Clinical analysis of liver dysfunction induced by SHR-1210 alone or combined with apatinib and chemotherapy in patients with advanced esophageal squamous cell carcinoma / 中华肿瘤杂志

Objective: To investigate the clinical characteristics of abnormal liver function in patients with advanced esophageal squamous carcinoma treated with programmed death-1 (PD-1) antibody SHR-1210 alone or in combination with apatinib and chemotherapy. Methods: Clinical data of 73 patients with esophageal squamous carcinoma from 2 prospective clinical studies conducted at the Cancer Hospital Chinese Academy of Medical Sciences from May 11, 2016, to November 19, 2019, were analyzed, and logistic regression analysis was used for the analysis of influencing factors. Results: Of the 73 patients, 35 had abnormal liver function. 13 of the 43 patients treated with PD-1 antibody monotherapy (PD-1 monotherapy group) had abnormal liver function, and the median time to first abnormal liver function was 55 days. Of the 30 patients treated with PD-1 antibody in combination with apatinib and chemotherapy (PD-1 combination group), 22 had abnormal liver function, and the median time to first abnormal liver function was 41 days. Of the 35 patients with abnormal liver function, 2 had clinical symptoms, including malaise and loss of appetite, and 1 had jaundice. 28 of the 35 patients with abnormal liver function returned to normal and 7 improved to grade 1, and none of the patients had serious life-threatening or fatal liver function abnormalities. Combination therapy was a risk factor for patients to develop abnormal liver function (P=0.007). Conclusions: Most of the liver function abnormalities that occur during treatment with PD-1 antibody SHR-1210 alone or in combination with apatinib and chemotherapy are mild, and liver function can return to normal or improve with symptomatic treatment. For patients who receive PD-1 antibody in combination with targeted therapy and chemotherapy and have a history of long-term previous smoking, alcohol consumption and hepatitis B virus infection, liver function should be monitored and actively managed in a timely manner.

Epidemiological characteristics and antimicrobial resistance of 151 cases of melioidosis in Hainan Province / 中国热带医学

@#Abstract: Objective　To analyze the epidemiological characteristics of 151 cases of melioidosis and the drug resistance of Burkholderia pseudomallei (BP), in order to provide the basis for diagnosis, treatment and reasonable prevention of melioidosis. Methods　A total of 151 inpatients and outpatients from the Second Affiliated Hospital of Hainan Medical University from January 1, 2013 to August 31, 2022 were collected, and clinical specimens were submitted for examination to isolate and identify BP strains. The clinical data of 151cases of melioidosis and the drug resistance characteristics of pathogenic bacteria were retrospectively analyzed, and using SPSS26.0 software for statistical analysis. Results　Among 151 cases with BP infection, there were 138 males (91.4%) and 13 females (8.6%); the most patients were aged from 45-<60 years old, accounting for 74 cases (49.0%); melioidosis incidence was concentrated in October (19.2%), November (19.2%), August (9.9%) and July (8.6%), and; the number of confirmed cases showed an increasing trend and the time for confirmation was <10 d; Internal medicine system (31.1%), surgery system (26.5%) and intensive care department (20.5%) were the common departments for treating melioidosis; blood (49.0%), sputum (9.9%) and wound secretion (8.6%) were the main clinical specimens for detecting BP; pulmonary infection (68.2%), sepsis (35.1%) and local suppurative infection (23.8%) were the top clinical manifestations in patients with BP infection; the effective rate of treating melioidosis was 74.8%; abnormal liver function was a risk factor for the curative effect of melioidosis (χ2=5.010, P<0.05); the sensitivity rates of BP strains to sulfamethoxazole-trimethoprim (SXT), doxycycline (DOX), imipenem(IPM), ceftazidime (CAZ), amoxicillin/clavulanate (AMC) and tetracycline (TCY) were generally more than 90%, with sensitivities of 98.7%, 97.2%, 96.7%, 94.0%, 93.2% and 90.7%, respectively. Conclusions　It can be concluded that misdiagnosis or missed diagnosis of melioidosis is easy to occur, and the understanding of the epidemiological characteristics and risk factors in this area should be strengthened. The sensitivity of BP to commonly used antibiotics has shown a certain downward trend, clinical use should be standardized, and drug resistance monitoring should be strengthened to improve the efficacy of melioidosis treatment.

Disfunção hepática em pacientes de unidade de terapia intensiva médica prevê desfecho desfavorável / Hepatic dysfunction in medical intensive careunit patients predicts poor outcome

ABSTRACT Background: A large number of patients admitted to the medical intensive care unit (MICU) have abnormal liver function tests (LFT). This includes patients with critical illness with or without preexisting liver disease and patients with acute primary liver injury. There are very few studies which have investigated the spectrum of liver disease, clinical profile and outcome in patients admitted to the MICU. Objective To evaluate the occurrence, etiology, clinical profile, laboratory profile and outcome of hepatic dysfunction in patients admitted to the MICU. To evaluate the utility of model for end-stage liver disease (MELD) score on admission as a predictor of adverse short term outcome in patients with hepatic dysfunction admitted in MICU. Methods: It was a prospective observational study, conducted from December 2017 to December 2018 in a tertiary care hospital. Two hundred and two patients admitted to the MICU with LFTs as per the inclusion criteria were analyzed and their short-term outcome at 7 days was studied in relation to various parameters. Results: LFT abnormalities were present in 202/1126 (17.9%) of the patients admitted to MICU. Critical illness associated liver dysfunction was found in 172 (85.2%) patients, chronic liver disease in 11 (5.4%) patients and acute viral hepatitis in 19 (9.4%) patients. Most common symptom was fever (68.3%) followed by vomiting (48.0%). Among LFT abnormalities, elevated transaminases, raised international normalized ratio and high MELD score on admission correlated with poor short-term outcome. Requirement for inotropes and mechanical ventilation correlated with poor short-term outcome. Mortality did not differ significantly between patients with chronic liver disease, patients with acute viral hepatitis and patients with critical illness associated hepatic dysfunction. Hepatic dysfunction in MICU was associated with poor outcome and a high short-term mortality of 56.4% (114/202). Conclusion: Liver function abnormality is common in patients who are admitted to the MICU and its presence is an indicator of poor short-term outcome.

RESUMO Contexto: Um grande número de pacientes internados na unidade de terapia intensiva (UTI) tem testes de função hepática anormais (TFH). Isso inclui pacientes com doença crítica com ou sem doença hepática pré-existente e pacientes com lesão hepática primária aguda. Há poucos estudos que têm investigado o espectro da doença hepática, perfil clínico e desfecho em pacientes admitidos em UTI. Objetivo Avaliar a ocorrência, etiologia, perfil clínico, perfil laboratorial e desfecho de disfunção hepática em pacientes internados na UTI médica. Avaliar a utilidade do modelo para doença hepática em estágio terminal (MELD). Escore na admissão como preditor de desfecho adverso a curto prazo em pacientes com disfunção hepática admitida em UTI. Métodos: Foi realizado um estudo observacional prospectivo, de dezembro de 2017 a dezembro de 2018 em um hospital de atenção terciária. Foram analisados 202 pacientes internados na UTI com TFH conforme os critérios de inclusão e seu desfecho a curto prazo de 7 dias foi estudado em relação a diversos parâmetros. Resultados: Anormalidades dos testes estiveram presentes em 202/1126 (17,9%) dos pacientes internados na UTI. Doença crítica associada à disfunção hepática foi encontrada em 172 (85,2%) pacientes, doença hepática crônica em 11 (5,4%) pacientes e hepatite viral aguda em 19 (9,4%) pacientes. O sintoma mais comum foi a febre (68,3%), seguido de vômito (48,0%) casos. Entre as anormalidades do TFH, transaminases elevadas, INR e escore MELD elevados na admissão correlacionaram-se com desfecho ruim de curto prazo. Exigência de inotrópicos e ventilação mecânica correlacionaram-se com desfecho de curto prazo ruim. A mortalidade não diferiu significativamente entre pacientes com doença hepática crônica, pacientes com hepatite viral aguda e pacientes com doença crítica associada à disfunção hepática. A disfunção hepática em UTI esteve associada a um desfecho ruim e à uma alta mortalidade a curto prazo de 114/202 (56,4%). Conclusão: A anormalidade da função hepática é comum em pacientes que são admitidos nas unidades de tratamento intensivo e sua presença é um indicador de desfecho de curto prazo ruim.

Progress in abnormal liver function related to food allergy / 国际儿科学杂志

The etiology of abnormal liver function in children is complex.Food allergy can cause liver immunity injury, which is one of the causes of abnormal liver function in children.The common clinical manifestation is hypertransaminasemia, mostly without cholestasis and hepatomegaly.After the exclusion of common causes of abnormal liver function, food challenge test to observe the changes of transaminase is used to diagnose abnormal liver function related to food allergy.This article reviews the research status, potential mechanism and clinical characteristic of abnormal liver function related to food allergy, aiming to improve the understanding of the phenomenon of clinicians, and better diagnosis and treatment of the disease.

Evaluation and Clinical Management of Abnormal Liver Function / 胃肠病学

As the routine clinical examination items, liver function tests can directly or indirectly reflect the physiological and biochemical function of the liver, and have important reference value for the diagnosis and evaluation of hepatobiliary diseases. Abnormal liver function means that when the liver is damaged by some pathogenic factors, its physiological and biochemical function changes, which leads to abnormal results of liver function tests. The characteristics and significance of several commonly used liver function tests in various liver diseases, as well as the evaluation and clinical management of the liver injury were briefly introduced and interpreted in this paper.

Relationship between ABCB1 Gene Polymorphism and Tacrolimus-related ADR in Renal Transplant Patients during Periopera- tive Period / 中国药房

OBJECTIVE： To investigate the relationship between ATP-binding cassette subfamily B member 1 （ABCB1） polymorphism and tacrolimus-related adverse drug reactions in renal transplant patients during perioperative period. METHODS： Totally 170 patients who underwent renal transplantation from Nov. 2014 to Mar. 2018 in our hospital as well as were tested for their ABCB1 C1236T （rs1128503）， ABCB1 G2677T/A （rs2032582） and ABCB1 C3435T （rs1045642） genotype were selected in this study. χ2 test was used to compare the incidence of tacrolimus-related ADR among patients with different genotypes. The related adverse reactions included digestive tract reaction， pulmonary infection， renal dysfunction， abnormal liver function， elevated blood sugar， elevated blood lipid and decreased white blood cells. Logistic regression model was used to analyze the unit point risk. The main haplotypes of the above genes were analyzed by PHASE software， and their correlation with tacrolimus-induced ADR was analyzed. RESULTS： Among 170 patients， 21 cases （12.3％） of CC type， 78 cases （45.9％） of CT type and 71 cases （41.8％） of TT type were detected by ABCB1 C1236T （rs1128503）. ABCB1 G2677T/A （rs2032582） test showed that 25 cases （14.7％） were GG type， 95 cases （55.9％） were GA+GT type and 50 cases （29.4％） were AA+AT+TT type. ABCB1 C3435T （rs1045642） test showed that 57 cases （33.5％） were CC type， 82 cases （48.2％） were CT type and 31 cases （18.3％） were TT type. There was no significant difference in the incidence of digestive tract reaction， pulmonary infection， renal dysfunction， elevated blood sugar， elevated blood lipid and decreased white blood cells among patients with different ABCB1 genotypes （P＞0.05）. However， there was significant difference in the incidence of abnormal liver function between ABCB1 C1236T （rs1128503） and ABCB1 C3435T （rs1045642） genotypes （P＜0.05）. There was no significant difference in the incidence of abnormal liver function among ABCB1 G2677T/A （rs2032582） genotypes （P＝0.069）， but P was lower than 0.1. Logistic regression analysis showed that ABCB1 C1236T （rs1128503） CC genotype [OR＝4.959， 95％CI （1.700， 14.468）， P＝0.003]， ABCB1 G2677T/A （rs2032582） GG genotype [OR＝3.500， 95％CI （1.164， 10.524）， P＝0.026] and ABCB1 C3435T （rs1045642） CC genotype [OR＝3.033， 95％CI （1.012， 9.095）， P＝0.048] were risk factors for tacrolimus-related abnormal liver function. ABCB1 CGC haplotype was the main haplotype. There was significant difference in the incidence of abnormal liver function caused by tacrolimus between ABCB1 CGC haplotype and non-ABCB1 CGC haplotype （P＝0.002）， and it was also a risk factor for tacrolimus-related liver dysfunction [OR＝3.173， 95％CI（1.512， 6.656）， P＝0.002]. CONCLUSIONS： The abnormal liver function of ABCB1 CGC haplotype kidney transplantation patients is more likely to occur when tacrolimus is administered during the perioperative period.

Management of liver dysfunction during pregancy and postpartum in pregnant women who are chronic carriers of hepatitis B virus / 中华肝脏病杂志

The reports of liver dysfunction during pregnancy or postpartum have gradually increased in pregnant women who are chronic carriers of hepatitis B virus (HBV), but there is no consensus on when to intervene and how to deal with it. This article reviewed recent literature reports and found that pregnant women who are chronic carriers of HBV, regardless of intervention of nucleos(t)ide analogs (NAs), have a certain proportion of hepatitis flares or severe disease during pregnancy and postpartum, suggesting that postpartum drug withdrawal is not always safe, and close follow-up is required. Furthermore, it recommends that treatment should be in accordance to the gestational weeks and ALT levels. NAs are the main treatment choice in the onset of hepatitis flares during pregnancy, however, postpartum hepatitis flares requires NAs or interferon therapy, and it have been reported that combination of NAs and interferon might achieve higher therapeutic response.

Meta-analysis of ADR Induced by Tripterysium Glycosides Tablet / 中国药房

OBJECTIVE:To evaluate the safety of Tripterysium glycosides tablet systematically,and to provide evidence-based reference.METHODS:Retrieved from Chinese Journal Full-text Database,China Science and Technology Journal Database,Wanfang database,PubMed,Embase,Medline (Ovid) and The Cochrane Library,randomized controlled trials (RCTs) about added or combined with Tripterysium glycosides tablet (trial group) versus basic treatment or combined with other drug (control group) in the treatment of various disease-induced ADR (the incidence of leukopenia,gastrointestinal reaction,irregular menstruation,lover dysfunction) were collected.After data extraction and quality evaluation with Cochrane 5.1.0 quality evaluation tool,RevMan 5.0 statistical software was used to conduct Meta-analysis.RESULTS:A total of 36 RCTs were included,involving 2 814 patients.Results of Meta-analysis showed that the incidence of leucopenia [OR=3.42,95 ％ CI (1.88,6.22),P＜ 0.001],irregular menstruation [OR=8.42,95％CI(4.93,14.38),P＜0.001] and abnormal liver function [OR=2.99,95％CI(2.01,4.46),P＜0.001] in trial group were significantly higher than control group,with statistical significance.Results of subgroup analysis showed that the incidence of irregular menstruation in trial group was significantly higher than control group,with statistical significance [OR=5.39,95％ CI (2.50,11.59),P＜0.001].When combining with glucocorticoids,the incidence of gastrointestinal adverse reactions in trial group was significantly lower than control group,with statistical significance [OR=0.40,95％CI(0.19,0.84),P=0.02].When the indications were the diseases of immune system,the incidence of leucopenia [OR=3.42,95％ CI (1.49,7.82),P=0.004] and abnormal liver function [OR=2.27,95％ CI (1.08,4.76),P=0.03] in trial group were significantly higher than control group,with statistical significance.CONCLUSIONS:ADR induced by Tripterysium glycosides tablet mainly include leucopenia,gastrointestinal reaction,irregular menstruation and abnormal liver function.More attentions should be paid on irregular menstruation when combining with other drugs.More attentions should be paid on leucopenia and abnormal liver function when treating the diseases of immune system.

Safety study on postpartum breastfeeding for HBV infected patients with E antigen positive and in immune tolerant phase / 中华实验和临床病毒学杂志

Objective@#Many physicians and patients still have concerns about the safety of breastfeeding in mothers infected with hepatitis B virus; we evaluate the safety of the newborn and the women with HBeAg positive and high viral load, who received nucleoside analogues to block maternal to child transmisssion and selected postpartum breastfeeding after drug discontinuance.@*Methods@#This prospective, observational study enrolled 60 HBeAg positive patients and HBV-DNA >2*10E+ 5 IU/ml, all patients started antiviral treatment for blocking maternal to child transmission at 24-28 weeks of pregnancy. All the newborns received the active-passive immunization therapy with hepatitis B immunoglobulin (HBIG) and HBVac. After the delivery, patients with normal liver function discontinued the antiviral drug and selected breastfeeding voluntarily. The safety of breastfeeding were compared with patients selected artificial feedings, they were followed up for 7 months. Primary measurements were the proportion of mothers with abormal liver function after stopping the drug and the level of newborn’s anti-HBs at 6 months of age; secondary measurements were the positive rate of neonatal HBsAg and the HBV-DNA value of the patients at 6 weeks postpartum.@*Results@#From December 1, 2015 to May 1, 2017, 415 patients were enrolled in Beijing You’an Hospital Affiliated to the Capital Medical University and all these patients were born following full-term single-child pregnancy. After the delivery and drug withdrawal, there was no significant difference in the incidence of ALT elevation between the breast fed group and the artificially fed group: 29 /220 versus 30/195, (χ2=0.411, P=0.521). Patients continued to take the antiviral medicines between the breast feeding group and the artificial feeding group: 15 /220 versus 20/195, (χ2=1.487, P=0.223), there were no significant differences between them (P> 0.05). At the month 7, there were no significant difference between the breast fed group and the artificially fed group (747.62±374.08 mlU/ml versus 709.76±374.32 mlU/ml, t-value: 0.309, P-value>0.05). At birth, hepatitis B surface antigen (HBsAg) was detected in 15/220 and 20/195 of newborns in the breast feeding and artificially fed groups, respectively. At month 7, an intention-to-treat analysis indicated 0/220 of HBsAg infants from the breast fed versus 0/195 in the artificially fed group (P>0.05) and no significant difference was found in the rate of positive HBsAg between the two groups. In the breast fed group, the mean HBV DNA at baseline was significantly higher than that of the artificially fed group: (1.17±1.82) E+ 8 IU/ml versus (1.12±0.39)E+ 8 IU/ml, and the difference was statistically significant.@*Conclusions@#We have not found the relationship between the rate of neonatal infection and the increase of maternal abnormal liver function in HBeAg positive and high viral load patients, who chose breastfeeding after drug discontinuance.

Risk Evaluation of Abnormal Liver Function Associated with LMWH in 76 PTE Patients of Our Hospital / 中国药学杂志

OBJECTIVE: To explore the clinical regularities and risk factor of abnormal liver function associated with LMWH in pulmonary thromboembolism patients. METHODS: Clinical date of pulmonary thromboembolism patients in use of LMWH was collected and analyzed from January 2008 to December 2016. RESULTS: 97 cases were enrolled. Of them, there were 76 cases were assessed as probable or possible. Single factor analysis showed the the levels of Scr (P=0.000), ALT (P=0.000), AST (P=0.000), γ-GGT (P=0.000), ALP (P=0.023), co-infection (P=0.024) and Ccr (P=0.026) had statistically significant difference. Multivariate analysis indicated that co-infection (OR=1.982, P=0.022) and high level of Scr (OR=1.045, P=0.000) were the independent risk factors of abnormal liver function associated with LMWH in PTE. CONCLUSION: The incidence of abnormal liver function due to LMWH in PTE patients is high. With high level of Scr and/or co-infection patients are high-risk persons of abnormal liver function. It is necessary to dynamically evaluate the liver function during hospitalization. Symptomatic treatment can be significant if the liver function become abnormal.

Relationship between the mid﹣term hepatic hemodynamics and abnormal liver function after liver transplantation / 器官移植

Objective To analyze the law of the mid﹣term hepatic hemodynamics after liver transplantation and to investigate its relationship with liver function. Methods A total of 56 recipients underwent liver transplantation in the Affiliated Hospital of Qingdao University from February 2014 to October 2015 were studied,and divided into normal group (n =24)and abnormal group (n =32)according to the liver function.General information and liver function of both groups were recorded.Furthermore,hepatic artery peak velocity (HAP),portal vein peak velocity (PVP)and portal vein flow (PVF)before the liver transplantation and on postoperative day 1,30 and 90 were measured through ultrasonic detection;hepatic arterial buffer capacity (BC)and adjustment BC were calculated.The univariable and multivariable analysis were performed to analyze the relationship between hepatic hemodynamics and liver function in two groups,and the receiver operating curve (ROC)was drawn. Results The PVP and PVF on postoperative day 30 in abnormal group were significantly higher than those of normal group (P =0.014,0.049).The BC and adjustment BC in normal group were significantly higher than those of abnormal group (P =0.048,0.011).The multivariable analysis showed that adjustment BC was the independent risk factor (P =0.047),with the area under the curve (AUC)of ROC of 0.705,sensitivity of 0.652 and specificity of 0.750. Conclusions PVP,PVF,BC and adjustment BC on postoperative day 30 may be related to abnormal liver function,of which adjustment BC can be used as one of the indicators for diagnosis and intervention of abnormal liver function.

Influence of Infusion Drop Speed on the Efficacy of Tiopronin for Injection in the Treatment of Abnormal Liver Function / 中国药师

Objective:To explore the influence of infusion drop speed on the efficacy of tiopronin for injection combined with sol-vents in the treatment of abnormal liver function. Methods:Totally 74 patients were randomly divided into the observation group and the control group with 37 ones in each. The infusion drop speed was 60-65 drops per minute in the observation group, and that was 30-35 drops per minute in the control group, and the infusion time was controlled in 1h in the observation group and 2h in the control group. The clinical effect and the improvement of liver function were compared between the two groups after a treatment course of 4 weeks. Results:The total effective rate of the observation group(83. 78%) was obviously higher than that in the control group(56. 76%) (P<0. 05) after the treatment, and ALT, AST and TBIL of liver function indices were improved obviously except for ALB in the two group, and the difference was statistically significant between the two groups(P<0. 05). Conclusion:Tiopronin for injection can effectively improve the clinical effect by strictly controlling the time and drop speed of infusion.

The clinicopathological analysis of 88 patients with abnormal liver function test of unknown etiology / 中华内科杂志

Objective To evaluate the clinical and histological features of patients with abnormal liver tests of unknown etiology, and then to investigate the diagnosis and differential diagnosis. Methods Patients with abnormal liver function test hospitalized and had liver biopsies during 2008-2009 constituted this retrospective study cohort. After excluding those patients diagnosed with hepatotropic viral hepatitis,space occupying lesions of the liver, alcoholic liver disease and obstruction of bile duct caused by stone or malignancy and AMA/AMA-M2 positive of primary biliary cirrhosis ( PBC ), the clinical and histological characteristics were evaluated. Results Out of the 180 patients who underwent liver biopsy, 88 patients were included in the present analysis. The final diagnosis involved 15 categories of diseases, with druginduced liver injury ( DILI ) [34. 09% ( 30/88 )], autoimmune liver diseases [22.73% ( 20/88 )], and nonalcoholic fatty liver disease (NAFLD) [12. 50% ( 11/88 )] being the most common causes, following by genetic and other rare diseases. Conclusion DILI, autoimmune liver disease and NAFLD were the most common causes of abnormal liver tests in these non-viral liver diseases. Some rare diseases such as hereditary metalbolic liver disease also represent a considerable proportion in patients with abnormal liver function test.

Abnormalities of liver function tests in patients with hyperthyroidism / 대한내과학회지

BACKGROUND: Abnormalities of liver function tests are common in patients with hyperthyroidism and may reflect thyroid hormone status. The aim of our study was to analyze the frequency of abnormal liver function tests in the patients with hyperthyroidism at diagnosis and the association with the thyroid function state after antithyroid therapy. METHODS: Three hundred seventy eight patients with hyperthyroidism who visited Chungnam National University Hospital from June 2004 to May 2005 and had no other causes for abnormal liver function tests were examined. At diagnosis, 272 of 378 patients had various abnormalities seen on the liver function tests. Among 272 patients, 65 were followed up for liver function tests and were analyzed for sex, age, use of an antithyroid drug, and thyroid function tests after administration of an antithyroid drug. We analyzed the frequency of liver function abnormalities and the relevance between abnormalities of liver function and the thyroid function state. RESULTS: Abnormalities in AST, ALT, total bilirubin, alkaline phosphatase and GGT were observed in 16.4%, 31.0%, 3.2%, 48.7% and 26.9% of the 378 patients with hyperthyroidism, respectively. The level of alkaline phosphatase was the most common abnormal parameter. After antithyroid therapy, 48 (73.8%) of 65 patients had normalization of their liver function abnormalities. The normalization rate for AST, ALT, alkaline phosphatase and GGT were higher in the euthyroid status group than the sustained hyperthyoid status group. The normalization rate for ALT was significantly higher in the female group than in the male group, but the effect of antithyroid drug use and age on the normalization rate was not statistically significant. CONCLUSIONS: These findings indicate that abnormalities of liver function tests are common in patients with hyperthyroidism and these abnormalities are strongly associated with thyroid hormone status.

Xiaozhi Jiangmei Decoction Treat Fat Liver together with Abnormal Liver Function / 浙江中医药大学学报

Objective To evaluate the curative effect of Xiaozhi Jiangmei Decoction in treating fat liver with abnormal liver function. Method 60 patients of fat liver with abnormal liver function take themselves as control, all taking Xiaozhi Jiangmei Decoction; observe for 3 months in succession. Result After 3 months, the serum glutamic pyruvic transaminase(GPT) increased to 39.21?3.42 from 67.31?2.52, the glutamic oxaloacetic transminase(GOT) decreased to 41.12?2.82 from 68.52?3.12. Meanwhile, the liver B ultrasound exam showed much relieved fat liver, even disappeared. Conclusion Xiaozhi Jiangmei Decoction has reliable therapeutic effect in removing symptoms of fat liver and protecting liver function, without any side effects.

A Clinical Study of Chicken Pox in Adolescents and Adults / 대한피부과학회지

BACKGROUND: Chicken Pox, a highly contagious exanthem that occurs most frequently in childhood, is the result of primary infection with varicella zoster virus. Although it is generally a benign, self-limiting disease, varicella zoster virus infection may be associated with serious complications, especially in older adults. OBJECTIVE: The aim of this study was to elucidate the epidemiological and clinical characteristics and histopathologic features of varicella in adolescents and adults. METHOD: 57 patients who were admitted with varicella as adolescents or adults during a 20-year period from 1985 to 2004 were evaluated in regard to age, sex, monthly incidence, prodromal symptoms, and cutaneous manifestations. Patients were further assessed over abnormalities of laboratory tests, associated diseases, or histopathologic features. RESULTS: The results were as follows: 1. Varicella was seen most frequently in the 20~29 year-old group (47%), followed by the 10~19 year-old group (30%). The ratio of males to females was 1.36: 1. As a result of calculating the average age in five-year peroids from 1985 to 2004, the average age in the last period (2000-2004) was 29.2 +/- 7.0 years. This was found to be higher than in the other 5-year periods. 2. With regard to monthly occurrence, varicella was found to be most prevalant in May (21%). 3. The most common prodromal symptom was fever (74%), followed by a sore throat (32%) and headache (30%). 4. Common cutaneous manifestations of varicella were papules (84%), vesicles (79%) and typical umbilicated vesicles (65%). Pruritus (96%) was an extremely common symptom. 5. The most common laboratory abnormality was an abnormal liver function (28%). 6. Associated diseases of varicella were observed in 6 patients (10%). These included hepatitis or the hepatitis B virus carrier (5%), diabetes mellitus (2%), pulmonary tuberculosis (2%), and ulcerative colitis (2%). 7. Complications of varicella were 1 case (2%) of keratitis and 1 case (2%) of secondary infection. 8. In 7 cases of varicella stained with hematoxylin-eosin, all cases showed necrosis of keratinocytes and ballooning degeneration, and 5 cases had severe inflammatory infiltrations. Intra-epithelial vesicles were found in 6 cases, and multinucleated giant cells were found in 2 cases. CONCLUSION: The mean age of varicella patients showed an increase in the last 5-year period. In adolescents and adults with varicella, we recommend that patients should be evaluated for abnormalities of liver function.

Risk Factors for Intracranial Hemorrhage Caused by Late Vitamin K Deficiency / 实用儿科临床杂志

Objective To explore the risk factors for intracranial hemorrhage caused by late vitamin K deficiency bleeding(VKDB),in order to prevent and reduce the incidence of intracranial hemorrhage caused by late VKDB.Methods A retrospective analysis of the risk factors of late VKDB and intracranial hemorrhage was applied to 2 groups of patients in PICU and department of neurology of Beijing children's Hospital from Jan.2002 to Dec.2007.In group Ⅰ,there were 90 patients suffering from intracranial hemorrhage caused by late VKDB;while in group Ⅱ,there were 23 patients of late VKDB without intracranial hemorrhage.Within 12 hours of hospitalization,the following 9 items were checked:the cranial CT,blood calcium concentration,liver function,serum sodium,blood glucose,prothrombin time,partial thromboplastin time,fibrinogen concentration,and platelet.Ten possible relevant risk factors of gender,age,birth situation,feeding patterns,recent diarrhea,cytomegalovirus(CMV)infection,hypocalcemia,dysglycemia,hyponatremia,and abnormal liver function were analyzed by the method of non-conditional Logistic regression analysis.Results Statistically significant difference had been found in the 3 factors of hypocalcaemia,recent diarrhea,abnormal liver function(Pa

Incidence of Abnormal Liver Function and Risk Factors in Male Employees / 대한산업의학회지

OBJECTIVES: This study was conducted to estimate the incidence of abnormal liver function and risk factors in male employees of an industry in Ulsan City. METHODS: Five hundreds and seventy nine male employees were selected as the study cohort and 533(92.1%) of them were followed after one year. The blood sample was collected to test for AST, ALT, gamma-GTP, total-cholesterol, fasting blood sugar and a self-administered questionnaire on life style was done. General characteristics(age, marital status, educational level), job department, exposure status for organic solvents, life style(alcohol, smoking, exercise, diet), past history of liver disease, family history of liver disease, drug intake, HBsAg, blood glucose, total-cholesterol were considered as risk factors. The result of liver function test after 1 year follow-up was treated as dependent variable. The operational definition of abnormal liver function was as follows; those who had abnormal liver functions in the two repeated tests with one month interval. RESULTS: The annual incidence of abnormal liver function was 9.6 per 100 and age-standardized incidence was 9.5. BMI, alcohol, past history of liver disease, and meat intake were significantly related to the incidence(p<0.05). In multiple logistic regression analysis, BMI(RR=2.70, 95% CI=1.41-5.16) and alcohol(RR=1.98, 95% CI=1.08-3.60) were proved as the significant variables. By stratified analysis considering changing pattern of alcohol and BMI, the relative risk of the BMI normal-normal and alcohol intake high-high group was 2.24(95% CI=1.09-4.62) and that of the BMI obese-obese and alcohol intake high-high group was 5.66(95% CI=2.69-11.88) compared with that of BMI normal-normal and alcohol intake low-low group. CONCLUSIONS: The age-standardized annual incidence of abnormal liver function was 9.5 per 100 in male employees. Thus, an active effort for reducing alcohol intake and controlling BMI should be done to reduce the incidence.

Factors for Chronic Hepatitis Defined as Elevated Level of Aminotransferases among Koreans / 한국역학회지

Sustained abnormal liver function is closely associated with chronic hepatitis in Korea with high prevalence of hepatitis B infection. Follow up about AST and ALT on 839 adults(male 727, female 112) was executed with interval of at least 6 months for 2 years to evaluate the factors contribute to the progression of chronic hepatitis. HBsAg, HBsAb, anti-HCV, body mass index(BMI), total cholesterol, fasting blood sugar(FBS), Clonorchis sinensis in stool(Cs), fatty liver on abdominal sonogram and alcohol habit were also checked. We defined abnormal liver function as both of AST 35 U/L and ALT 50 U/L. As the result of first time liver function test(LFT), the frequency of abnormal liver function was 13.6%(114/839). The positive rate of HBsAg and HBsAb was 7.0% and 73.9%, respectively, and the positive rate of anti-HCV and Cs was 0.7% and 1.3%. As the result of the follow up, 6.2%(52/839) in total has a tendency of chronic hepatitis with sustained abnormal LFT. Among abnormal LFT, 45.6%(52/114) was sustained LFT abnormality, and 12.8%(93/725) was aggravated LFT abnormality from normal LFT at the first check. From these results, male and hepatitis B infection were evaluated as important factors for the progression of chronic hepatitis. HBsAb considered that has a protective effect to the progression of chronic hepatitis. Therefore, even though no symptoms or sign, periodic examination for hepatitis B marker and LFT is important to control the chronic hepatitis, especially for male. Furthermore, because only 25%(13/52) of sustained abnormal LFT was HBsAg positive, it suggests that further study for evaluating the factors except hepatitis B infection would be needed for the control of chronic hepatitis.

A Case of Wernicke's Encephalopathy Caused by Hyperemesis Gravidarum Complicated with Thyroid Storm and Abnormal Liver Function / 대한내분비학회지

A 27-year-old woman developed Wemicke's encephalopathy in the 16th week of her first pregnaney. She had thyroid storm and abnormal liver function. Her thyrotoxic symptom and abncemal liver function was recovered after medication of antithyroid drug, steroid, hepatotonic drug and administration of thiamine(fursulthiamin), but the fetus was lost, Thereafter her thyroid function returned to normal and euthyroid state was maintained without medication of antithyroid drug, but her neurological defect was remained. We suggest that severe hyperemesis gravidarum is a possible risk factor of the thyroid storm and Wemicke's encephalopathy in patients with hyperthyroidism, and consider the check of the thyroid function. The need for parenteral thiamine supplementation and medication of antithyroid drug is warranted in patients with severe hyperemesis gravidarum which lasts longer than 3 weeks and abnormal thyroid function.