Effects of ursolic acid on activation of NOX2/ROS/NLRP3 inflammasome in liver fibrosis rats / 基础医学与临床

Objective To investigate the effect of ursolic acid(UA) on NOX2/ROS/NLRP3 inflammasome activation in carbon tetrachloride(CCl4)-induced liver fibrosis SD rat,and to observe the improvement of collagen deposition in liver tissues. Methods All rats were randomly divided into 3 group:control group,CCl4model group,UA treatment group. Liver fibrosis model SD rats was established by the CCl4-induced method and half of them was used as UA treatment group. Serum ALT was detected by ALT detection kit.The liver pathology and collagen deposition were ob-served by HE and Sirius-red staining. The mRNA expression of Nox2,Nlrp3,Caspase1,IL-1β in liver tissues was detected by RT-qPCR. The protein expression of NOX2,NLRP3,caspase-1 and IL-1β in liver tissues was detected by Western blot and immunohistochemistry and the ROS generation in liver tissues was detected by DCFH-DA fluores-cence probe. Results Compared with control group,in the CCl4model group,the serum ALT was much higher (P<0.05);the Ishak's fibrosis score and collagen deposition was significantly increased(P<0.05) and mRNA of Nox2, Nlrp3,Caspase1,IL-1β was increased.In addition,both the NOX2,NLRP3,caspase-1 p10 and IL-1β protein expres-sion and ROS level (P<0.05) of CCl4model group were significant increased.Compared with CCl4model group,in the UA treatment group Ishak's fibrosis score,collagen deposition and ALT decreased.Both mRNA expression of the Nox2, Nlrp3,Caspase1,IL-1β and protein expression of NOX2,NLRP3,caspase-1 p10 and IL-1β as well as ROS were signif-icant decreased,but the caspase-1 p45 protein level has no difference among all these groups (P>0.05). Conclusions Ursolic acid attenuates the liver injury and reduces the collagen deposition,which may relate to its inhibitory effects on NOX2/ROS/NLRP3 inflammasome activation to reduce IL-1β releasing.

Epidemiology and endoscopic treatment of portal hypertension associated with ectopic varices / 中国内镜杂志

Portal hypertension (PH) was defined as an increase in portal pressure caused by various etiologies. The formation of portosystemic collateral circulation was a compensatory form of PH. Gastrointestinal varices were one of the clinical manifestations of PH, and which clould be broadly divided into esophageal varices (EV), gastric varices (GV) and ectopic varices (EcV). At present, it is found that EcV has difficulty in diagnosis, large amount of bleeding, difficulty in hemostasis and poor prognosis. So far, the study of EcV is very limited. There was no guideline and expert consensus on EcV treatment. This review will focus on the epidemiological features of EcV and the research status of endoscopic treatment.

Relationship between symptom response and esophageal pH level on standard dose of esomeprazole treatment for gastroesophageal reflux disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The relationship between symptom elimination and normalization of esophageal acid level of gastroesophageal reflux disease (GERD) on proton-pump inhibitor (PPI) therapy has been questioned. This study aimed to evaluate the relationship between symptom response and gastro-esophageal acidity control in Chinese patients with GERD on esomeprazole therapy, and to assess the role of 24-hour esophageal pH-metry after therapy in GERD patients.</p><p><b>METHODS</b>GERD patients with typical reflux symptoms were enrolled and received esomeprazole 40 mg once daily for 4 weeks. Patients with positive baseline 24-hour esophageal pH-metry were divided into two groups depending on an additional dual-channel 24-hour pH-metry after treatment. The pH- group achieved normalization of esophageal pH level whereas the pH+ group did not.</p><p><b>RESULTS</b>Of the 80 patients studied, 76 had abnormal baseline esophageal pH levels. Of these, 90% (52/58) of symptom-free patients and 67% (12/18) of symptom-persistent patients achieved esophageal pH normalization after therapy (P = 0.030). The mean post-therapy gastric nocturnal percent time of pH < 4.0 was significantly higher in pH+ group than that in pH- group (P < 0.001) after therapy. The multivariate regression analysis identified hiatus hernia (P < 0.001) and persistent reflux symptom (P = 0.004) were two independent factors predicting the low post-therapy esophageal pH level.</p><p><b>CONCLUSIONS</b>Symptom elimination is not always accompanied by esophageal pH normalization, and vice verse. Esophageal pH-metry is recommended for GERD patients with hiatus hernia or with persistent reflux symptoms after PPI therapy.</p>

Impact of risk factors on the severity of esophageal mucosal injury in patients with gastroesophageal reflux disease / 中华消化内镜杂志

Objective To assess the risk factors that could influence the severity of esophageal inju- ry in patients with gastroesophageal reflux disease(GERD).Methods GERD patients diagnosed on the ba- sis of endoscopic reflux esophagitis or pathological results of 24 hour esophageal pH monitoring were divided into three groups as non-erosive reflux disease group(NERD)(n=83),mild esophagitis group(n=51) and severe esophagitis group(n=22).The clinic data and esophageal pH parameters were recorded in the three groups.A logistic regression was used to assess the joint influences of clinic characteristics,hiatus her- nia,and esophageal pH parameters on the severity of esophageal injury.Results Patients in severe esoph- agitis group were more likely to have advanced age and hiatus hernia.The number of supine long reflux epi- sodes measured by esophageal pH monitoring significantly increased with increasing grades of mueosal dam- age(P