95% CI 1.367-6.466, P=0.003). As for the gait characteristics of the lower limbs, stride length and step length of the PD group were lower than those of the control group ((1.10±0.17) m vs (1.31±0.10) m in stride length, β=-0.169, 95% CI -0.300--0.038, P=0.015; (0.55±0.09) m vs (0.65±0.04) m in step length, β=-0.081, 95% CI -0.150--0.013, P=0.023). For both groups, statistically significant differences were not observed in step width, stride length and step length between single-task and dual-task walking ( P>0.05). The PD group completed the turning process faster than the control group ((1.66±0.30) s vs (1.37±0.23) s, β=0.302, 95% CI 0.049-0.555, P=0.023). As for the rotation-onset pattern, no statistically significant differences were found between the PD and the control group for the onset of the head, trunk and pelvic rotation ( P>0.05). Participants started to rotate their heads before the pelvis in all groups (β=-0.060, 95% CI-0.107--0.014, P=0.011). Conclusions:The quantified gait parameters can more accurately reflect the gait characteristics of early PD. Patients with PD exhibited smaller arm swing magnitude, greater arm swing asymmetry, shorter stride length, and slower turning speed compared to the controls. Arm swing asymmetry further differs between subjects with early PD and controls under dual-task walking.
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As a drug carrier, polymer microspheres have been widely used in oral drug delivery systems, which can achieve the purposes of protecting drug stability, slowing drug release, enhancing immunity, and improving drug absorption. The polymer materials used in the preparation of microspheres can be derived from natural substances, such as cellulose, polysaccharides, and proteins. These materials can also be derived from synthetic polymer substances, such as polycaprolactone and polylactic acid. In this paper, the role of microspheres in oral drug delivery and the types of oral microspheres were reviewed to provide references for in-depth research and development of oral microspheres.
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Objective: To screen out active ingredients, and predict the anti-cancer targets of Ligustri Lucidi Fructus-Astragali Radix based on the "herbs-active ingredient-action targets" network. Method: The traditional Chinese medicine (TCM) system pharmacology platform (TCMSP) was employed to screen out the active ingredients and putative targets of anti-cancer of glossy privet fruit and astragalus. DisGeNET database and Online Mendelian Inheritance in Man (OMIM database) were employed to predict the targets for treating cancer, and then "herbs-active ingredients-key targets" network was constructed by using Cytoscape software. The omicshare platform was employed to match the putative targets of ingredients and the targets for treating cancer. Finally, the protein interaction network of key targets was constructed by using String database, and the analysis of biological functions and pathways of them was carried out by using DAVID database. Result: Totally 33 drug active ingredients were screened out, involving a total of 203 targets, and 14 of them were related to cancer. These 14 key targets played an therapeutic role in treating cancer by regulating target proteins, such as ERBB2, AR, SRC, EGFR, ESR1, as well as proteoglycans in cancer, cancer pathways, microRNAs in cancer and other pathways. Conclusion: The therapeutic mechanism of Ligustri Lucidi Fructus-Astragali Radix reflects the multi-component, multi-target, and multi-pathway characteristics of TCMs, providing the scientific basis for further study and the material basis of Ligustri Lucidi Fructus-Astragali Radix against cancer.
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Objective To interrogate the detection of anti-HLA antibodies using two methods of Luminex xMAP,and to compare their detection capacity and to analyze their misdetection rate for initial screening,providing more accurate results in clinical practice.Methods 214 serum samples from recipients with a history of sensitization before renal transplantation were collected and detected by LM (LABScreen Mixed) and LSA (LABScreen Single Antigen) respectively on the Luminex xMAP platform.Results For the LM detection,the positive rates of anti-HLA class Ⅰ and Ⅱ were 50.9% and 23.4% respectively,which were lower than those used by the LSA detection (58.9% and 46.7% respectively).The difference had statistical significance (P < 0.05).The sensitivity,specificity,miss rate and mistake rate of anti-HLA class Ⅰ and Ⅱ[detection were 80.2%,90.9%,19.8%,9.1% and 49.0%,99.1%,51.0%,0.9% respectively.The missed detection gene with the highest rate was Cw * 17:01,B * 15:12,B * 45:01 for anti-HLA class Ⅰ and DPA1 * 01:03,DPB1 * 06:01,DPA1 * 01:03,DPB1 * 01:01 for anti-HLA class Ⅱ.The highest MFI value was 10603 and 3659.For the recipients with only blood transfusion history or pregnancy history,LM and LSA detection showed no statistically significant difference when detecting anti-HLA class Ⅰ antibodies,but had statistically significant difference when testing anti-HLA class Ⅱ antibodies.For the patients with history of both blood transfusion and pregnancy history,LM and LSA showed no significant difference in the detection of anti-HLA class Ⅰ antibodies and anti-HLA class Ⅱ antibodies.The miss rate of anti-HLA class Ⅰ antibody detection was lower than that of anti-HLA class Ⅱ antibody detection.Conclusion LSA detection has the higher sensivity and lower miss rate than LM detection.In the light of the disadvantage of LM detection as diagnostic preliminary screening,it is suggested that LSA detection should be used directly for the recipients with a history of sensitization.By this process optimization,it is more likely to cause missent inspection and the occurrence of rejection,as well as a poor long-term survival rate.
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Objective To observe the changes of liver and kidney function in hepatitis B virus(HBV)carriers after renal transplantation. Methods A total of 116 patients with HBV infection undergoing renal transplantation and 348 counterparts without HBV infection were recruited in this clinical trial. The liver function parameters including alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels and renal function parameter including serum creatinine(Scr)level were measured before and at 1, 3, 6, 12, 18, 24, 36 and 60 months after renal transplantation. Preoperative and postoperative changes of liver and kidney function were statistical y compared between the hepatitis B surface antigen(HBsAg)(+)and HBsAg(–)groups. According to the results of preoperative HBV serology, preoperative quantitative detection of HBV DNA and preoperative liver function test, 116 HBsAg(+)patients undergoing renal transplantation were divided into(HBsAg, HBeAg and anti-HBc all positive)and(HBsAg, anti-HBe and anti-HBc all positive)groups, HBV DNA(+)and HBV DNA(–)groups, and normal and abnormal liver function groups.Preoperativeandpostoperativechangesofliverandkidneyfunctionwerestatisticalycomparedbetweendifferentsubgroups. Results(1)Preoperative ALT and AST levels in HBsAg(+)patients were significantly higher compared with those in their HBsAg(–)counterparts. In 36 months after renal transplantation, liver function parameters significantly differed between two groups(al P<0.05), whereas no statistical significance was noted at postoperative 60 months(al P>0.05). Before and in 60 months after renal transplantation, no statistical significance was observed in the Scr levels between the HBsAg(+)and HBsAg(–)groups(all P>0.05).(2)Before and in 60 months after renal transplantation, no statistical significance was observed in the liver and kidney function parameters between the(HBsAg, HBeAg and anti-HBc all positive)and(HBsAg, anti-HBe and anti-HBc all positive)groups, and HBV DNA(+)and HBV DNA(–)groups(all P>0.05).(3)The ALT levels before and at 1, 3, 6 and 12 months after renal transplantation significantly differed between the normal and abnormal liver function groups(al P<0.05), whereas no statistical significance was observed at other time points(all P>0.05). The AST levels before and at 1 month after renal transplantation significantly differed between two groups(both P<0.05), whereas did not significantly differ at alternative postoperative time points(all P>0.05). No statisticalsignificancewasobservedinthekidneyfunctionparametersbeforeandat60monthsfolowingrenaltransplantation between two groups(al P>0.05). Conclusions HBV infection cannot exert significant effect upon kidney function within 5 years after renal transplantation, whereas it can affect short-term postoperative liver function.
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<p><b>OBJECTIVE</b>To observe the effect of Compound Zhajin Granule (CZG) on Toll-like re-ceptor 4 (TLR4) signaling pathway in high-fructose corn syrup induced NASH mice.</p><p><b>METHODS</b>Thirty 6-week-old male C3H mice were divided into the high fat and high fructose (HFHFr) group (n = 20) and the control group (n = 10) according to body weight. Mice in the HFHFr group ate high fat diet and drank 20% fructose water, while those in the control group ate common diet and drank common water. After 8 weeks mice in the HFHFr group were divided into two group according to body weight, the HFHFr group and the CZG group, 10 in each group. Mice in the CZG group were fed with high fat forage and 20% fructose water, and administered with 50 mL/kg 12. 8% CZG (prepared by hawthorn, Radix Curcumae, Alisma Orientale, Fritillaria Thunbergii, Silybum Marianum, peach seed in the ratio of 3:1.5:1.5:2:1.5:2:1) by gastrogavage. Mice in the HFHFr group were fed in the same way and daily administered with equal volume of distilled water by gastrogavage. Sixteen weeks later all mice were sacrificed. Body weight, liver wet weight, liver function, and lipid metabolism were detected. Pathological changes of liver tissues were assessed by HE staining, oil red O staining, and Masson staining. Expressions of TLR4, myeloid differentiation factor 88 (MyD88), tumor necrosis factor-alpha (TNF-α) were detected using immunohistochemical staining and real-time fluorescent quantitative PCR.</p><p><b>RESULTS</b>Body weight, alanine aminotransferase (ALT), aspartate aminotransferase (AST) were obviously lower in the CZG group than in the HFHFr group (P < 0.05); oil red O stained area and density were decreased more in the CZG group than in the control group. HE staining showed ballooning inflammation was reduced more in the CZG group than in the HFHFr group. Masson staining was negative. Positive rates of TLR4 and MyD88 and mRNA expressions were significantly lower in the CZG group than in the HFHFr group (all P < 0.05).</p><p><b>CONCLUSION</b>CZG could significantly inhibit TLR4 signaling pathway of liver in NASH mice.</p>