Significance of heart-type fatty acid binding protein and brain glycogen phosphorylase isoenzyme type in septic myocardial injury / 中国小儿急救医学

Objective@#To demonstrate the relevance of heart-type fatty acid binding protein(H-FABP) and brain glycogen phosphorylase isoenzyme type(GPBB) with myocardial injury in sepsis.To explore the effect of H-FABP and GPBB on the severity of disease and clinical prognosis.@*Methods@#A total of 40 cases of children with sepsis were selected in this study from January 1, 2017 to October 31, 2017.According to the illness severity, they were divided into sepsis group(n=15), severe sepsis group(n=13) and septic shock group(n=12), 19 cases of children with non-infectious diseases were selected as the control group for the same period.The levels of serum WBC, C-reactive protein, procalcitonin, cTnI, CK, CK-MB, CK-MB isoenzyme quality and NT-proBNP were collected within 24 hours of admission.The APECHEⅡ scores were calculated for each child.The peripheral blood of the patients within 24 hours after admission was used to determine the levels of serum H-FABP and GPBB by ELISA method.The differences of clinical indicators among the groups were analyzed.According to the survival of patients with sepsis, they were divided into 37 cases in the improved group and 3 cases in the death group.All patients with sepsis were divided into left ventricular ejection fraction(LVEF) normal group(n=26) and LVEF decreased group(n=14). According to whether the serum cTnI was elevated, all children with sepsis were divided into cTnI normal group (n=29) and cTnI increased group (n=11). The differences of H-FABP and GPBB levels were compared.According to the presence or absence of LVEF decline, the area under the ROC curve was used to evaluate the predictive power of each index for myocardial injury in sepsis.Based on the decrease of LVEF, the area under the ROC curve was used to evaluate the prediction of each index for myocardial injury in sepsis.@*Results@#There were significant differences in H-FABP and GPBB levels among the control group, sepsis group, severe sepsis group and the septic shock group (H=42.241, P<0.05; H=32.486, P<0.05). Although there was no significant difference between the improved group and the death group(P>0.05), there was an elevated trend of H-FABP and GPBB in the death group.The levels of H-FABP (t=-3.770, P=0.001) and GPBB (Z=-2.113, P=0.033) were statistically significant in the LVEF normal group and the LVEF decreased group (LVEF≤60%). There were no significant differences in the levels of H-FABP and GPBB between the cTnI normal group and the cTnI increased group (P>0.05), but the cTnI increased group had an increasing trend.The area under the ROC curve in the diagnosis of myocardial injury in sepsis were H-FABP 0.821, NT-ProBNP 0.738, GPBB 0.661, CK 0.560, cTnI 0.512, in which the sensitivity(0.833) and specificity(0.786)of H-FABP were both higher.@*Conclusion@#The serum H-FABP and the GPBB levels can be used to monitor for myocardial damage, and it has a correlation with the severity of the disease and the prognosis.H-FABP has a significant advantage over traditional myocardial markers in sensitivity and specificity to determine the myocardial injury of sepsis.

Anti-diabetic activity of quercetin extracted from Phyllanthus emblica L. fruit:In silico and in vivo approaches / 药物分析学报

In this study, molecular interactions of the ligands, quercetin, gallic acid, and metformin with various diabetes mellitus-related protein targets, such as glycogen phosphorylase and peroxisome proliferator-activated receptor gamma, were assessed. It was revealed that quercetin possesses good binding affinity to both targets. Quercetin is a major constituent of methanolic extracts of Phyllanthus emblica fruit. The antihyperglycemic effect of quercetin in streptozotocin (STZ)-induced diabetic rats was examined. The isolated quercetin administered at a dose of 75 mg/kg body weight produced a maximum decrease of 14.78％in blood glucose levels in the diabetic rats after 7 days of treatment. Furthermore, quercetin doses of 50 and 75 mg/kg were shown to significantly improve the profiles of triglycerides, high-density li-poprotein, very-low-density lipoprotein, low-density lipoprotein, and total cholesterol at the end of the study in STZ-induced diabetic rats. The administration of quercetin (25, 50, and 75 mg/kg body weight) daily for 28 days in STZ-induced diabetic rats resulted in a significant decrease in blood glucose and urine sugar levels, with a considerable rise in plasma insulin and hemoglobin levels. Therefore, quercetin is a potential drug with antidiabetic and antihyperglycemic action mediated by changes in the levels of glucose, cholesterol, and triglycerides as indicated by in silico and in vivo studies.

The level of glycogen phosphorylase isoenzyme BB and ischemia modified albumin in newborn with asphyxia and myocardial injury and its clinical significance / 国际检验医学杂志

Objective To explore the clinical significance of early biomarkers in neonatal asphyxia diagnosis with myocardial damage by detection of ischemia modified albumin in neonatal serum(IMA) and glycogen phosphorylase isoenzyme BB(GPBB) for screening sensitive markers with direct myocardial injury.Methods 166 neonates were selected in our hospital as the research object,in which 136 cases with myocardial injury dividend into the experimental group and 30 cases into the control group.The experimental group were divided into mild group and severe group according to the degree of asphyxia.All the children were tested for GPBB and IMA 1 h after admission.Results The levels of GPBB in neonatal asphyxia myocardial injury group and severe asphyxia group were significantly higher than those in the control group,the difference was statistically significant(P<0.05).The sensitivity of GPBB in diagnosis of asphyxia was higher than that of IMA,the difference was statistically significant(P<0.05).Conclusion The degree of asphyxia is closely related to serum IMA,GPBB level in neonatal asphyxia complicated with myocardial injury.The sensitivity and specificity of GPBB in diagnosis asphyxia is better than IMA in children complicated with myocardial damage.

Correlation of heart-type fatty acid-binding protein and glycogen phosphorylase enzyme BB in brain with septic myocardial injury / 中国小儿急救医学

The incidence of sepsis is on the rise, and the mortality is also high. Myocardial injury caused by sepsis is one of the important causes of death. However,there is no clear and unified diagnostic criteria to sepsis complicated with myocardial injury. The clinical diagnostic criteria of myocardial injury is mainly based on cardiac ultrasound,myocardial markers and so on. But the measurement of ejection fraction is needed to consider the impact of preload and afterload of left ventricula,also the subjective level of opera-tors. So cardiac markers play an important role in the detection of myocardial injury in sepsis and can reflect the severity of myocardial injury and sepsis,especially in the early diagnosis and prognosis. Heart-type fatty acid binding protein and brain glycogen phosphorylase isoenzyme type exhibit higher sensitivity, specificity and stability compared to other traditional cardiac markers in the clinical diagnosis of myocardial injury, which are worth to be studied and applied in the clinical diagnosis of myocardial injury.

Falta de evidencia en la determinación de la isoenzima BB de la fosforilasa de glucógeno (GPBB) como prueba diagnóstica de preeclampsia / Lack of evidence for offering the qualitative determination of glycogen phosphorylase isoenzyme BB (GPBB) in capillary blood of pregnant women as diagnostic test of pre-eclampsia

Resumen OBJETIVO: estructurar una pregunta clínica para conocer la utilidad de la prueba cualitativa de GPBB en sangre capilar de pacientes embarazadas, con la finalidad de establecer el diagnóstico de preeclampsia. MATERIALES Y MÉTODOS: estudio ambispectivo efectuado con base en las respuestas a la pregunta clínica estructurada: ¿cuál es la validez diagnóstica de la prueba cualitativa de la isoenzima BB de la fosforilasa de glucógeno (GPBB) en sangre capilar para preeclampsia? se buscaron las fuentes primarias en PubMed, mediante las palabras clave (MeSH): "Glycogen phosphorylase isoenzyme BB AND Pregnancy" y "Glycogen phosphorylase isoenzyme BB AND Pre-eclampsia". Se seleccionaron los artículos más relevantes, se les asignó nivel de evidencia, se investigó si la muestra y metodología fueron iguales, comparables o diferentes de la prueba cualitativa en sangre capilar, y se analizaron sus resultados con la finalidad de establecer el diagnóstico clínico de preeclampsia. RESULTADOS: no se encontraron estudios de la determinación cualitativa de GPBB en sangre capilar. En tres ensayos de casos y controles (nivel de evidencia 4) se compararon las concentraciones de GPBB en suero mediante ELISA y se encontraron cifras elevadas al momento de establecer el diagnóstico clínico; sin embargo, se consideró como un rasgo fenotípico de preeclampsia clínica, pero no como una prueba diagnóstica. CONCLUSIONES: no existe suficiente evidencia médica que respalde la utilidad de la determinación cualitativa de GPBB en sangre capilar de pacientes embarazadas para establecer el diagnóstico de preeclampsia; por lo tanto, no se sustenta su aplicación en ningún escenario clínico.

Abstract OBJECTIVE: To establish if the clinical use of the test for the diagnosis of pre-eclampsia is scientifically supported by evidence-based medicine. MATERIALS AND METHODS: Ambispective study based on the responses to the PICO clinical question was constructed, then primary sources were searched in PubMed by the strategies Glycogen phosphorylase isoenzyme BB AND Pregnancy, and Glycogen phosphorylase isoenzyme BB AND pre-eclampsia, the relevant ones were selected, with allocation of level of evidence, determining if samples and methodology were similar, comparable or different to the capillary blood test, and results were analized under diagnosis clinical intention. RESULTS: No studies were found on qualitative GPBB detection in capillary blood. Three case-control studies (evidence level 4) compared GPBB maternal serum levels determined by ELISA, and described an elevation of GPBB at clinical diagnosis, rather as a phenotypical feature of clinical Pre-eclampsia, but not a diagnostic test. CONCLUSIONS: There is no evidence at all to offer the qualitative determination of GPBB in capillary blood of pregnant women; its clinical use is not supported whatsoever.

Synthesis and biological evaluation of novel amide derivatives of pentacyclic triterterpenes as inhibitors of glycogen phosphorylase / 中国药科大学学报

@#Eight novel amide derivatives of corosolic acid were synthesized by acylation, amidation and hydrolysis reactions, etc. Six novel amide derivatives of oleanolic acid were synthesized by acylation, alkylation and reduction reactions, etc. Biological evaluation of the target compounds as inhibitors of glycogen phosphorylase(GP)has been described. Results indicated that eleven derivatives exhibited moderate-to-good inhibitory activities against glycogen phosphorylase. Among them, four target compounds possess better inhibition effects than lead compounds and compound 6 show the best inhibition effect with the IC50 of 11. 2 μmol/L.

Application of the glycogen phosphorylase BB and heart-type fatty acid binding protein to the early diagnosis of neonatal myocardial injury / 实用医学杂志

Objective To evaluate the efficiency of glycogen phosphorylase BB (GPBB) and heart-type fatty acid binding protein (H-FABP) in the early diagnosis of neonatal myocardial injury (NMI). Methods The GPBB and H-FABP levels in the blood were detected at 3, 6, 12 and 24 h after onset of the NMI. The GPBB and H-FABP levels were compared among NMI, Non-NMI and control groups. The NMI diagnosis sensitivity and specificity for GPBB, H-FABP, GPBB combined with H-FABP were compared. The relationships of GPBB, H-FABP levels with the risk factors were analyzed. Results The GPBB and H-FABP levels of NMI group were higher than those of Non-NMI and control groups (P < 0.01). The diagnosis sensitivity of four time points (3, 6, 12 and 24 h) of combined GPBB and H-FABP were higher than those of the GPBB and H-FABP (P < 0.05). The GPBB and H-FABP were negatively correlated with blood glucose level, positively correlated with asphyxia degree and septicemia degree. Conclusion The combined application of GPBB and H-FABP can improve sensitivity in the early diagnosis of NMI.

Synthesis and biological activity of heterocycle-fused derivatives of pentacylic triterpenes as glycogen phosphorylase inhibitors / 中国药科大学学报

Aim: To search for novel modulators of glycogen metabolism through structural modifications of natural pentacyclic triterpenes. Methods: A series of N-heterocyclic derivatives were synthesized by fusing indole, qui-noxaline and pyrazine rings with A-ring of oleanolic and ursolic acids. The compounds were biologically evaluated for their inhibitory activity against rabbit muscle glycogen phosphorylase. Results and Conclusion: Twelve heter-ocyclic triterpene derivatives were synthesized and their structures were confirmed by IR, ~1H NMR, ~(13)C NMR and MS. Except for compound 12, all of the compounds exhibited glycogen phosphorylase inhibitory activity with IC_(50) values in the range of 14-252 μmol/L Among this series of compounds, compound 15 showed the best potency with IC_(50), of 14 μmol/L

Glycogen phosphorylase isoenzyme BB in the diagnosis of acute myocardial infarction in early stage / 中国医师进修杂志

Objective To evaluate the value of glycogen phosphorylase isoenzyme BB (GPBB) in the diagnosis of early acute myocardial infarction (AMI). Methods The plasma levels of GPBB were mea-sured by sandwich ELISA in 115 patients with suspected AMI at admission within 6 hours after onset of chest pain and 55 normal healthy subjects. The plasma concent of cardiac troponin-Ⅰ (cTnI), creatine kinase-MB (CK-MB) and myoglobin (MYO) was assayed at the same time by using corpuscle chemiluminescence. The patients were classified retrospectively into AMI group (n = 45) , unstable angina pectoris (UAP) group (n =40) , stable angina pectoris (SAP) group (n = 13) and non-cardiac chest pain (NCCP) group (n =17).The diagnostic validity was evaluated in terms of sensitivity and specificity. Results The diagnostic sensitivity of GPBB for AMI was 64.29 % within 3 hours and 88.89 % within 6 hours after onset of chest pain,which is significantly higher than that of cTnI (28.57 %, 60.00 %) and CK-MB (21.43 %, 64.44 % ). There was no significant difference in specificity among the four markers. The diagnostic accuracy of GPBB within 3hours and 6 hours (80.77 %, 89.57% ) was significantly higher than that of cTnI (61.54%, 81.74% ),CK-MB (50.00%, 75.65%) and MYO (73.08% ,73.91%). Conclusions GPBB seems to be a sensitive and specific biochemical cardiac marker for AMI in the early stage. Its diagnostic accuracy is higher than that of cTnI, CK-MB, MYO.

Hypoglycemic action of the pectin present in the juice of the inflorescence stalk of plantain (Musa sapientum)—Mechanism of action.

The pectin isolated from the juice of the inflorescence stalk of plantain (Musa sapientum) has been found to show significant hypoglycemic effect both in normoglycemic and alloxan diabetic rats. After its administration at a dose of 20mg/100g body weight, there was increase in the concentration of hepatic glycogen, increased glycogenesis as evident from the increased activity of glycogen synthetase and in normoglycemic rats increased incorporation of labelled glucose into hepatic glycogen. Glycogenolysis and glyconeogenesis were lower as was evident from the decreased activity of glycogen phosphorylase and gluconeogenic enzymes.

Glycogen metabolism in human fetal testes.

The ontogeny of glycogen synthetase, glycogen Phosphorylase and α-Dglucosidase, enzymes which are associated with glycogen metabolism and glycogen level has been studied in human fetal testes of gestational age ranging from 14-32 weeks. Glycogen synthetase activity reaches the peak value at 17-20 weeks of gestation, thereafter it decreases. α-D-Glucosidase activity increases with the advancement of pregnancy up to 28 weeks of gestation decreasing thereafter very rapidly. Phosphorylase activity remains more or less constant throughout gestation. The maximum increase in glycogen content at early stages of gestation (17-20 weeks) and gradual reduction with the advancement of pregnancy are correlated with histochemical observation by the periodic acid-Schiff technique.