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Biochemical liver function tests are important methods to determine liver function in clinical practice, but abnormal liver biochemical parameters are not completely equivalent to liver damage. Some genetic and immune factors can also cause abnormal liver biochemical parameters, but with good prognosis in most cases. This article summarizes the causes of some benign abnormal liver biochemical parameters, so as to help clinicians to broaden their thinking of diagnosis and treatment, take into account genetic and immune factors, and avoid misdiagnosis and mistreatment.
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Objective:To investigate the value of a novel technique called visual transient elastography (ViTE) and liver steatosis analysis (LiSA) in assessing liver function injury in hepatitis B virus-related hepatocellular carcinoma (HBV-related HCC) patients after ablation therapy.Methods:A total of 129 HBV-related HCC patients in Harbin Medical University Cancer Hospital from January 2022 to August 2023 were retrospectively analyzed.ViTE and LiSA examinations were applied to record the liver stiffness E value and LiSA value before ablation. An albumin-bilirubin (ALBI) score was constructed using laboratory indicators. Spearman correlation analysis was used to assess the correlation between E value, LiSA value and ALBI score, body mass index (BMI). According to the change of ALBI grade in perioperative period, the patients could be divided into two groups: liver function unchanged group and liver function injury group. Univariate and multivariate statistical methods were used to analyze related factors affecting changes in liver function after ablation, followed by establishing a predictive model.Results:Spearman analysis showed a strong positive correlation between E value and ALBI score ( rs=0.686, P<0.001), and LiSA value was weakly positively correlated with BMI ( rs=0.338, P<0.001). There were no significant correlations between E value and BMI, LiSA value and ALBI score (all P>0.05). Univariate analysis showed that differences of age, BMI, ablation parameters, E value, and LiSA value in the two groups were statistically significant (all P<0.05). Multivariate analysis showed that E value, LiSA value, and ablation time were independent predictors of hepatic dysfunction after ablation (all P<0.05). AUC was 0.892 indicating high accuracy in the predictive model based on above indicators. Conclusions:Under the real-time ultrasound guidance, a non-invasive liver function injury prediction model based on ViTE and LiSA technology can offer personalized predictions for ablative perioperative changes in liver function among HBV-related HCC patients.
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[Objective]To investigate the protective effect and mechanism of Ganoderma lucidum extract(GLE)on liver cirrhosis in mice.[Methods]Ten male C57BL/6 mice were randomly selected as control group,the remaining forty mice were intraperitoneally injected with carbon tetrachloride olive oil suspension to induce liver cirrhosis model.They were randomly divided into model group and GLE low(50 mg/kg·d),medium(100 mg/kg·d)and high(200 mg/kg·d)dose groups,while the control group and model group received 0.9%sodium chloride solution gastric irrigation,and the control group mice were given the same volume of olive oil solution twice a week.Liver index was calculated.The activities of alanine aminotransferase(ALT),aspartate transaminase(AST)and the levels of total cholesterol(TC),total bilirubin(TB)and creatinine(Cr)in serum of mice were detected by automatic biochemical analyzer.Hematoxylin eosin(HE)staining was used to observe the histopathological changes of liver,and Masson staining was used to observe the degree of liver fibrosis.Terminal-deoxynucleotidyl transferase mediated dUTP nick end labeling(TUNEL)staining was used to observe the apoptosis of hepatocytes.The levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),IL-6,malondialdehyde(MDA)and activity of superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)in serum were detected by enzyme linked immunosorbent assay(ELISA).The relative expression of nuclear factor E2 related factor 2(Nrf2)and nuclear Nrf2,heme oxygenase-1(HO-1)and NAD(P)H:quinone oxidoreductase 1(NQO1),α-smooth muscle actin(α-SMA),Collagen Ⅰ and E-cadherin protein in liver tissue were detected by Western blot.[Results]Compared with control group,the liver had significant damage,the liver index,serum ALT,AST activities,TC,TB and Cr levels,liver fibrosis degree,hepatocyte apoptosis index,the levels of serum TNF-α,IL-1 β,IL-6 and MDA,the relative expression of α-SMA and Collagen I protein increased(P<0.05),while the activity levels of serum SOD and GSH-Px,and the relative expression of total Nrf2 and nuclear Nrf2,HO-1,NQO1 and E-cadherin protein in liver tissue decreased in model group(P<0.05).Compared with model group,liver injury gradually reduced,the liver index,serum ALT,AST activities,TC,TB and Cr levels,liver fibrosis degree,hepatocyte apoptosis index,the levels of serum TNF-α,IL-1β,IL-6,MDA and the relative expression of α-SMA,Collagen I protein decreased(P<0.05),while the activity levels of serum SOD and GSH-Px,and the relative expression of Nrf2 and nuclear Nrf2,HO-1,NQO1 and E-cadherin protein in liver tissue increased in GLE low,medium and high dose groups(P<0.05).[Conclusion]GLE can alleviate the histopathological damage and improve liver function in cirrhotic mice.This may be related to the decreased level of oxidative stress and inflammatory reaction after activation of Nrf2/ARE signaling pathway,which may interfere with liver fibrosis.
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By exploring the theory of “the liver is the basis of resistance to fatigue”, it is believed that liver with its physiological function of storing blood and governing the free flow of qi plays an important role in the body's tole-rance to physical fatigue and mental fatigue, and it is also related to the physiological activities of eyes and tendons. The formation of asthenopia is related to the dysfunction of liver, spleen and kidney. The liver plays a key role in the occurrence and development of asthenopia. The deficiency of liver blood and liver dysfunction will cause the abnormal circulation of qi and blood, which leads to the loss of malnutrition of eyes and affects the normal physiological function of eyes. During treatment, we pay attention to nourishing the blood and soothing the liver to nourish the spirit, regulating and tonifying liver qi to stimulate the liver yang, strengthening the spleen and soothing liver to replenish qi and promoting yang, nourishing the liver and kidney to harmonize yin and yang, which are meant to restore the physiological characteristics of liver being yin in form but yang in function, so as to cure asthenopia.
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Objective To compare the effects of CalliSpheres drug-eluting beads transcatheter arterial chemoembolization(DEB-TACE)and conventional TACE(c-TACE)on liver fibrosis and liver function in the treatment of primary hepatocellular carcinoma(HCC).Methods A total of 40 patients diagnosed with HCC at Xuzhou Municipal Cancer Hospital of China between October 2020 and October 2022 were enrolled in this study.According to therapeutic scheme,the patients were divided into DEB-TACE group(n=20)and c-TACE group(n=20).The preoperative,and postoperative 5-day and one-month hyaluronidase(HA),type Ⅲ procollagen peptide(P Ⅲ NP),type Ⅳ collagen(CⅣ)and laminin(LN),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),albumin(Alb),and prothrombin time(PT)were compared between the two groups.Results The technical success rate was 100%in both groups,and tumor staining completely disappeared immediately after TACE in all patients.The postoperative 5-day levels of HA,LN,P Ⅲ NP,and CⅣ in both groups were remarkably higher than the preoperative ones(P<0.05).One month after TACE,HA level in the DEB-TACE group was prominently higher than its preoperative value(P<0.05);HA and LN levels in the c-TACE group were obviously higher than their preoperative values(P<0.05);and the HA and LN levels in c-TACE group were significantly higher than those in DEB-TACE group(P<0.05).Five days after TACE,in the DEB-TACE group the AST and PT levels were higher than their preoperative values while the Alb level was lower than its preoperative value(P<0.05);in the c-TACE group the ALT,AST,TBiL and PT were higher than their preoperative values while the Alb level was lower than its preoperative value(P<0.05);the ALT and AST levels in the c-TACE group were strikingly higher than those in the DEB-TACE group while Alb level was strikingly lower than that in the DEB-TACE group(P<0.05).Conclusion Both CalliSpheres DEB-TACE and c-TACE can aggravate liver fibrosis and cause liver function damage.However,the degree of liver fibrosis and liver function damage caused by CalliSpheres DEB-TACE is less than that caused by c-TACE.(J Intervent Radiol,2024,33:259-263)
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Objective To investigate deep neuromuscular blockade(NMD)and moderate NMD on hepatic perfusion and liver function during laparoscopic hepatectomy.Methods A total of 60 patients who received laparoscopic hepatectomy in Fudan University Shanghai Cancer Center were recruited from Dec 2021 to Dec 2022.They were randomly divided into two groups:deep NMD group(D group,n=30)and moderate NMD group(M group,n=30).D group was induced by administration of rocuronium 0.9 mg/kg followed by continuous infusion to maintain intraoperative post-tetanic count(PTC)of 1-2,while M group was induced by administration of rocuronium 0.6 mg/kg followed by continuous infusion to maintain intraoperative train-of-four(TOF)of 1-2.Indocyanine green(ICG)of 0.25 mg/kg was given intravenously both after induction and after specimen excision,and retention rate at fifteen minutes(ICGR15)was recorded.In addition,intraoperative rocuronium dosage,surgical operation satisfaction score,postoperative shoulder pain,and the occurrence of vomiting on postoperative day 1(POD1)were also recorded.Results Compared with M group,the dosage of rocuronium in D group was significantly increased(P<0.01),but there was no difference of ICGR15 between the two groups(P=0.581),even other parameters of perioperative liver function.The surgical operation satisfaction score was significantly higher(P<0.05),while the postoperative shoulder pain(P=0.037,OR=1.37,95%CI:1.01-1.86)and the occurrence of vomiting on POD1(P=0.017,OR=1.64,95%CI:1.07-2.53)were significantly lower in D group than those in M group.Conclusion Compared with moderate NMB,deep NMB can significantly improve surgery condition,reduce postoperative shoulder pain and vomiting.However,there was no significant difference between them on the hepatic perfusion and perioperative liver function.
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Objective To explore the value of curvature value of liver surface nodularity(LSN)based on MRI in evaluating liver function in patients with liver cirrhosis.Methods A retrospective analysis was made on the patients who underwent upper abdomen MR examination at 3.0T.The normal liver function patients and cirrhosis patients were enrolled in the study and then the Child-Pugh score of the patients were calculated.The patients were divided into three groups:normal liver group,compensated cirrhosis group and decompensated cirrhosis group.The water phase imaging of 3D modified Dixon fast field echo(mDixon-FFE)sequence was copied in DICOM format.ITK software was used to manually draw the full-thickness liver edge by two observers.The curvature value of LSN was obtained by using matlab self compiled code for follow up analysis.Kruskal-Wallis H test was used to compare the curvature value between the groups.The receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was obtained.Spearman test was used for the correlation analysis.Results The curvature values of LSN among the normal liver,compensated cirrhosis and decompensated cirrhosis groups gradually increased(P<0.05).Comparing normal liver with compensated cirrhosis,the AUC of diagnosing compensated cirrhosis was 0.84,with the sensitivity of 72.7%and the specificity of 89.3%.Comparing compensated cirrhosis with decompensated cirrhosis,the AUC of diagnosing decompensated cirrhosis was 0.91,with the sensitivity of 80%and the specificity of 90.9%.There was a moderate positive correlation between the curvature value of LSN and liver function score in patients with cirrhosis(r=0.63,P=0.002).Conclusion The curvature value of LSN based on MRI can be used for preliminary evaluation of liver function of liver cirrhosis,with the AUC more than 0.80 and higher sensitivity and specificity.
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Objective To explore the effect of low replacement plasma exchange(LPE)combined with double plasma molecular adsorption(DPMAS)in the treatment of patients with chronic acute liver failure(ACLF)and its influence on liver function,inflammatory cytokines and short-term prognosis.Methods One hundred patients with ACLF were randomly divided into the observation group and the control group by envelope method,with 50 cases in each group.On basis of routine symptomatic treatments(liver protection,removing jaundice,reducing enzymes,anti-viruses,bleeding prevention),the control group and the observation group were treated with plasma exchange(PE)and LPE plus DPMAS,respectively.The liver function,coagulation function,the levels of inflammatory cytokines,incidence of adverse reactions,and 90-day survival rate were compared between the two groups after treatment.Results After treatment,the liver function and coagulation function in the observation group were significantly improved(P<0.05)and the levels of inflammatory cytokines were significantly lowered than those in the control group(P<0.05).There was no statistically significant difference in the 90-day survival rate and the total incidence of adverse reactions between the groups(P>0.05).Conclusion LPE combined with DPMAS can effectively improve liver function and coagulation function,and reduce levels of inflammatory cyto-kines in ACLF patients,with high safety.
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@#Objective To investigate the imaging value and associated clinical features of enhanced CT evaluation of spontaneous portosystemic shunts(SPSS)in patients with cirrhotic portal hypertension.Methods Patients with cirrhosis who attended Panjin Central Hospital from June 2020 to July 2022 were retrospectively collected to evaluate the presence,size and type of spontaneous portal shunts for statistical analysis,and relevant clinical and laboratory indices were recorded.Results A total of 119 patients with liver cirrhosis were included in this study.Total bilirubin level,albumin level,prothrombin time,international normalized ratio,Child-Pugh grade,hepatic encephalopathy,portal vein thrombosis,and renal vein diameter were all statistically significant difference(P<0.05)compared to the three groups of patients in the no-SPSS,SPSS<8mm and SPSS≥8mm groups.Multi-factor logistic analysis could identify Child-Pugh grade C and portal vein thrombosis as independent risk factors for the occurrence of spontaneous splenorenal shunt(SSRS)≥8mm.In the group without SPSS and in the group with SSRS,there was a statistically significant difference(P<0.05).When comparing uric acid values,left gastric vein diameter and left renal vein diameter.Conclusion The presence of SPSS can be detected early by enhancing CT.The presence of SPSS,especially in patients with a diameter greater than or equal to 8mm,is associated with poorer liver function and a greater risk of portal vein thrombosis;the presence of SPSS reflects the patient's cirrhotic state to some extent.
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OBJECTIVE:To evaluate the efficacy of exosomes derived from mesenchymal stem cells on animal models of acute liver failure. METHODS:PubMed,Web of Science,Embase,The Cochrane Library,CBM,CNKI,WanFang,and VIP databases were retrieved from inception to January 16,2023.A series of animal experiments on the treatment of acute liver failure animal models by exosomes derived from mesenchymal stem cells were collected.Two evaluators screened the literature and extracted the data independently.The bias risk was evaluated by the SYRCLE tool.The extracted data were analyzed by Revmen 5.4.1 software and Stata 17.0 software. RESULTS:A total of 241 articles were retrieved and 9 animal experiments were included,with 219 animals:110 animals in the model group and 109 animals in the exosome group.The results showed that the survival rate of animals in the exosome group improved significantly[RR=9.34,95%CI(3.91,22.29),P<0.001],the levels of serum alanine transaminase[SMD=-5.31,95%CI(-7.43,-3.19),P<0.001]and aspartate aminotransferase[SMD=-4.47,95%CI(-5.85,-3.10),P<0.001]were reduced obviously.The expressions of interleukin-1β[SMD=-11.54,95%CI(-18.12,-4.95),P=0.000 6],interleukin-6[SMD=-5.75,95%CI(-8.08,-3.41),P<0.001]and tumor necrosis factor-α[SMD=-4.46,95%CI(-6.83,-2.09),P=0.000 2],were suppressed obviously. CONCLUSION:Exosomes derived from mesenchymal stem cells effectively inhibit the inflammatory response,ameliorate liver function of animals with acute liver failure,and improve their survival rate.The results of subgroup analysis showed that the shorter survival time of animals(≤24 hours),the lower dose of transplanted exosomes(<1 mg/kg)and the source of exosomes(adipose-derived mesenchymal stem cells)may affect the efficacy of the exosomes derived from mesenchymal stem cells in the animal model of acute liver failure.This conclusion and its clinical transformation still need to be confirmed by randomized controlled studies with large sample sizes and high quality.
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Introducción: las enzimas y marcadores del perfil hepático permiten evaluar la funcionalidad y condición del hígado. Sus elevaciones pueden ser silentes y con cierta prevalencia en muchos adultos. Objetivo: determinar las principales alteraciones en el hepatograma en pacientes que acuden a consulta médica de rutina. Metodología: estudio descriptivo, prospectivo y transversal realizado a partir de resultados de laboratorio de historias clínicas de 364 pacientes de todas las edades y ambos sexos pertenecientes a un policlínico del distrito de Villa el Salvador, Perú desde enero de 2021 a julio de 2022. Las variables fueron: edad, sexo, valores de transaminasa glutámico pirúvica (TGP), transaminasa glutámico oxalacética (TGO), bilirrubina directa, indirecta y total, albúmina, globulinas y fosfatasa alcalina (FA). Resultados: en el promedio total de la muestra, la TGP fue alta (51,05 U/L), así como la bilirrubina total (1,50 mg/dL) y la FA (135,84 U/L). La TGP fue alta en hombres (54,92 U/L) y mujeres (48,86 U/L). La TGO fue normal en mujeres y alta en hombres (48,24 U/L). La bilirrubina indirecta fue alta en hombres (1,33 mg/dL). La FA fue más alta en ambos sexos (143,28 U/L en hombres y 126,38 en mujeres). Según grupo etario, los valores de TGO fueron más altos en el grupo de edad igual o mayor a 40 años (49,99 U/L). Los valores de TGP fueron elevados en ambos sexos (55,96 U/L en hombres y 50,90 U/L en mujeres), así como en la bilirrubina total, la que fue más alta en el grupo de edad igual o mayor a 40 años (2,03 mg/dL). La bilirrubina indirecta, albúmina y FA fueron normales en el grupo de edad igual o menor de 39 años, pero fueron elevadas en el grupo de edad igual o mayor a 40 años (1,13 mg/dL, 5,77 gr/dL y 147,95 U/L, respectivamente). Conclusiones: existen alteraciones en el perfil hepático en pacientes asintomáticos en la muestra estudiada. A pesar de no ser elevaciones significativamente grandes, se recomienda identificar y tratar las posibles causas que pudieran desencadenar dichas elevaciones, así como la realización de más estudios similares a nivel nacional para caracterizar el perfil hepático de nuestra población.
Introduction: The enzymes and markers of the liver profile allow us to evaluate the functionality and condition of the liver. Their elevations may be silent and have a certain prevalence in many adults. Objective: To determine the main alterations in the hepatogram in patients who attend routine medical consultation. Methodology: Descriptive, prospective and cross-sectional study carried out based on laboratory results from medical records of 364 female and male patients of all ages attending a polyclinic in the district of Villa El Salvador, Peru from January 2021 to July 2022. The variables were: age, sex, values ââof alanine aminotransferase (ALT), aspartate transaminase (AST), direct, indirect and total bilirubin, albumin, globulins and alkaline phosphatase (ALP). Results: In the total average of the sample, ALT was high (51.05 U/L), as well as total bilirubin (1.50 mg/dL) and ALP (135.84 U/L). ALT was high in men (54.92 U/L) and women (48.86 U/L) while AST was normal in women and high in men (48.24 U/L). Indirect bilirubin was high in men (1.33 mg/dL) and ALP was higher in both sexes (143.28 U/L in men and 126.38 in women). According to age group, AST values ââwere highest in the age group equal to or greater than 40 years (49.99 U/L). ALT values ââwere high in both sexes (55.96 U/L in men and 50.90 U/L in women), as well as total bilirubin, which was highest in the age group equal to or greater than 40 years (2.03 mg/dL). Indirect bilirubin, albumin and ALP were normal in the age group equal to or less than 39 years, but were elevated in the age group equal to or greater than 40 years (1.13 mg/dL, 5.77 gr/dL and 147.95 U/L, respectively). Conclusions: There are alterations in the liver profile of asymptomatic patients in the sample studied. Although they are not significantly large elevations, it is recommended to identify and treat the possible causes that could trigger these elevations, as well as carrying out more similar studies at a national level to characterize the liver profile of our population.
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ABSTRACT Background: Non-invasive markers have been developed to assess the presence and severity of liver abnormalities related to non-alcoholic fatty liver disease (NAFLD). Objective: To analyze the diagnostic accuracy of non-invasive NAFLD markers (NAFLD liver fat score [NLFS], non-invasive non-alcoholic steatohepatitis detection score [NI-NASH-DS] and fibrosis score based on four variables [FIB-4]) in individuals with obesity undergoing bariatric surgery. Methods: A descriptive retrospective cross-sectional study was carried out enrolling 91 individuals who underwent bariatric surgery at a tertiary-level public university hospital. Non-invasive NAFLD markers were calculated using laboratory tests, clinical and anthropometric variables and diagnostic accuracy tests were calculated comparing them in relation to the gold-standard test for this analysis (histopathological evaluation). Results: A total of 85.7% of the participants were female and mean age was 39.1±9.8 years. The average body mass index was 38.4±3.6 kg/m2. At histopathological examination, 84 (92.3%) patients presented with steatosis, 82 (90.1%) with some type of fibrosis; 21 (23.1%) patients were diagnosed with NASH according to the NAFLD activity score criteria. The overall accuracy of NLFS score was 58.2% for general hepatic steatosis and 61.5% for moderate to severe steatosis. The overall accuracy of FIB-4 was 95.4% for advanced fibrosis. NI-NASH-DS had a 74.7% overall accuracy for NASH. Conclusion: In a population of individuals with obesity, the FIB-4 score had high overall accuracy in assessing the presence of advanced liver fibrosis, whereas the NFLS and NI-NASH-DS had moderate accuracies for the assessment of steatosis and NASH, respectively.
RESUMO Contexto: Marcadores não-invasivos foram desenvolvidos para avaliar a presença e a gravidade de anormalidades hepáticas relacionadas à doença hepática gordurosa não-alcoólica (DHGNA). Objetivo: Analisar a acurácia diagnóstica de marcadores não-invasivos de DHGNA (escore de gordura hepática da DHGNA [NLFS], escore não-invasivo de detecção de esteato-hepatite não-alcoólica [NI-NASH-DS] e escore de fibrose de 4 variáveis [FIB-4]) em indivíduos obesos submetidos à cirurgia bariátrica. Métodos: Foi realizado um estudo descritivo retrospectivo transversal com 91 indivíduos submetidos à cirurgia bariátrica em um hospital universitário público de nível terciário. Marcadores não-invasivos de DHGNA foram calculados por meio de exames laboratoriais, variáveis clínicas e antropométricas; testes de acurácia diagnóstica foram calculados comparando-os em relação ao exame padrão-ouro para essa análise (avaliação histopatológica). Resultados: Um total de 85,7% dos participantes eram do sexo feminino e a média de idade foi de 39,1±9,8 anos. O índice de massa corporal médio foi de 38,4±3,6 kg/m2. Ao exame histopatológico, 84 (92,3%) pacientes apresentavam esteatose, 82 (90,1%) com algum grau de fibrose; 21 (23,1%) pacientes foram diagnosticados com esteato-hepatite não-alcoólica (EHNA) de acordo com os critérios do escore de atividade da DHGNA. A acurácia global do escore NLFS foi de 58,2% para esteatose hepática e 61,5% para esteatose moderada a grave. A acurácia global do FIB-4 foi de 95,4% para fibrose avançada. NI-NASH-DS apresentou uma acurácia global de 74,7% para EHNA. Conclusão: Em uma população de indivíduos com obesidade, o escore FIB-4 teve alta acurácia global para avaliar a presença de fibrose hepática avançada, enquanto o NFLS e o NI-NASH-DS tiveram acurácias moderadas para avaliar a esteatose e EHNA, respectivamente.
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Background: Malaria is one of the most severe public health problems worldwide. India contributes a substantial burden of malaria. It can cause several complications. Aims and Objectives: This study was conducted to determine the association of parasitemia of current malaria with age of patients, hemoglobin level, liver function test (LFT), platelet count, previous history of malaria, and relapse/recrudescence of malaria up to 1 year. Materials and Methods: An observational study conducted in hospital settings included thin and thick smear preparation with Leishman’s staining to determine the parasitemia as per the WHO guidelines from the blood samples of 280 malaria parasite dual antigen (MPDA) kit positive patients and their details were taken during study period of 2 years. Hemoglobin, LFT, and platelet count were tested and they were correlated with parasitemia. The previous history of malaria was taken and follow-up was done up to 1 year for relapse/recrudescence and their association with parasitemia in current disease was evaluated. Statistical tool R was used for data analysis. Results: Age group 20–40 years was most commonly affected with maximum mean percentage parasitemia. Higher parasitemia was associated with higher grade of anemia, LFT derangement, and thrombocytopenia. Disease severity was maximum for mixed infection followed by falciparum and vivax malaria. About 9.28% of patients with the previous history of malaria developed lower parasitemia in current infection. Relapse rate in vivax malaria –2.325% and recrudescence rate in falciparum malaria–12.5%. Conclusion: Malaria parasitemia should be reported routinely as it carries prognostic importance.
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An open-label prospective noncomparative study was conducted to examine the efficacy and safety of Beliv tablet, a polyherbal Ayurvedic medicine, in 30 adult patients suffering from liver disorders. Two tablets were administered daily for 56 days. Patients were evaluated at Day 0, Day 21, Day 42 and at Day 56. The primary end point of the study was a change in liver function test parameters measured by the levels of serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT) and total bilirubin at all assessment points. Results showed a significant reduction in the serum levels of SGOT, SGPT and total bilirubin from baseline to 21 days, 42 days and 56 days. The total icterus symptom score was also significantly reduced from 5.17 ± 2.26 (baseline) to 2.6 ± 1.48, 1.37 ± 1.13 and 0.77 ± 0.73 at Days 21, 42 and 56, respectively. The Subjective Global Assessment (SGA) decreased significantly from 3.33 ± 1.16 (Day 21) to 2.33 ± 1.16 and 1.80 ± 0.76 at Days 42 and 56, respectively. The Physician Global Assessment (PGA) score was also significantly reduced from 3.0 ± 1.02 (Day 21) to 2.07 ± 0.83 and 1.70 ± 0.79 at Days 42 and 56, respectively. A significant reduction in serum creatinine level was observed at Day 56. No adverse effects or serious adverse effects were observed during the study period. The study concluded that Beliv tablet was highly effective for the treatment of liver disorders, as evidenced by the reduction in serum levels of SGOT, SGPT, total bilirubin, icterus symptoms and PGA and SGA scores. No treatment-related side effects were reported by any of the study participants suggesting that it was safe for clinical use in humans for the treatment of liver disorders.
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Background: The seed of breadfruit is a major food consumed in some parts of Nigeria. It has been identified as an important leguminous food that is highly rich in carbohydrates and protein with abundant minerals and vitamins and is known to contain important anti-nutrients. Aim: This study aims to assess the possible toxicological effect of feed fortified with cooked, parboiled, and grilled breadfruit on the liver and kidney function parameters of Wistar rats. Method: Kidney and liver function tests were carried out using standard diagnostic methods. Results: The results of the kidney function test carried out revealed that feed fortified with 30% cooked and parboiled breadfruit showed a significant (p<0.05) increase in the creatinine level while a significant increase (p<0.05) in the Urea level was observed in all the groups fed with the processed breadfruit with respect to the normal control group. The liver function test carried out showed an increase (p<0.05) in Alanine Transaminase (ALT) activity in the group fortified with 30% cooked breadfruit, a significant increase in Aspartate Transaminase (AST) activity (p<0.05) in all fortified groups with an exception to the group fortified with 30% cooked breadfruit. A significant increase (p<0.05) in Alkaline phosphatase (ALP) activity was seen in the group fortified with 50% grilled breadfruit. Conclusion: The rise in the level of kidney function parameters and liver function enzymes in the blood of the rats fed with feeds fortified with processed breadfruit is an indication that prolonged consumption of breadfruit may have an adverse effect on the renal and hepatic function.
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Introduction: gastrointestinal involvement in COVID-19 occurs in approximately 20% of patients and may include nausea, vomiting, abdominal pain, diarrhea or abnormal liver function tests. In our country, the characteristics of gastrointestinal involvement in COVID-19 patients have not been studied. Objectives: to determine the prevalence of gastrointestinal and liver involvement in patients with COVID-19 treated at two hospitals in Bogotá, Colombia. To determine the association between COVID-19 gastrointestinal involvement and length of hospital stay, severity and mortality. Design and methodology: a cross-sectional study carried out at two hospitals in a hospital subnetwork in Bogotá, Colombia from February 2020 to March 2021. Results: a total of 1,176 patients with a positive reverse transcription polymerase chain reaction (RT-PCR) were included. Gastrointestinal manifestations occurred in 50% (95%CI 47-52%), with the most frequent being diarrhea in 18.4%, odynophagia in 17.6%, anorexia in 14.7% and abdominal pain in 8.8%. An association was found between diarrhea during hospitalization and prolonged hospitalization (OR 1.93 95%CI 1.19-3.13), and between gastrointestinal bleeding on admission and death (OR 3.13, 95%CI 1.1-9.1), among others. Abnormal liver function tests occurred in 46% (95%CI 43-49%) and were more frequent in patients with severe disease and those who died. Conclusions: the prevalence of gastrointestinal manifestations in patients with COVID-19 was 50%. Diarrhea was associated with a longer hospital stay, and gastrointestinal bleeding was associated with respiratory failure and death. Forty-six percent of patients had abnormal liver function tests, with elevated transaminases being the most frequent. Elevated aspartate transaminase (AST) on admission was associated with greater mortality. (Acta Med Colomb 2022; 48. DOI:https://doi.org/10.36104/amc.2023.2729).
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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.
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Humans , Esophageal Squamous Cell Carcinoma/drug therapy , Esophageal Neoplasms/pathology , Prospective Studies , Programmed Cell Death 1 Receptor/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Liver Diseases/etiologyABSTRACT
At present, hepatectomy has become the preferred treatment modality for most benign and malignant hepatobiliary diseases. Liver failure is a common complication after hepatectomy, and for malignant diseases, how to remove the lesion to the maximum extent and reduce the incidence rate of liver failure after hepatectomy is the key problem at present. Accurate and adequate preoperative evaluation of liver reserve function can provide a basis for judging the progression, therapeutic outcome, and prognosis of liver diseases. There are currently various methods for evaluating liver reserve function and surgical feasibility, each with its own advantages and disadvantages, and there is still a lack of a single comprehensive evaluation method. This article reviews the characteristics of commonly used evaluation methods and related research advances.
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OBJECTIVE To investigate the improvement effect and mechanism of different extracts from Tylophora yunnanensis on non-alcoholic steatohepatitis (NASH). METHODS Normal human liver LO2 cells were induced to steatosis by free fatty acid, then were divided into normal group, model group, silybin group (100 μmol/mL), T. yunnanensis ethanol extracts (TYS) group (50 μg/mL), T. yunnanensis ethyl acetate extracts (TYSA) group (50 μg/mL), and T. yunnanensis n-butanol extracts (TYSB) group (50 μg/mL). After 24 hours of drug intervention, the deposition of lipid droplets was observed in LO2 cells in each group. The contents of total cholesterol (TC), triacylglycerol (TG), malondialdehyde (MDA) and glutathione (GSH), the activities of aspartate transaminase (AST), alanine transaminase (ALT) and superoxide dismutase (SOD), the mRNA expressions of Kelch-like ECH-associated protein 1( Keap1), nuclear factor E2-related factor 2( Nrf2) and heme oxygenase 1( HO- 1) were detected. NASH rat model was induced by a high-fat diet, and then divided into normal group, model group, silybin group (12.6 mg/kg), TYS group (80 mg/kg), TYSA group (80 mg/kg) and TYSB group (80 mg/kg), with six rats in each group. The liver indexes of rats in each group were calculated after 6 weeks of drug intervention. The liver histopathological changes were observed, and the contents of TC, TG, HDL-C and LDL-C, AST and ALT activities in serum, the contents of MDA and GSH, SOD activities in liver tissue were detected. RESULTS Compared with model group, TYS, TYSA and TYSB could reduce lipid droplet deposition, intracellular TC, TG and MDA contents, AST and ALT activities, and increase SOD activity, GSH content, and Keap1, Nrf2, HO-1 mRNA expression levels in LO2 cells after steatosis to varying degrees, with some differences being statistically significant (P<0.05). They also significantly improved liver injury in NASH model rats, reduced their liver indexes, TC, TG, LDL-C and MDA contents, AST and ALT 1-042) activities, and increased HDL-C (except for TYS and TYSB), GSH contents and SOD activity, with TYSA having the most significant effect (P<0.05). CONCLUSIONS TYS, TYSA and TYSB have a certain improvement effect on NASH, among which TYSA has the most obvious effect. Its mechanism of action may be related to upregulating the Keap1/Nrf2/HO-1 signaling pathway and inhibiting oxidative stress
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@#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.