Clinical significance of autoantibody and liver function test in patients with chronic hepatitis B combined with autoimmune liver disease / 中国热带医学

@#Abstract:Objective To detect the expression of hepatic function indices and autoantibodies in patients with chronic hepatitis B patients, patients with autoimmune liver disease and patients with chronic hepatitis B combined with autoimmune liver disease, and to evaluate the clinical significance of autoantibodies and hepatic function indexes in the early diagnosis of chronic hepatitis B combined with autoimmune liver disease.Methods A total of 109 healthy controls (HC), 72 patients with chronic hepatitis B (CHB), 74 patients with autoimmune liver disease (AILD), and 24 patients with chronic hepatitis B combined with autoimmune liver disease (CHB+AILD) in the Fifth People’s Hospital of Suzhou from 2013 to 2021 were enrolled in this study. Basic information and the value of admission hepatic function indexes and autoantibodies were collected for all enrolled samples, while no autoantibody test was performed for healthy volunteers. All data were processed using GraphPad Prism and SPSS software.Results There were no significant differences in age and gender among the four groups. The detection rates of anti-mitochondrial antibody M2 (AMA-M2) and anti-soluble acidic phosphorylated nuclear protein antibody (anti-SP100 antibodies) in CHB+AILD group [29.2%(7/24), 17.4%(4/23)] were significantly higher than those in CHB group [5.1%(3/59), 0(0/59)], suggesting that the detection of these two autoantibodies is helpful to the differential diagnosis of CHB and CHB+AILD. In addition, eight hepatic function indexes displayed significant differences among the four groups. The levels of total bilirubin and direct bilirubin in CHB+AILD group were significantly higher than those in CHB and AILD groups, while the levels of total protein and albumin were significantly lower than those in CHB and AILD groups. Alkaline phosphatase and glutamyltranspeptidase in AILD group and CHB+AILD group were significantly higher than those in CHB group. The logistic regression analysis showed that total bilirubin, direct bilirubin, albumin, alanine aminotransferase and alkaline phosphatase could form a promising prediction model, which was useful for clinicians in the differential diagnosis of CHB and CHB+AILD (area under the curve, AUC=0.902).Conclusion The combination of autoantibody and hepatic function index detection can be helpful for clinicians in the differential diagnosis of CHB, AILD and CHB+AILD, thus contributing to the early and correct diagnosis of CHB+AILD and providing theoretical basis for patients to obtain reasonable treatment and clinical cure earlier.

Gum resin extract of Boswellia serrata attenuates lipopolysaccharide-induced inflammation and oxidative damage in hepatic and renal tissues of rats

Objective: To explore the effect of ethyl acetate gum resin extract of Boswellia serrata on lipopolysaccharide (LPS) induced inflammation and oxidative damage in hepatic and renal tissues of rats. Methods: The rats were divided into four groups: control, LPS, LPS+Boswellia serrata extracts (100 mg/kg and 200 mg/kg). LPS (1 mg/kg) and the extract (100 and 200 mg/kg, 30 min before LPS) were administered intraperitoneally for 3 weeks. The levels of liver enzymes, albumin, total protein, creatinine, blood urea nitrogen (BUN), interleukin (IL)-6, malondialdehyde (MDA), and total thiol groups and superoxide dismutase (SOD) and catalase (CAT) activities were measured. Results: The levels of liver enzymes, creatinine, and BUN, IL-6, MDA in the LPS group were markedly increased (P<0.001) while albumin, total protein, and total thiol concentration, as well as SOD and CAT activities, were decreased compared with the control group (P<0.05 or 0.01). Boswellia serrata extracts diminished the levels of liver enzymes, creatinine, BUN, IL-6, and MDA (P<0.01 and P<0.001), and elevated the concentration of total protein and total thiol and SOD and CAT activities (P<0.05 or 0.01). Conclusions: The ethyl acetate gum resin extract of Boswellia serrata reduces LPS-induced inflammatory reactions and oxidative damage, thus ameliorating hepatic and renal function.

Effects of 5-HMF on glycolipid metabolism and hepatic function in mice with diabetes and hepatic injury / 预防医学

Objective@#To observe the effect of 5-hudroxymethyl-2-furfural (5-HMF) on glycolipid metabolism and hepatic function in mice with type 2 diabetes mellitus (T2DM) and hepatic injury. @*Methods@#A low, a medium and a high 5-HMF dose group, a model group, and a control group were designed, with ten female ICR mice in each group. The low, medium and high dose group were given 0.27, 0.80 and 2.67 mg/kgbw 5-HMF, respectively, for 12 weeks; while the model group and the control group were given volume controlled deionized water. The model group and three dose groups were fed with high-fat and high-sugar food (36%), and the intraperitoneal injection of alloxan (60 mg/kgbw) was executed in the 10th and 11th week; the control group were fed with normal food. The body weight, blood glucose, blood lipid, and liver function of mice were determined regularly. The livers were stained by periodic acid Schiff and the changes in pathology were observed. @*Results@#Compared with the control group, the serum levels of glucose (GLU), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) were significantly higher in the model group (P<0.05). Compared with the model group, the AST level in the low and high 5-HMF dose group, and the LDH level in the low, medium and high 5-HMF dose group, were significantly lower (P<0.05). There were no significant differences in the levels of GLU, total cholesterol, LDL-C, triacylglycerol, HDL-C and ALT between the model group and the three dose groups (P>0.05). Moderate to severe vacuolar degeneration was observed in the model group, while mild vacuolar degeneration was observed in the high dose group. Medium or large amount of hepatic glycogen granules were observed in the high dose group and the model group. @*Conclusion@#Under the conditions of this experiment, 5-HMF does not show any obvious function of reducing blood glucose and lipid in the mice with T2DM and liver injury, but show some protective effects on liver function．

Effects of Lycium barbarum polysaccharides on blood indexes andliver tissue morphology in rats with intrahepatic cholestasis / 预防医学

Objective@#To study the effects of Lycium barbarum polysaccharides ( LBP ) on blood indexes and liver tissue morphology in rats with intrahepatic cholestasis.@*Methods@#Sprague-Dawley rats were randomly divided into the control group, the model group, and LBP low, medium and high dose group. The rats in the model group and LBP dose groups were given 60 mg/kg alpha-naphthylisothiocyanate ( ANIT ) by gavage every three days of the experiment, and the rats in the control group were given salad oil instead of ANIT. From the third day, the rats in each dose group were given 40, 150 and 600 mg/kg LBP, and the rats in the model group were given distilled water. After four weeks, the blood and urine indexes were measured, and the morphological changes of liver tissue were observed. @*Results@#From the third day of the experiment, the activity of rats in the model group and LBP dose groups decreased, and the color of urine changed to dark yellow. There was no abnormality in the group. In the model group, the levels of serum total bilirubin, direct bilirubin, total bile acid ( TBA ), alkaline phosphatase ( ALP ), γ-glutamyltransferase(γ-GGT), cholesterol, alanine aminotransferase ( ALT ), aspartate aminotransferase ( AST ), white blood cell ( WBC ), percentage of granulocyte, urinary bilirubin, urinary bile acid, liver mass and liver to body ratio were higher than those in the control group, while red blood cell and percentage of lymphocyte were lower than those in the control group ( all P<0.05 ). Pathological changes of liver tissue were observed. The levels of serum TBA, ALP, γ-GGT, ALT, AST, WBC and liver to body ratio in LBP high dose group were lower than those in the model group ( all P<0.05 ). The infiltration of inflammatory cells, proliferation and expansion of bile duct, degeneration and necrosis of liver cells were alleviated. @*Conclusions@#LBP can improve the blood indexes and pathological changes of liver tissue in rats with intrahepatic cholestasis at the dosage of 600 mg/kg. Inhibition of inflammatory response and reduction of oxidative stress injury may be the mechanism for alleviating cholestatic liver injury.

Efficacy and Safety of Emricasan in Liver Cirrhosis and/or Fibrosis

This study aimed to perform a meta-analysis to determine the efficacy and safety of emricasan. Nine databases were searched for clinical trials investigating the efficacy of emricasan treatment in patients with liver cirrhosis or fibrosis. A manual search was conducted to identify the missing trials. The quality of the included studies was assessed using the revised Cochrane risk of bias tool. Efficacy of emricasan treatment was defined as a positive change in apoptosis-related parameters from baseline to the last follow-up visit. Overall, emricasan treatment is more effective in patients with liver cirrhosis or fibrosis than placebo (standardized mean difference [SMD] [95% confidence intervals (CI)]=0.28 [0.14; 0.41]). No significant change in model for end-stage liver disease (MELD) score between the emricasan and placebo groups was noted (SMD [95% CI]=0.18 [-0.01; 0.36]; p=0.058). A 50 mg dose of emricasan had the highest efficacy rate compared to placebo (SMD [95% CI]=0.28 [0.06; 0.50]; p=0.012), followed by the 5 mg dosing regimen (SMD [95% CI]=0.28 [0.06; 0.50]; p=0.012). Treatment with emricasan resulted in significant reductions in ALT (mean difference (MD) [95% CI]=-5.89 [-10.59; -1.20]; p=0.014) and caspase3/7 levels (MD [95%CI]=-1215.93 [-1238.53; -1193.33]; p<0.001), respectively. No significant increase in the rate of overall adverse events was noted (OR [95% CI]=1.52 [0.97; 2.37]; p=0.069). Treatment with emricasan is more effective in improving liver function and apoptosis parameters compared to placebo, with a well-tolerated safety profile. However, due to the poor quality of the analyzed studies, the small number of trials and patients, and the short follow-up periods, more robust trials are still warranted.

Carfilzomib ameliorates hepatic function in mice with cancer cachexia and its molecular mechanism / 中华内分泌外科杂志

Objective To study the role of CFZ in the amelioration of hepatic function in cancer cachexia and its associated mechanism.Methods Forty BALB/c mice were selected.BALB/c mice were divided into 4 groups randomly,including a healthy control group (HC),a CFZ prevention group (CP),a CFZ treatment group (CT) and a cancer cachexia group (CC).Cancer cachexia model was induced by injecting murine colon 26 adencarcinoma cells into male BALB/c mice intraperitoneally.Following administration of CFZ intraperitoneally twice a week to CP and CT groups on the days 5 and 12 after tumor cells injection,respectively,all mice were acrificed on day 19.hepatic function was detected by automatic biochemistry analyzer,The concentration of inflammatory cytokines and CRP were detected by ELISA.The mRNA and protein expression of IκBα and p65 were detected by real-time PCR and western blotting.Results Compared with HC group,CP group and CT group,the albumin in CC group was significantly decreased,and the concentration of glutamate transaminase,total bilirubin,direct bilirubin and triglyceride were significantly increased,(221.67±12.38)U/L、(315.53±13.60)U/L、(1.65±0.32)mmol/L、(0.88±0.21) mmol/L、(4.98±0.32)mmol/L respectively.Liver biochemical test of CP group [(108.27±16.55)U/L、(180.45±15.28)U/L、(1.15±0.27) mmol/L、(0.58±0.12) mmol/L、(2.93±0.18) mml/L) and CT group [(148.56± 18.16)U/L、(247.18±21.64)U/L、(1.34±0.19) mmol/L、(0.69±0.16) mml/L、(3.75±0.28) mmol/L] was improved after CFZ treatment,and CP group was better than that of CT group.The concentrations of TNFa,IL-1,IL-6 and CRP in CC group [(156±9.56)ng/L、(762±9.46)ng/L、(962±9.12) ng/L、(772±10.04 ng/L)] were significantly higher than those in HC group[(16.42±5.63ng/L、174±9.61 ng/L、206±8.27 ng/L、397±10.2 ng/L)],CP group[(71.25± 4.41 ng/L、398±9.72 ng/L、398±9.72 ng/L、483±9.71 ng/L)] and CT group [(113±8.01 ng/L、506±8.74 ng/L、703± 7.76ng/L、651±11.31 ng/L)].The expression of IκBα in HC group,CP group and CT group were higher than that in CC group,and the difference was statistically significant.The expression of IκBαwas was more obvious in CP group than that in CT group.Compared with HC group,the expression of p65 in CP group,CT group and CC group was significantly increased,respectively,and the difference was statistically significant.The expression of p65 in CP group was lower than that in CT group(P=0.000).Conclusion CFZ ameliorates hepatic function in cancer cachexia mice,which may be related to the inhibition of NF-κB resulting in liver function improvement,the inhibition of tumor growth and the consumption of skeletal muscle.

Effect of early intervention with heparin on function of coagulopathy, liver and kidney in rats with exertional heatstroke under the ambient air of high temperature and low humidity / 中华危重病急救医学

Objective To explore the effects of early intervention with heparin on function of coagulopathy, liver and kidney as well as the prognosis in rats with exertional heatstroke (EHS) under the ambient air of high temperature and low humidity. Methods 108 healthy SPF male Sprague-Dawley (SD) rats were randomly divided into normal temperature control group, EHS + normal saline (NS) group and EHS + heparin group. Of which 54 rats were collected for survival analysis (18 rats in each group), the weight change and 8-hour survival rate were observed,and Kaplan-Meier survival curves were drawn. Other 54 rats were collected for intervention experiment, the rats in each group were subdivided into 0, 1, 2 hours subgroups according to the time points of intervention with heparin after model reproduction, with 6 rats in each subgroup. The rats were placed in an artificial experiment cabin with northwest special environment, and the temperature and the relative humidity were (25.0±1.0) ℃ and (35±5)%, respectively, in normal temperature control group, and the rats were not treated in the cabin. The rats in EHS + NS group and EHS + heparin group kept running in the cabin which temperature and relative humidity were set at (43.0±0.5)℃ and (35±5)% until the anus temperature of rats reached 43.0 ℃, and then the rats were placed in room temperature. The rats were injected with 1 mL/kg NS or 250 U/kg heparin sodium injection through their caudal veins at 0, 1, and 2 hours, respectively, and then the blood was collected after 1.5 hours to determine the biochemical parameters including coagulation, liver and kidney as well as platelet count (PLT). Results ① The weight loss of EHS + NS group and EHS + heparin group was more significant than that of normal temperature control group (g: 8.28±1.41, 8.39±1.38 vs. 2.06±1.06, both P < 0.05), but there was no significant difference between EHS + NS group and EHS + heparin group. ② As the time went on after modeling, serum creatinine (SCr), blood urea nitrogen (BUN), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK), activated partial thromboplastin time (APTT), and D-dimer of EHS rats showed a tendency of increasing, but fibrinogen (FBG), antithrombin Ⅲ (ATⅢ) and PLT were decreased gradually, which were obviously abnormal as compared with those at corresponding time point of the normal temperature control group. Heparin intervention 0 hour after modeling could improve the function of liver and kidney, FBG, D-dimer, ATⅢ and PLT, but APTT was prolonged further. The SCr, BUN, ALT, AST and CK in EHS 2 hours + heparin group were still better than EHS + NS group [SCr (μmol/L): 93.33±7.69 vs. 110.50±13.56, BUN (mmol/L): 20.55±1.35 vs. 24.88±2.41, ALT (U/L): 322.17±36.36 vs. 492.33±64.19, AST (U/L): 1 252.33±240.86 vs. 2 725.67±461.17, CK (U/L):1 4628.67±2 784.68 vs. 2 6843.00±2 637.16, all P < 0.01], APTT was significantly prolonged (s: 51.83±6.11 vs. 33.83±4.31, P < 0.01), and ATⅢ and PLT were significantly increased [ATⅢ: (78.03±9.15)% vs. (64.28±12.55)%, PLT (×109/L): 457.67±32.33 vs. 415.83±26.45, both P < 0.05], however, there was no obvious influence on FBG or D-dimer. ③ The rats in normal temperature control group were all survived within 8 hours, and all dead in EHS + NS group. The survival rate of rats given heparin intervention at 0, 1, 2 hours after successfully modeling was 50.0%, 33.3% and 0%, respectively. Kaplan-Meier survival curve analysis showed that 8-hour cumulative survival rate in EHS 0 hour, 1 hour + heparin groups was higher than that in EHS 0 hour, 1 hour + NS groups (χ12 = 7.930, P1= 0.005; χ22 = 4.408, P2= 0.036), however, there was no significant difference between EHS 2 hours + heparin group and EHS 2 hours + NS group (χ2= 2.660, P = 0.103). Conclusion Early heparin intervention can improve the coagulation function and organ function of EHS rats, while improving the survival rate of rats, indicating the earlier intervention of heparin, the better prognosis of rats is.

Clinical analysis of drug hypersensitivity syndrome in 22 children / 临床儿科杂志

Objective To analyze the clinical diagnosis and treatment of drug hypersensitivity syndrome (DIHS) in children. Method The allergenic drugs, clinical manifestations, laboratory examinations, treatment effects, complications and prognosis in 22 children with DIHS were analyzed retrospectively. Results All 22 patients had a medication history and fever. Among them, 90.9% patients had erythema morbilliforme, 90.9% had liver damage, 18.2% had renal damage, 54.5% had superficial lymph node enlargement and 36.4% had granulocytosis. Five patients had serious complications. One patient was complicated by autoimmune hemolytic anemia, 3 patients had transaminase elevated greater than 10 times and 1 patient died due to hepatic failure, hepatic encephalopathy and multiple organ failure. The treatment mainly included the use of glucocorticoid and gamma globulin, and, if necessary, plasma exchange. Conclusion The incubation period of children with DIHS is long, and the skin lesions are mainly erythema morbilliforme. Most of the affected organs are mainly liver, and some of patients can be combined with eosinophilia. Glucocorticoid therapy is effective.

Analysis of 4 cases of hepatic function failure caused by tigecycline / 中国生化药物杂志

Objective To pay more attention to the adverse drug reactions caused by tigecycline. Methods Four cases in our hospital which happened acute or subacute liver failure after the uses of tigecycline were analyzed, including age, basic disease, drug combination,the time when liver function failure happen ,dosage of tigecycline and the course of treatment. Results The aged of four patients was 49-77 years old, the average age (67.5±12.79)years; the time when liver failure happened from 6 d to 20 d, the average(11.75±6.24) d; the course of treatment was 9 d to 23 d, the average(9.75±6.63) d; the total dose of tigecycline was 900 mg to 3650 mg, the average (1812.5±1243.23) mg.The four patients have many basic diseases, combined with many drugs, all of them have mechanical ventilation. Conclusion More attention should be paid to adverse events caused by tigecycline.

Efficacy of Silybinin meglumine on hepatic fibrosis rats and possible mechanisms / 中国免疫学杂志

Objective:To investigate the efficacy of Silybinin meglumine on hepatic fibrosis rats and possible mecha -nisms.Methods:The liver fibrosis rats were randomly divided into 4 groups,the model group,Silybinin meglumine 120 mg/kg group, Silybinin meglumine dose group 60 mg/kg and Silybinin meglumine low dose group 30 mg/kg,and the control group.All groups had been treated for 4 groups.Results:No deaths rat.Compared with the control group ,the reduced body weight ,less dynamic,dark hair, decreased liver and spleen indexes ,increased ALT,AST,TBIL,TG,TC and LDLC,and the decreased ALB, and the increased LXRαand SREBP1c had been observed in the model group (P<0.05).Compared with the model group ,better activity and body weight ,the in-creased liver and spleen indexs decreased ALT ,AST,TBIL,TG,TC and LDLC,and the increased ALB , and the decreased LXRαand SREBP1c had been observed in the Silybinin meglumine groups (P<0.05),in a way of dose-depended.Conclusion: The Silibinin meglumine can treat liver fibrosis ,by improving liver function,lowing lipid and decreaseing LXRαand SREBP1c expression in liver tis-sue.But the mechanism of two proteins reduced remains for further investigation .

The effect of heparin on endothelial function and prognosis in sepsis shock / 中华急诊医学杂志

Objective To detect the effect of low-dose heparin on endothelial function by detecting the change of yon Willebrand factor (vWF) in blood plasma of patients with sepsis shock after treatment with low-dose heparin in order to observe organ function and prognosis of patients.Methods A total of 118 patients with sepsis shock were randomized into low-dose heparin group and control group.In addition to the routine treatment,the patients in low-dose heparin group were given low-dose heparin,while those in control group were not.The levels of APTT,PT,platelet (PLT) count,hepatic function and renal function were determined before and after treatment in two groups,and hemorrhagic events or other complications were recorded.The lengths of stay in ICU and in hospital,the days of mechanical ventilation and the rates of acute respiratory distress syndrome (ARDS),disseminated intravascular coagulation (DIC) and multiple organ dysfunction syndrome (MODS) and 28-day survival rate in the two groups were documented.The levels of vWF in patients of two groups were determined by using immunoturbidimetry before and after treatment.Results The rates of DIC and MODS in low-dose heparin group decreased significantly after therapy (rate of DIC,10.6％ vs.26.7％,P ＜ 0.05;rate of MODS,19.3％ vs.32.0％,P ＜ 0.05).Hepatic function and renal function in low-dose heparin group were significantly improved than that in the control group (P ＜ 0.05),28-day survival rate in the low-dose heparin group was higher than that in the control group (78.3％ vs.69.1％,P ＜0.05),the differences between low-dose heparin group and control group were not statistically significant in the lengths of stay in ICU and hospital,the days of mechanical ventilation and the rate of ARDS (P ＞ 0.05).The differences in APTT,PT and PLT were not significant from pre-treatment to after treatment and between the two groups (P ＞ 0.05).The levels of vWF in low-dose heparin group decreased significantly after therapy rather than those in control group (P ＜ 0.05).Conclusions The endothelial function is improved in patients with sepsis shock after employment of lowdose heparin.Low-dose heparin alleviates the interaction between coagulation and inflammation,improves hepatic,renal and other important organs function,decreases the rate of MODS and increases 28-day survival rate patients with sepsis.The low-dose heparin therapy is a safe and promising treatment in sepsis patients without severe side effects.

Correlation between preoperation hepatic function and short to medium term mortality after heart transplantation / 中华胸心血管外科杂志

Objective To evaluate the correlation between preoperation hepatic function and mortality after heart transplantation using the Receiver Operating Characteristic(ROC) cures and Kaplan-Meier survival analysis.Meanwhile determining the Optimal Operating Point(OOP) and doubtable value interval of the significant indicator for studing it with short to medium term survival analysis.Methods To collect statistical data of 91 cases with heart transplantation in the heart transplantation centre of Anzhen Hospital from January 2009 to June 2014,including the last preoperation hepatic function index.Containing alanine aminotransferase (ALT),aspartate aminotransferase (AST),total protein (TP),albumin (ALB),ratio of albumin and globulin(A/G),serum total bilirubin(STB),connect bilirubin(CB),ratio of connect bilirubin and serum total bilirubin CB/STB,etc.Plotting the ROC curves for all variables in perioperation using SPSS 17.0 statistical software,firstly.Next,to determine the significant indicator according to the area under the ROC curve (AUC) (AUC ＞ 0.7),and to find OOP/Youden index and doubtable value interval of the significant index.And then,total cases were divided into three groups according to doubtable value points.Finally,using Kaplan-Meier survival analysis to reveal the variation tendency of three survival cures for different groups.Results The ratio of albumin and globulin is the sole variable associated with mortality in perioperation,and AUC =0.825(SE =0.056,P =0.000,95％ CI =0.715～0.936).Paients whose A/G≤1.13 had significantly lower survival rates than the other two groups in short to medium postoperative term,P ＜0.001.But after 32 months,the variation tendency of three groups tended to stability.Conclusion The preoperative ratio of albumin and globulin of patient and postoperative mortality were related,but the correlation decreased with the increase of time.The short to medium term survival rates declined significantly for patients whose A/G≤ 1.13.So preoperative A/G could forecast the prognosis of paitents as reference indicator.

Protective effect of magnesium isoglycyrrhizinate on the liver of hepatic arterial chemoembolization / 中国基层医药

Objective To investigate the protective effect of magnesium isoglycyrrhizinate on the liver of hepatic arterial chemoembolization.Methods 68 patients with hepatic arterial chemoembolization were selected as research subjects,they were divided into magnesium isoglycyrrhizinate group and control group.All patients were routinely given hepatoprotective drug treatment from seven days before surgery until three days after surgery,magnesium isoglycyrrhizinate group was given magnesium isoglycyrrhizinate treatment on the basis of hepatoprotective treatment. Detected and compared the alanine aminotransferase,aspartate aminotransferase,total bilirubin,total protein,albumin and cholinesterase levels before and after liver cancer before and after surgery.Results The alanine aminotrans-ferase,aspartate aminotransferase levels at 3 days after surgery[(60.2 ±25.8)and (71.5 ±29.6)IU /L]were higher than before surgery in the control group[(34.7 ±18.6)and (49.5 ±20.4)IU /L](t =7.264 and 5.974,all P 0.05).The alanine aminotransferase,aspartate amin-otransferase and total bilirubin levels before surgery in magnesium isoglycyrrhizinate group had no differences with the control group (P >0.05).The alanine aminotransferase,aspartate aminotransferase levels at 3 days after surgery in the magnesium isoglycyrrhizinate group[(44.8 ±22.8)and (57.3 ±24.8)IU /L]were higher than those in the control group[(60.2 ±25.8)and (71.5 ±29.6)IU /L](t =6.385 and 7.358,all P 0.05).The albumin and cholinesterase levels at 3 days after surgery in the magnesium isoglycyrrhizinate group[(28.4 ±4.7)g/L,(8.0 ±4.8)kU /L]were lower than those of control group [(29.3 ±3.5 )g/L,(6.9 ±4.3)kU /L](t =8.436 and 6.947,all P <0.05 ).The incidence rates of adverse reactions of the magnesium isoglycyrrhizinate group (upper abdominal pain incidence rate was 35.3%,fever incidence rate was 29.4%,nausea and vomiting incidence rate was 52.9%)were lower than those of the control group(55.9%,88.2%,76.5%)(χ2 =7.246,6.472,6.274,all P <0.05).Conclusion Hepatic arterial chemoem-bolization has some damage to liver function of liver cancer patients.Magnesium isoglycyrrhizinate can reduce liver damage,improve liver synthetic function,and has a protective effect on liver.

Clinical Research of Huanglian Jiedu Decoction for Intervention of Dyslipidemia / 广州中医药大学学报

Objective To observe the effect of Huanglian Jiedu Decoction ( HJD) for the treatment of dyslipidemia, thus to provide evidence for the prevention and treatment of dyslipidemia with traditional Chinese medicine. Methods A total of 80 dyslipidemia patients were randomized into HJD group ( 50 cases) and simvastatin group ( 30 cases) . After treatment for 4 weeks, blood lipid levels, metabolic parameters and alanine aminotransferase (ALT) levels were detected. Results (1) After treatment, HJD group and simvastatin group both had lower total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol levels (P0.05). ( 2) After treatment, uric acid was reduced in HJD group ( P0.05). The inter-group comparison showed that HJD had lower blood glucose level than simvastatin group, and the difference had statisticall significance ( P<0.05). ( 3) During the treatment, the patients showed good compliance, and had no obvious hepatic or renal damage. Conclusion HJD could reduce TC, TG and low density lipoprotein cholesterol, and increase high density lipoprotein cholesterol of dyslipidemia patients, the effect being similar to simvastatin. HJD could also significantly reduce uric acid of dyslipidemia patients, showing good safety.

Effect of intraoperative amino acid infusion on postoperative liver and renal function in elderly patients undergoing gastrointestinal surgery / 中国癌症杂志

Background and purpose:Previous researches have shown that intravenous amino acid infusion during general anaesthesia prevents the decreases in core temperature. This study aimed to investigate the effect of amino acid infusion on postoperative liver and renal function in elderly patients undergoing gastrointestinal surgery. Methods:Forty ASAⅠ orⅡ patients (33 males, 7 females) aged 65-75 years undergoing elective gastrointestinal can-cer operation under epidural block combined with general anesthesia were randomly divided into 2 groups (n=20 each). GroupⅠ received intravenous infusion of mixed amino acids at a rate of 2 mL·(kg·h) -1 from induction of anesthesia to the end of operation (AA group); GroupⅡ received infusion of equal volume of normal saline (NS group). Snuff temperature was monitored for induction of anesthesia immediately, after 90 min and at closed abdomen. Renal and hepatic function was performed regularly before operation and on the 1st and 7th postoperative day.Results:The naso-pharyngeal temperatures at 90 min after the beginning of surgery and the time when the peritoneum was closed in AA group were signiifcantly higher than those in NS group (P0.05).Conclusion:Intraoperative amino acid infusion has no signiifcant effects on the renal or hepatic function in elderly patients undergoing gastrointestinal surgery.

Evaluation of the Effect of Sorghum bicolor Aqueous Extract on the Haematological, Renal and Hepatic Parameters in Rats Fed with Low and High Iron Diet.

Aims: To determine the effect of Sorghum bicolor aqueous leaf sheath extract on the hematological, renal and hepatic parameters in rats fed with low and high iron diets. Study Design: Phytochemical screening of leaf sheath of Sorghum bicolor and effect of the leaf extract on hematological, hepatic and renal indices of rats fed with iron deficient and iron sufficient diets. Results: The result of the phytochemical screening indicated the presence of cardiac glycosides, alkaloids, flavonoids, glycosides, saponins and terpenoids. The evaluated hematological parameters (PCV, Hb, RBC,MCV,MCH, MCHC) prior the administration of the leaf sheath extracts (control) in the iron sufficient fed rats revealed a higher value compared to the result obtained in iron deficient fed rats, with the exception of MCHC. Subsequently, the administration of the leaf sheath extracts at different concentration (200,400,800,1600mg/kg body weight of the sample) for both iron sufficient and iron deficient fed rats revealed increased values of the hematological parameters, with the highest values recorded upon the administration of 1600mg extract/kg, Similarly, the results of the evaluated liver biomarkers for the control (albumin, AST, ALT, alkaline phosphatase and total protein) in the iron sufficient fed rats showed a higher value compared to the result obtained in iron deficient fed rats. The result of the liver biomarkers after administration of leaf sheath showed a slight elevation in both iron sufficient and iron deficient fed diet. Furthermore, the result revealed that aqueous sorghum leaf sheath extracts showed a slight increase in the renal function indices at varying concentration of the extracts. Conclusion: The present study showed that administration of sorghum leaf sheath extract enhanced the hematological parameters in rats fed with iron deficient diet thereby supporting the claim that the leaf sheath extract could be used in alleviating anemic condition. The studies further established that the extract is non toxic to the liver and also that the integrity of the kidney is maintained after administration. This on the overall confirms the safety of the extract upon consumption.

Study on correlation between human cytomegalovirus infection with infantile hepatitis syndrome and hepatic function damage / 重庆医学

Objective To explore the correlation between human cytomegalovirus(HCMV) infection with infantile hepatitis syn‐drome(IHS) and hepatic function damage .Methods The real‐time fluorescent quantitative polymerase chain reaction(PCR) was a‐dopted to test the urine HCMV DNA in 236 infants with IHS and 236 healthy infants ,respectively .The hepatic functions in 254 in‐fants with HCMV infection were analyzed retrospectively .Results Among these 236 cases of IHS ,the positive rates of HCMV DNA in urine sample was 62 .7% (148/236) .The positive rates of HCMV DNA and HCMV IgM in the IHS group were significant‐ly higher than those in the control group with statistical difference(P< 0 .01) .The liver function indexes in 254 infants with HCMV infection showed that the serum concentrations of total bilirubin (TBIL ) ,gamma glutamyl transpeptidase (GGT ) ,total bile acid (TBA) ,aspartate aminotransferase(AST ) and alanine aminotransferase(ALT ) were higher than the normal reference ranges ,and the differences were statistically significant(P < 0 .01) .Conclusion The detection rate of HCMV infection is high among the in‐fants with IHS in Guangxi area and HCMV is an important pathogen of IHS .HCMV may lead to hepatic function damage .

Individualización de dosis en el paciente oncológico con insuficiencia hepática / Customization of doses in oncological patients with impaired hepatic function

Objetivo: determinar qué citostáticos requieren ajuste de dosis en pacientes con insuficiencia hepática. Métodos: se realizó una búsqueda en PubMed de toda la bibliografía publicada hasta julio de 2011 sobre dosificación de citostáticos en pacientes con función hepática alterada. Se procedió a su valoración según la clasificación de la Scottish Intercollegiate Guidelines Network. Se sintetizó un índice de fuerza de la recomendación farmacoterapéutica, para lo que se asoció el grado de recomendación de la evidencia encontrada y el número de pacientes incluidos en los estudios encontrados. Se clasificó la recomendación para cada fármaco como de fuerza alta, media o baja. Resultados: se encontraron un total de 46 publicaciones con información sobre dosificación en pacientes con insuficiencia hepática para un total de 17 citostáticos. El 67 por ciento (n= 31) de las publicaciones fueron estudios de cohortes con un nivel de evidencia 2+. No pudieron establecerse recomendaciones de fuerza alta, pero sí de fuerza moderada (76 por ciento; 13 fármacos) y baja (24 por ciento; 4 fármacos). Conclusiones: aunque el nivel de la evidencia disponible fue bajo, podrían establecerse recomendaciones sobre la dosificación de citostáticos en pacientes con insuficiencia hepática para mejorar la seguridad en el uso de estos fármacos en el referido grupo de enfermos(AU)

Objective: to determine the cytostatic drugs requiring dose adjustment in patients with impaired hepatic function. Methods: aliterature review of all the papers about dosage of cytostatic drug in patients with impaired hepatic function published till July 2011 in Pubmed search was made. They were assessed as rated by the Scottish Intercollegiate Guidelines Network. An index of pharmacotherapy recommendation strength was developed, for which the grade of recommendation of the evidence found and the number of patients included in the studies were then correlated, ranking the strength of recommendation for each drug as high, medium or low. Results: atotal of 46 publications with information about dosing in liver failure were found for 17 cytostatic drugs. Sixty seven percent (n= 31) of the publications were cohort studies with a level of evidence 2+. High strength recommendations could not been established, but moderate strength (76 percent; 13 drugs) and low strength (24 percent; 4 drugs) recommendations were finally established. Conclusions: although level of evidence was low, dosage recommendations of cytostatic drugs to be used in liver failure patients were established to improve safety in the use of these drugs in the stated group of patients(AU)

Função renal, hepática e cardíaca de cães hígidos sob terapia prolongada com celecoxibe / Renal, hepatic and cardiac function in healthy dogs during long-term celecoxib therapy

O presente estudo teve como objetivo avaliar os efeitos da terapia prolongada com celecoxibe sobre a função renal, hepática e cardíaca em cães hígidos. Foram utilizados 12 cães fêmeas, divididos em 2 grupos: Gcelecoxibe: terapia com celecoxibe, na dose de 5mg kg-1 por via oral, a cada 12 horas, durante 20 dias (peso médio de 8,9±1,6); Gcontrole: terapia com placebo, a cada 12 horas, por via oral, 20 dias (peso médio de 9,8±1,8). O exame físico, a função renal (urinálise; gamaglutamil transpeptidase -GGT e sódio urinários; ureia, creatinina, sódio e potássio séricos; e clearance endógeno de creatinina), tempo de coagulação (TC), biomarcadores cardíacos (creatinofosfoquinase -CK e creatinofosfoquinase fração MB- CK-MB) e função hepática (alanina aminotransferase -ALT, aspartato aminotransferase -AST e albumina) foram avaliados antes, aos 5, 10 e 20 dias (T0, T5, T10 e T20) do tratamento. No Gcelecoxibe, os valores de clearance de creatinina revelaram diminuição significativa no T20, em relação ao T0 e T5, bem como redução em relação ao Gcontrole em T10 e T20. A urinálise, sódio, potássio, ureia e creatinina séricos, enzima GGT urinária e o TC não apresentaram variação entre os momentos ou grupos avaliados. Houve aumento significativo de CK-MB no T20 e ALT no T5, T10 e T20 no Gcelecoxibe, entretanto, com valores dentro da normalidade para cães. Conclui-se que o celecoxibe revelou-se seguro em relação ao perfil cardíaco e hepático em cães sadios, mesmo sob terapia prolongada. Sob vigência de terapia prolongada, deve ser usado cautelosamente em cães portadores de alterações renais.

The aim of this study was to evaluate the effects of long-term celecoxib therapy on renal, hepatic and cardiac profiles in healthy dogs. Twelve female were randomly assigned to 2 groups (G): Gcelecoxib: treated with celecoxib orally (5mg kg-1), every 12 hours, for 20 days (8.9±1.6 body weight); Gcontrol: received placebo orally, every 12 hours, for 20 days (9.8±1.8 body weight). Physical examination, renal function (urinalysis, urinary sodium and gamma-glutamyl transpeptidase -GGT), serum urea, creatinine, potassium and sodium, and endogenous creatinine clearance), clotting time (CT), cardiac biomarkers (creatine phosphokinase -CK and CK-MB) and liver function (aspartate aminotransferase -AST, alanine aminotransferase -ALT and albumin) were evaluated before, at 5, 10 and 20 days (T0, T5, T10 and T20) of treatment. The creatinine clearance values showed significant decrease at T20, in relation to T0 and T5 in the Gcelecoxib, and reduction in relation to Gcontrol at T10 and T20. The urinalysis, values of sodium, potassium, urea and creatinine serum and urinary GGT enzyme showed no difference through the study between moments or groups. There was a significant increase on CK values at T20 and on ALT values at T5, T10 and T20 in the Gcelecoxib, however with normal range values for dogs. Celecoxib revealed to be safe in relation to cardiac and hepatic profiles, even under prolonged therapy. However, it should be used judiciously during long-term therapy in dogs with renal dysfunction.

Effects of Xiongshao Decoction on immune liver fibrosis in rats / 中草药

Objective To research the effects of Xiongshao Decoction (XSD) on immune liver fibrosis in rats. Methods Eighty-four SD rats were randomly divided into normal control group, model group, Fuzheng Huayu (FZHY) Capsule group, XSD prevention group, XSD high-dose and low-dose groups (15.8 and 7.9 g/kg). The hepatic fibrosis model was induced by injecting porcine serum to the abdominal cavity of rats. To observe the effects of XSD on the serum hepatic function of rats: ALT, AST, ALB, and AJG, the serum marker of hepatic fibrosis: hyaluronic acid (HA), laminin (LN), procollagen III (PCIII), and collogen IV (CIV), and hepatic tissue pathomorphology as well. Results Compared with the model group, the levels of ALT, AST, HA, LN, and PCIII in every XSD treatment group were obviously decreased (P<0.05, 0.01), the levels of ALB and A/G were obviously increased (PO.01). The CIV level of serum in XSD prevention group was significantly decreased (P<0.05) and the degrees of hepatocyte degeneration and necrosis in all treatment groups were lower, with less liver fibrosis, especially those in XSD prevention group and high-dose group. Conclusion XSD could not only relieve the degree of liver cells damage of immune hepatic fibrosis in rats, improve hepatic function of them, and regulate the extracellular matrix metabolism, but also arrest the hepatic fibrosis or make it reversed.