ABSTRACT
In 2022, the European Association for the Study of the Liver issued Clinical practice guidelines on sclerosing cholangitis. With reference to the 2017 edition of Role of endoscopy in primary sclerosing cholangitis: European Society of Gastrointestinal Endoscopy (ESGE) and European Association for the Study of the Liver (EASL) Clinical Guideline (2017) and in comparison to the corresponding contents in Guidelines on the diagnosis and management of primary sclerosing cholangitis (2021) issued by Chinese Society of Hepatology, Chinese Medical Association, in 2021, this article summarizes the updates in diagnosis, treatment, monitoring, and management of special populations and analyzes the basis for updated recommendations and their guiding significance in optimizing the clinical management of primary sclerosing cholangitis (PSC). The comparative analysis shows that the new version of the guidelines is similar to the Chinese guidelines in terms of diagnosis, treatment, and follow-up, and it is worth learning from the technical details such as the recommended dose of ursodeoxycholic acid and long-term follow-up plan. Since PSC is a chronic refractory disease, the drugs recommended by current guidelines cannot delay or reverse disease progression, and there is still a lack of consensus statements on immunotherapy and screening protocols for end-stage complications, which might be the directions for further research.
ABSTRACT
@#In this paper, cobalt chloride was used to stimulate human umbilical vein endothelial cells (HUVEC) to establish a model of abnormal hypoxic injury, to investigate the effect of heparin-derived oligosaccharides (HDO) on glycolysis in HUVEC cells and its molecular mechanism.The experiment was divided into the control group (FBS-free DMEM medium), the model group (FBS-free DMEM medium +50 μmol/L CoCl2), and the HDO group (modeling+0.01, 0.1, 1 μmol/L HDO).Firstly, a biochemical kit was used to detect the effects of HDO on glucose uptake and lactic acid accumulation in HUVEC cells, then Western blot and qPCR were used to detect the effects of HIF-1α, GLUT-1 and LDHA gene transcription and protein expression, and finally, PI3K/Akt signaling pathway was detected.The results showed that HDO inhibited glucose uptake and lactate production, down-regulated the expression of HIF-1α, GLUT-1, and LDHA, and affected the activation of the PI3K/Akt signaling pathway.HDO could regulate the glycolysis level of HUVEC cells by inhibiting the activation of the PI3K/Akt/HIF-1α signaling axis.