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Objective To systematically evaluate the efficacy and safety of magnesium isoglycyrrhizinate (MgIG) in the treatment of viral hepatitis based on clinical studies. Methods Searches were conducted in the databases of Cochrane, PubMed,Science Direct,CNKI,CMCI and Wanfang (until Dec.2016 since database setup) to identify randomized controlled tri-als (RCTs) evaluating clinical effects of MgIG vs Compound Glycyrrhizin(CG).Literatures according to inclusion and exclusion criteria were screened.All meta-analysises were conducted with RevMan version 5.3. Results A total of 3 790 patients enrolled in 32 studies were included in the meta-analysis.Firstly,the comparison of curative effect in two groups favors MgIG for the treat-ment of viral hepatitis[OR=2.87,95% CI=(2.29,3.61),P<0.000 01].Secondly,MgIG showed statistically significant benefit in reducing ALT [MD=-17.27,95%CI=(-28.87,-5.66),P=0.004],AST [MD=-14.18,95%CI=(-18.29,-10.08),P<0.000 01] and T-BiL[MD=-4.53,95%CI=(-6.38,-2.68),P<0.000 01].Lastly,comparative trials demonstrated a significant safety advantage of MgIG over CG [OR= 0.29,95%CI=(0.19,0.44),P<0.000 01]. Conclusion MgIG has a significant beneficial effect for the treatment of viral hepatitis by means of both decreasing transaminase and normalizing liver function.Fur-thermore,it is worth for the application in clinical use with less adverse drug reactions.
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Objective To study the preventive effects of Nitroglycerin (NTG) on post-ERCP pancreatitis (PEP) and hyperamylasemia.Methods A total of 150 patients were enrolled and randomly divided into 2 groups to receive buccal NTG 0.5mg (NTG group) or buccal Vitamin C 0.1 g (control group).Incidence of PEP and hyperamylasemia and adverse reactions were observed.Results Three patients were excluded according to the exclusion criteria. The overall incidcnces of PEP and hyperamylascmia were 16.3％ (24/147) and 28.6％ (42/147),respectively.The incidence of hyperamylasemia in NTG group (15/74,20.3％) was significantly lower than that of control group (27/73,37.0％) (x2=5.032,P=0.025).Incidence of PEP in NTG group (12.2％) was lower than that of control group (20.5％) without significance (x2=1.892,P=0.169).No severe adverse effects was observed.Conclusion NTG can effectively prevent post-ERCP hyperamylaemia,but its effect on PEP is limited.
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<p><b>OBJECTIVE</b>To evaluate the role of nuclear factor-kappa B (NF-kappaB) and inhibitory kappaB alpha (IkappaBalpha) in hepatocellular cacinoma (HCC) SMMC7721 cells, the consequence of NF-kappaB inhibition in SMMC7721 cells transfected with mutated IkappaBalpha (mIkappaBalpha) plasmid and the effect of stable inhibition of NF-kappaB activity in combination with Doxorubicin.</p><p><b>METHODS</b>Western blot was used to determine the expression of NF-kappaB and IkappaBalpha in SMMC7721 cells and normal liver cells. Nuclear protein was used to evaluate the binding of the (32)P-labeled tandem kappaB sequence using electrophoretic mobility shift assay and the expression of NF-kappaB using Western blot between SMMC7721 cells transfected with mIkappaBalpha plasmid (SMMC7721-MT) and control cells. Furthermore, cell viability was plotted between SMMC7721-MT and control cells. The binding of kappaB sequence and cell viability between SMMC7721-MT and control cells at different concentrations of Doxorubicin were also investigated.</p><p><b>RESULTS</b>Western blot analysis for nuclear extract showed more P50 (NF-kappaB1) and P65 (RelA) expression in SMMC7721 cells compared with normal liver cells. The expression of cytosolic IkappaBalpha protein in SMMC7721 cells was less than that in normal cells. SMMC7721-MT cells inhibited NF-kappaB nuclear translocation at 0, 24, 48 and 96 hours. Furthermore, NF-kappaB cannot be detected in the nuclear protein of SMMC7721-MT cells by Western blot. By calculating cell viability, the proliferation of SMMC7721-MT cells was shown to be suppressed more significantly than that of control cells. NF-kappaB in untransfected cells was activated by Doxorubicin in a dose-dependent manner, but that in SMMC7721-MT cells was not induced at low concentrations of Doxorubicin. Compared with untransfected cells, the viability of SMMC7721-MT cells was significantly suppressed at the same concentration of Doxorubicin (P < 0.01).</p><p><b>CONCLUSIONS</b>The present study demonstrates that upregulation of NF-kappaB and downregulation of inhibitory kappa B (IkappaBalpha) in SMMC7721 cells are related with the growth of hepatocellular cacinoma cells. Stable expression of mIkappaBalpha in SMMC7721-MT cells can inhibit NF-kappaB nuclear translocation and suppress cell growth. Furthermore, stable inhibition of NF-kappaB activity in combination with Doxorubicin can significantly inhibit cell proliferation in SMMC7721-MT cells. Thus, modulation of NF-kappaB may represent an improvement in the efficacy of HCC therapies and be worthy of further research and investigation.</p>
Subject(s)
Humans , Antineoplastic Agents , Pharmacology , Blotting, Western , Carcinoma, Hepatocellular , Metabolism , Pathology , Cell Division , Doxorubicin , Pharmacology , Electrophoretic Mobility Shift Assay , I-kappa B Proteins , Liver Neoplasms , Metabolism , Pathology , NF-kappa B , Physiology , Tumor Cells, CulturedABSTRACT
Objective To develop a noninvasive diagnostic model comprising of transabdominal ultrasonography and serum markers for assessing esophageal varices in liver cirrhosis.Methods Totally 230 liver cirrhosis patients were randomly allocated to either an estimation group(161 cases)or a validation group(69 cases).Gastroscope was performed and whether esophageal varices existed or not was assessed in every patient.Seventeen common ultrasonographic and serum markers were analyzed initially in the estimation group to derive a predictive model.The model created was then assessed with ROC analysis.It was also applied to the validation group to test its accuracy.Results Among seventeen variables associated with esophageal varices selected by univariate analysis,splenic thickness,diameter of portal vein,prothrombin time were indentified by multivariate Logistic regression analysis as independent risk factors of varices.A varices index constructed from the above three markers was established.In ROC analysis,the AUC was 0.853(0.764,0.942)for predicting existence of varices using the optimal cutoff score 6.3.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 81.2%,85.7%,92.35%,68.21%,82.77% respectively.For the validation group,the AUC and diagnostic accuracy were 0.889(0.814,0.965)and 82.86% respectively.Conclusion A noninvasive model consisting of splenic thickness,diameter of portal vein and prothrombin time is helpful in predicting existence of esophageal varices in cirrhosis.
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Objective To evaluate the efficacy and safety of endoscopic variceal ligation(EVL)with ?-blockers(BB)in prophylaxis on the rate of first esophageal variceal bleeding in patients with cirrhosis.Methods We searched Cochrane Central Register of Controlled Trials(4th Quarter 2006)、MEDLINE(1966—2006-10)、EMBASE(1985—2006-10),CJFD(1994—2006)and handsearched the related journals to identify Randomized Controlled Trials(RCT)of endoscopic variceal ligation(EVL)and ?-blockers for prevention of first variceal bleeding in cirrhosis.Meta-analysis was conducted using the method recommended by The Cochrane Collaboration.Results Eight trials were included.Summary RR of meta-analysis showed a significant reduction in EVL group in rate of first variceal hemorrhage(RR=0.63,95%CI:0.46,0.85;P=0.0003;RRR=0.37,NNT=12)and severe adverse events(RR=0.23,95%CI:0.12,0.43;P
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Objective:To study the effects of combination of rhubarb and early enteral nutrition on severe acute pancreatitis(SAP).Methods:A total of 73 patients with SAP were randomly divided into one of the three groups: 21 patients treated with total parenteral nutrition(TPN),27 patients treated with early enteral nutrition(EEN),and 25 patients treated with combination of rhubarb and early enteral nutrition(REN).The hospitalization cost,length of stay,mortality,recovery time of intestinal function and score of APACHE Ⅱ were observed.The plasma procalcitonin(PCT),the levels of C-reactive protein(CRP)and prealbumin were detected.Results: In REN group,there was no death.There was 1 patient died in EEN group and 2 patients in TPN group.The recovery time of intestinal function in REN group was(2.49?0.59) days,the length of stay was(25.13?4.35) days,and the hospitalization cost was(56.9?7.2) thousand yuan.They were obviously shorter than those in the other groups(TPN group,P