Etiological diagnosis value of metagenomic next generation sequencing in the patients with spinal infection / 中华传染病杂志

Objective:To investigate the efficacy of metagenomic next generation sequencing (mNGS) in the etiological diagnosis of patients with spinal infection, so as to provide reference for timely diagnosis and treatment.Methods:A total of 40 patients with suspected spinal infection admitted to the Department of Infectious Diseases in Henan Provincial People′s Hospital from January 2020 to July 2022 were included. The results of tissue culture, histopathological examination and tissue mNGS detection were analyzed retrospectively. According to the clinical diagnose, the patients were divided into the spinal infection group (28 cases) and the non-spinal infection group (12 cases). The positive rate, sensitivity and specificity of mNGS and tissue culture in the pathogen detection of patients with spinal infection were compared. McNemar test was used for statistical analysis.Results:There were 23 males and 17 females in 40 patients. The positive rate of mNGS was higher than that of tissue culture (75.0%(30/40) vs 12.5%(5/40)), and the difference was statistically significant ( χ2=0.08, P<0.001). Based on clinical diagnostic criteria, the sensitivity of mNGS in the diagnosis of spinal infection was higher than that of tissue culture (82.1% vs 17.9%), with a statistically significant difference ( χ2=0.02, P<0.001), while the specificity compared to the tissue culture (33.3% vs 100.0%), the difference was not statistically significant ( P>0.05). Conclusions:mNGS has a high pathogen detection rate and sensitivity in the etiological diagnosis of patients with spinal infection, which could provide clinical guidance for the diagnosis and treatment of patients with spinal infection.

Clinical characteristics of six patients with aspergillus spondylitis / 中华传染病杂志

Objective:To investigate the clinical characteristics of patients with aspergillus spondylitis, and to provide reference for timely diagnosis and treatment.Methods:The clinical manifestations, imaging performance, laboratory examination results, diagnosis and treatment outcomes of six patients with confirmed aspergillus spondylitis in Department of Infectious Diseases, Henan Provincial People′s Hospital during April 30, 2015 and May 1, 2020 were retrospectively analyzed.Results:The main manifestations of six patients were fever and neck pain or low back pain. The time from the onset of clinical manifestations to diagnosis was more than two months to 14 months. Spine magnetic resonance imaging (MRI) showed long T1 and T2 signals on vertebral body, high pressure lipid signal, obvious enhanced scan enhancement, and paravertebral abscess formation might be presented. Among the six patients, C-reactive protein increased in four patients, erythrocyte sedimentation rate increased in five patients, β-D-glucan test (G test) increased in three patients, galactomannan antigen test (GM test) increased in four patients. Six patients with aspergillus spondylitis were all confirmed by biopsy of diseased tissue for fungal smear, tissue culture or metagenomics next generation sequencing. After treatment with voriconazole or itraconazole, five patients recovered and one patient was still under treatment.Conclusions:The clinical manifestations and imaging examination of patients with aspergillus spondylitis are nonspecific. Peripheral blood G test and GM test need to be combined for diagnosis. The diagnosis depends on tissue puncture pathology examination, and the metagenomics next generation sequencing is needed if necessary.

Distribution characteristics of pathogen and antibiotic susceptibility in diabetic foot osteomyelitis / 中华内分泌代谢杂志

Objective@#To retrospectively analyze distribution characteristics of pathogenic bacteria and their antimicrobial susceptibility in patients with diabetic foot osteomyelitis(DFO).@*Methods@#Sixty cases of suspected DFO were collected from the Endocrinology Department of Henan Provincial People′s Hospital. After admission, bone biopsy was carried out to confirm the pathological diagnosis, and the pathogenic bacteria and drug sensitivity were determined by bone culture. In addition, bacterial culture was carried out in the basal tissue of the wound, and the results of bacterial culture were compared with those of bone culture.@*Results@#Sixty patients were diagnosed as DFO after bone biopsy. Among the 60 patients, 45 patients underwent bone culture and basal tissue culture. There are 24 patients of whom the results were consistent, accounting for 53.3%. The positive rate of bone culture was 55.0%, there were 16 strains of gram-positive bacteria and 22 strains of gram-negative bacteria. Staphylococcus aureus(9 strains) occurrence was the most, common finding, followed by Escherichia coli(6 strains). The course of diabetic foot, albumin(ALB), and antibiotic usage rate before admission were lower in bone culture positive group than those in bone culture negative group, while white blood cell(WBC) and C-reactive protein(CRP) were higher in bone culture negative group(P<0.05). There was no significant difference in gender, age, course of diabetes, HbA1C, and creatinine(CREA) levels between the two groups(P>0.05). The results of bone culture showed that Staphylococcus aureus was the main Gram-positive bacteria, which was more sensitive to vancomycin, tigecyclin, linezolid, etc. Escherichia coli was the main Gram-negative bacteria, which was more sensitive to tigecyclin, carbapenems, amikacin, etc.@*Conclusion@#Bone biopsy and bone culture should be carried out in cases for suspected DFO patients to identify the pathogenic bacteria, and the bone tissue should be preserved and obtained according to the operation specification before the application of antibiotics, and the appropriate antibiotics should be selected according to the drug sensitivity results.

Distribution characteristics of pathogen and antibiotic susceptibility in diabetic foot osteomyelitis / 中华内分泌代谢杂志

Objective:To retrospectively analyze distribution characteristics of pathogenic bacteria and their antimicrobial susceptibility in patients with diabetic foot osteomyelitis(DFO).Methods:Sixty cases of suspected DFO were collected from the Endocrinology Department of Henan Provincial People′s Hospital. After admission, bone biopsy was carried out to confirm the pathological diagnosis, and the pathogenic bacteria and drug sensitivity were determined by bone culture. In addition, bacterial culture was carried out in the basal tissue of the wound, and the results of bacterial culture were compared with those of bone culture.Results:Sixty patients were diagnosed as DFO after bone biopsy. Among the 60 patients, 45 patients underwent bone culture and basal tissue culture. There are 24 patients of whom the results were consistent, accounting for 53.3%. The positive rate of bone culture was 55.0%, there were 16 strains of gram-positive bacteria and 22 strains of gram-negative bacteria. Staphylococcus aureus(9 strains) occurrence was the most, common finding, followed by Escherichia coli(6 strains). The course of diabetic foot, albumin(ALB), and antibiotic usage rate before admission were lower in bone culture positive group than those in bone culture negative group, while white blood cell(WBC) and C-reactive protein(CRP) were higher in bone culture negative group( P<0.05). There was no significant difference in gender, age, course of diabetes, HbA 1C, and creatinine(CREA) levels between the two groups( P>0.05). The results of bone culture showed that Staphylococcus aureus was the main Gram-positive bacteria, which was more sensitive to vancomycin, tigecyclin, linezolid, etc. Escherichia coli was the main Gram-negative bacteria, which was more sensitive to tigecyclin, carbapenems, amikacin, etc. Conclusion:Bone biopsy and bone culture should be carried out in cases for suspected DFO patients to identify the pathogenic bacteria, and the bone tissue should be preserved and obtained according to the operation specification before the application of antibiotics, and the appropriate antibiotics should be selected according to the drug sensitivity results.

Downregulation of miR-196b in regulating the growth and apoptosis of hepatoma cells by targeting nuclear apoptosis-inducing factor 1 / 临床肝胆病杂志

ObjectiveTo investigate the mechanism of action of miR-196b in regulating the growth and apoptosis of hepatoma cells by targeting nuclear apoptosis-inducing factor 1 (NAIF1). MethodsReal-time PCR was used to measure the expression of miR-196b in hepatoma HuH-7, SNU-449, HepG2, and SMCC7721 cells versus normal human HL7702 hepatocytes. The hepatoma HepG2 cells were collected and divided into Control group (blank control), Anti-NC group (transfected with inhibitor control), Anti-miR-196b group (transfected with miR-196b inhibitor), si-NC group (transfected with siRNA control), si-NAIF1 group (transfected with NAIF1 siRNA), Anti-miR-196b+si-NAIF1 group (co-transfected with miR-196b inhibitor and NAIF1 siRNA), and Anti-miR-196b+si-NC group (co-transfected with miR-196b inhibitor and siRNA control). MTT assay was used to measure the change in proliferation, plate colony formation assay was used to measure colony formation ability, flow cytometry was used to measure cell apoptosis, and Western blot was used to measure the protein expression of Bax and C-caspase-3. Target gene prediction software predicted that NAIF1 might be a target gene of miR-196b, and the luciferase reporting system was used to identify the targeting relationship. The t-test was used for comparison of continuous data between two groups; a one-way analysis of variance was used for comparison between multiple groups, and the SNK-q test was used for further comparison between two groups. ResultsThere was a significant difference in the expression level of miR-196b between hepatoma HuH-7, SNU-449, HepG2, and SMCC7721 cells and normal human HL7702 hepatocytes (1.85±0.16/1.63±012/2.36±0.25/1.92±0.13 vs 1.00±0.09, F=29.05, P＜0.001). Compared with the Anti-NC group, the Anti-miR-196b group had significant reductions in the expression level of miR-196b (0.42±0.03 vs 1.02±0.10, P＜0.05), cell proliferation (0.20±0.02 vs 0.30±0.05, P＜0.05), and colony formation ability (64.35±6.97 vs 119.54±11.82, P＜0.05) and significant increases in apoptosis rate (22.30%±2.09% vs 4.26%±0.35%, P＜0.05) and relative protein expression of Bax (0.69±0.08 vs 0.30±0.05, P＜0.05) and C-caspase-3 (0.63±0.05 vs 0.21±0.04, P＜0.05). Compared with the si-NC group, the si-NAIF1 group had significant increases in proliferation ability (0.46±0.05 vs 0.31±0.04, P＜0.05) and colony formation ability (138.92±9.66 vs 118.47±838, P＜0.05) and significant reductions in apoptosis rate (4.12%±0.40% vs 1.23%±0.12%, P＜0.05), NAIF1 (0.10±0.01 vs 0.17±0.02, P＜0.05), and protein expression of Bax (0.18±0.02 vs 0.29±0.03, P＜0.05) and C-caspase-3 (0.12±0.01 vs 020±0.03, P＜0.05). Compared with the Anti-miR-196b+si-NC group, the Anti-miR-196b+si-NAIF1 group had significant increases in proliferation ability (0.28±0.02 vs 0.21±0.03, P＜0.05) and colony formation ability (97.12±8.23 vs 66.35±5.20, P＜0.05) and significant reductions in apoptosis rate (9.60%±1.11% vs 21.14%±1.32%, P＜0.05), NAIF1 (0.30±0.04 vs 0.52±0.06, P＜0.05), and protein expression of Bax (0.28±0.03 vs 0.67±0.06, P＜0.05) and C-caspase-3 (0.22±0.05 vs 0.60±004, P＜0.05). ConclusionDownregulation of miR-196b can inhibit the growth and induce the apoptosis of hepatoma cells via negative regulation of NAIF1.

Advances in combination therapy of ombitasvir and dasabuvir for chronic hepatitis C virus genotype 1 infection / 中华肝脏病杂志

Since 2014, the United States and Europe has approved all oral, interferon free- regimens that combine with direct-acting antiviral agents. Hence, the sustained virological response rate of patients with chronic HCV genotype 1 infection has improved over 90%, and the treatment modalities has introduced a new era. These drugs, ombitasvir and dasabuvir, received customary authorization of Food and Drug Administration in 2015 and are the first combined direct-acting antiviral agents for treating HCV genotype 1 infection. It has superior application prospects in China because of its high-sustained virological response rate and safety profile. This article reviews the pharmacokinetics, drug interactions, efficacy and safety of this therapeutic regimen.

The efficacy and safety of daclatasvir combined with asunprevir in the treatment of 26 cases with chronic hepatitis C / 中华传染病杂志

Objective To explore the efficacy and safety of daclatasvir (DCV ) combined with asunprevir (ASV) for chronic genotype 1b (GT1b) hepatitis C .Methods Twenty-nine GT1b hepatitis C patients who were treated with DCV combined ASV in Henan Provincial People′s Hospital from September 2017 to November 2017 were included .Hepatitis C virus (HCV ) RNA levels were tested before treatment ,1 week ,2 weeks ,3 weeks ,4 weeks ,8 weeks ,12 weeks and 24 weeks after treatment , and 12 weeks after the end of the treatment .The comorbidities ,combined use of drugs and adverse clinical events were registered .T test was used to compare the measurement data with normal distribution and M (P25,P75) was used for measurement data with non-normal distribution .Results A total of 29 patients with GT1b were included ,with 4 cirrhosis cases and 25 non cirrhotic cases .Seven patients had history of previous interferon and ribavirin combination treatment .There were 9 patients with comorbidity and 7 patients with combined medication . Finally , 25 patients completed a 24-week course of antiviral treatment ;3 patients were lost to follow-up ,and 1 patient withdrew after 16weeks of antiviral treatment because of a virus rebound .Of the 26 followed up patients ,25 achieved sustained virological response at 12-week (SVR12 ) , and one patient failed .And the HCV RNA NS5A resistance-associated variants (RAV) were detected in the patients with treatment failure .No severe adverse clinical events occurred in 26 patients .Conclusions DCV combined with ASV is effective and safe in the treatment of GT 1b chronic hepatitis C .However , the effect of RAV on therapeutic efficacy should be concerned during the treatment .

Analysis of genotype 1b hepatitis C virus NS5A resistance-associated variants and its related factors / 中华传染病杂志

Objective To analyze hepatitis C virus genotype(HCV GT)1b NS5A resistance-associated variants(RAV)and its related factors,and to provide references for direct-acting antivirals (DAA)agent selection and application.Methods From January 2017 to July 2017,53 hepatitis C patients were selected from the Department of Infectious Diseases of Henan Province People's Hospital. The mutations of L31M and Y93H in NS5A RAV were analyzed in 43 HCV GT1b patients,and their correlations with hepatitis C virus,liver function,platelet and liver fibrosis diagnostic model[APRI, gamma-glutamyl transpeptidase to platelet ratio(GPR),FIb-4]were analyzed.The quantitative data were compared by two independent samples t test,and the qualitative data were compared by chi square test. Results Fifty-three subjects were enrolled,including 43 GT1b(9 males and 34 females)and 10 GT2a(2 males and 8 females).No other genotype was detected.The incidence of NS5A RAV in 43 HCV GT1b patients was 13.9%(6/43),of which L31M and Y93H were 1/43(2.3%)and 5/43(11.6%)with no significant difference(χ2= 1.500,P= 0.219).There were no significant differences in HCV RNA, ALT,AST,albumin,platelets and age between patients with or without mutation(all P> 0.05). Conclusions The incidence of NS5A RAV in HCV GT1b patients is high,but not affected by virus, biochemical factors and liver fibrosis.The detection of NS5A RAV before HCV treatment is helpful for rational selection of DAA,which could reduce the drug resistance.

Clinical features and risk factors for patients with liver failure complicated by invasive pulmonary aspergillosis / 临床肝胆病杂志

ObjectiveTo investigate the clinical features and risk factors for patients with liver failure complicated by invasive pulmonary aspergillosis (IPA), and to provide a reference for clinical diagnosis and treatment. MethodsThe clinical data of 477 patients with liver failure who were diagnosed and treated in Henan Provincial People′s Hospital from January 2010 to December 2014 were collected, and the clinical features, laboratory markers, and results of imaging examinations of patients with IPA were retrospectively analyzed. Another 49 patients with liver failure who were hospitalized within the same period, had similar ages, and were not complicated by pulmonary infection were randomly selected as controls. The independent samples t-test was used for comparison of continuous data between groups, the chi-square test or Fisher′s exact test were used for comparison of categorical data between groups, and multivariate logistic regression analysis was performed to analyze the risk factors for liver failure complicated by IPA. ResultsAmong the 447 patients with liver failure, 43(96%) were complicated by IPA. Age (P=0.023), hepatic encephalopathy (P=0.021), long-term use of broad-spectrum antibiotics (P=0.007), use of hormone (P=0.016), and deep venous catheterization (P＜0.001) were independent risk factors for the development of IPA. Clinical manifestations of liver failure patients with IPA lacked specificity. Lung CT scan showed multiple nodules, masses, and wedge-shaped consolidation near the pleura in both lungs, but typical halo sign and air crescent sign were rarely seen. Among the 35 patients who received antifungal therapy, 30 were improved or cured, 3 died of digestive tract bleeding, 2 clied of plumonary infection, and all the other patients who did not receive therapy also died. ConclusionPatients with liver failure have various risk factors for the development of IPA, and the clinical manifestations are not typical, with high incidence and fatality rates. Early detection and treatment is the key to improving survival rates.

Epidemiological and clinical characteristics of 231 cases with spinal infections / 中华传染病杂志

Objective To describe the epidemiology and clinical characteristics of spinal infections to assist the clinical diagnosis and treatment .Methods Clinical data of all cases with spinal infections at He′nan Provincial People′s Hospital from January 2010 to December 2014 were analyzed retrospectively . The demographic characteristics , risk factors , clinical characteristics and outcomes were evaluated . Variables were compared by t‐test ,chi‐square test or Fisher exact test when appropriate .Results Totally 231 patients fulfilled the inclusion criteria and were reviewed ,of which 179 (77 .5% ) were pyogenic spinal infection (PSI) and 52 (22 .5% ) were tuberculous spinal infection (TSI) .The most common risk factor for infection was history of previous spinal surgery or procedure (43 .3% ) ,followed by diabetes mellitus (14 .7% ) .The infection site of lumbosacral spine was prominent with 114 cases (63 .7% ) in PSI and 38 cases (73 .1% ) in TSI .At initial presentation ,white cell blood count ([10 .8 ± 4 .5] × 109/L vs [7 .3 ± 3 .2]× 109/L ,t=2 .685) and C‐reactive protein levels ([79 ± 33] vs [37 ± 21] mg/L ,t=6 .241) in PSI were higher compared to TSI (both P<0 .05) .The positive rate of blood culture was significant higher than tissue culture in PSI (47 .9% vs 21 .8% ,χ2 = 6 .782 , P< 0 .05 ) .But the positive rate of blood culture was significantly lower than tissue culture in TSI (0 vs 39 .4% ,χ2 =8 .312 , P<0 .05) .Surgical treatment was performed in 30 .2% of PSI and 25 .0% of TSI .Conclusions History of spinal surgery or procedure is the most common risk factor for spinal infections , followed by diabetes mellitus . The lumbosacral spine is the common involved site in both PSI and TSI .The incidence of PSI is higher among spinal infections in our hospital .And Staphylococcus aureus is the most common pathogenic bacteria in PSI .

Clinical features and gene mutation profiles of patients with chronic hepatitis B and Gilbert's syndrome / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the clinical features and gene mutation profiles of patients with chronic hepatitis B (CHB) and Gilbert's syndrome.</p><p><b>METHODS</b>Thirty-three patients with CHB and Gilbert's syndrome were enrolled in the study. Serum markers of liver function and histological features of disease-related liver injury were assessed by standard methods. Gene mutations were detected by PCR and direct DNA sequencing.Statistical analysis was carried out with the chi-square and t tests.</p><p><b>RESULTS</b>Sequencing of the Gilbert syndrome-associated gene, UGT 1A 1, revealed mutations in the upstream promoter phenobarbital-responsive element module (PBREM) (-3279 mutation, 23 cases), in the promoter TATA box (a TA insertion mutation, 21 cases), and in the coding region of exon 1 (a GGA-AGA Gly71Arg mutation, 18 cases); there was no statistical difference found for any of the three mutations among this patient population (x2 =1.640, P more than 0.05).</p><p><b>CONCLUSION</b>The traditional methods of diagnosis for patients with CHB and Gilbert's syndrome remain a technical challenge in the clinic, and gene detection may represent a more favorable method for diagnosing this patient population.</p>

Adefovir dipivoxil effects on and related factors of blood phosphorus metabolism in patients with chronic hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effects of adefovir dipivoxil (ADV) on blood phosphorus metabolism in patients with chronic hepatitis B (CHB).</p><p><b>METHODS</b>Patients with hepatitis B surface antigen (HBsAg)-positive CHB were treated with ADV alone, ADV combined with interferon (IFN), or ADV combined with lamivudine (LAM). Changes in levels of calcium, phosphate, urea, and creatinine were assessed at treatment weeks 4, 12, 24, 48, 72 and 96. Statistical analysis was carried out with SPSS 16 software; influential factors were analyzed by ANOVA and non-conditional logistic regression analysis.</p><p><b>RESULTS</b>During the course of treatments, 32 (42.6%) of the patients presented with low phosphorus. The highest incidence of low phosphorus was found to have occurred at treatment week 24 (25.0%, 27.5% and 36.4% respectively, with no statistical difference between three groups, x2=0.225, P>0.225). Patients with hypophosphatemia did not show a significant difference in serum phosphorus levels from the other patients (F=1.853, P=0.169). Logistic regression showed a correlation between low phosphorus and sex (x2=7.876, P<0.05), age (t=2.479, P<0.05), and serum creatinine (t =-2.256, P<0.05), but not with blood urea nitrogen or blood calcium (P>0.05).</p><p><b>CONCLUSION</b>ADV antiviral treatment can decrease the blood phosphorous levels of CHB patients, particularly over extended time of treatment, and the occurrence of low phosphorus is more common than of mild phosphorus decrease.Male and elderly patients may be at greater risk of this complication. The incidence and severity of low phosphorus is not significantly different for the different ADV-based treatment regimens.</p>

A clinical analysis of 374 cases with fever of unknown origin / 中华传染病杂志

Objective To summarize the causes of patients with fever of unknown origin (FUO) and to analyze the relationship between infectious diseases and FUO,in order to provide envidence for experiential therapy.Methods Clinical data of 374 FUO inpatients at He'nan Provincial People's Hospital from June 1,2009 to May 31,2013,including gender,age,diagnosis and department were analyzed retrospectively.Results Three hundred and twenty-seven cases among the overall 374 FUO patients (87.4％) were eventually etiological diagnosed based on supplementary examinations or diagnostic treatment.As for the causes of fever,209 were infection,accounting for 55.9％,among which 78 cases (20.9％) were diagnosed with tuberculosis,23 cases (6.1％) brucellic diseases,19 cases (5.1％) rickettsia infection.Meanwhile,the noninfectious diseases,such as connective tissue diseases (47,12.6％),hematonosis (37,9.9％) as well as the solid tumors (13,3.5％) also constituted considerable shares of the causes for FUO.However,the causes of 47 cases (12.6％) were not identified before discharge.Conclusions Infectious diseases are the main cause of FUO,in which tuberculosis accounts for the majority.Brucellosis and rickettsia infection also account for a considerable proportion.The causes of most FUO cases could be identified through detailed analysis of clinical data and supplemental examinations.

Comparison of five scoring systems for predicting the prognosis of patients with chronic severe hepatitis / 中华传染病杂志

Objective To investigate the roles of five scoring systems including model for endstage liver disease (MELD), Child-Turcotte-Pugh (CTP), Mayo, MESO and MELD-Na scoring systems, in predicting the prognosis of patients with chronic severe hepatitis. Methods The clinical data of 213 patients with chronic severe hepatitis were retrospectively studied. The five scoring systems were applied respectively to evaluate the scores in survival group and death group. The capability of these five scoring systems to predict the prognosis of severe hepatitis were compared by the receiver operating characteristic (ROC) curve, area under curve (AUC) and cut-off value.Measurement data were compared by group t test. The comparisons of AUC among scoring systems were done using MEDCLAC software. Results The scores of death group evaluated by MELD, CTP,Mayo, MESO or MELD-Na scoring systems (30.6 ± 9.5, 11.3 ± 1.5, 10.4 ± 1.3, 2.3 ± 0.8 and 39.0 ± 11.8, respectively) were consistently higher than those of survival group (21.1± 6.8, 10.6 ±1.6, 9.0±1.5, 1.6±0.5 and 22.6±8.2, respectively) (P＜0.01). The values of AUC of these five systems were 0.810, 0.623, 0.749, 0.829 and 0.885, respectively. The Youden's indexes of these five systems were 0.507, 0.175, 0.389, 0.528 and 0.650, respectively. Conclusions The CTP scoring systems can not predict the prognosis of chronic severe hepatitis very well. The Mayo scoring systems can partially predict the prognosis. On the contrary, MELD, MESO and MELD-Na systems can successfully predict the disease prognosis, and the score of MELD-Na system shows the best correlation with the prognosis.

Dynamic expression of uncoupling protein 2 in rats models of acute liver failure and its significance / 中华传染病杂志

Objective To explore the expression and significance of uncoupling protein (UCP)2in rats models of acute liver failure (ALF). Methods Thirty-six healthy male SD rats were randomly divided into normal control group and model group, and the model group was divided into 5 subgroups:6, 12, 24, 36 and 48 hours sub groups with 6 rats in each sub group. The rat model of ALF was established by intraperitoneal injections of D-galactosamine (D-Gal) and lipopolysaccharide (LPS).Sections of liver tissue were stained with hematoxylin and eosin and observed under optical microscope.UCP2 and UCP2 mRNA in rat liver were determined at different time points with immunohistochemical method and reverse transcription-polymerase chain reaction ( RT-PCR ),respectively. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels and malondialdehyde (MDA) concentration in the liver tissues were analyzed at the same time points.Comparisons among all the experimental groups were done by SNK test. Results Infiltration of inflammatory cells and necrosis of hepatic cells were marked in model group,and ALT, AST and MDA in model group were significantly higher than those in control group [(24. 0 ± 2. 0) U/L, (82. 3±16. 9) U/L, (2. 55±0. 22)μmol/g] at all time points. And they reached a peak at 24 h [(8346. 7±1363. 1) U/L, (9766. 7±1274. 1) U/L, (8. 34±1. 13) μmol/g; all P<0. 05]. UCP2 and UCP2 mRNA expressed scarcely in the liver tissues of control group, while increased markedly from 6 to 48 hours after D-Gal/LPS challenge in model group (P<0. 05). They both reached a peak at 24 h. And the discrepancy between consecutive experimental group had statistical significance ( P < 0. 05).Conclusions The rat model of ALF was established successfully by intraperitoneal injections of D-gal and LPS. The expression levels of UCP2 mRNA and UCP2 are consistent with the extent of liver injury and the level of oxidative stress in the rat model of ALF.