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Ascites is the most frequent decompensating event of cirrhosis.At present,ascites recurs at a high rate due to lack of effective management strategy and is frequently complicated with spontaneous bacterial peritonitis,hepatorenal syndrome,and liver failure,which increase the fatality rate.Albumin treatment for hepatocirrhosic ascites has a long history,but it is limited as an acute or short-term treatment.In contrast,long-term albumin administration represents a completely different treatment paradigm.Results from several recent clinical studies indicate that long-term albumin treatment can be able to modify the disease courses of some decompensated cirrhosis when albumin is given at a sufficient dose for a sufficient time.In this review,we analyze the available data acquired from long-term albumin treatments,trying to establish a secure and effective management scheme involving maximal target popula-tion,albumin dose,administration time,and standards for albumin withdrawal,and thus provide references for the clinical practice.
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Objective@#To evaluate the efficacy, safety and remission rates of pruritus of bezafibrate and UDCA combination therapy in the treatment of refractory PBC.@*Methods@#PubMed, Embase, The Cochrane Library databases, Science direct, Web of Science, CBM, WangFang Data, CNKI, VIP databases were searched to collect randomized controlled trials, crossover trials and self-control clinical trials of combination therapy of UDCA and bezafibrate with UDCA monotherapy for PBC up to June, 2018. RevMan 5.3 software was used for meta-analysis. Two evaluators independently screened the literature, extracted the data, and evaluated the risk of bias of relevant study.@*Results@#Eleven studies, including 465 patients were included. Ursodeoxycholic acid combined with bezafibrate had greatly improved liver biochemical indicators (P < 0.01) and pruritus scores in patients with refractory primary biliary cholangitis (MD = -2.97, 95% CI: -4.34~ -1.60, P < 0.01). However, there was no statistically significant differences in adverse events (RR = 1.28, 95% CI: 0.96 to 1.70, P = 0.09), and mortality rate (RR = 2.58, 95% CI: 0.57 to 11.73, P = 0.22) between the two groups.@*Conclusion@#Ursodeoxycholic acid combined with bezafibrate may improve the biochemical response and pruritus score of refractory PBC, but has no significant effect on adverse events and mortality rate.
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Objective@#To explore the effects of oleic acid and palmitic acid on lipid deposition and mTOR/S6K1/SREBP-1c pathways in HepG2 cells.@*Methods@#The model of steatosis was established with induction of oleic acid and palmitic acid and was intervened by rapamycin. The changes in lipid droplets were observed after staining the cells with oil Red O. Intracellular triglyceride (TG) contents in cells were measured by TG kit. mTOR, S6K1, and SREBP-1c mRNA expression levels were detected using QRT-PCR. Western blot was used to determine protein expression levels of mTOR, S6K1 and SREBP-1c.@*Results@#Both fatty acids increased lipid droplets in HepG2 cells. Fatty degeneration with elevated TG occurred with significant changes in oleic acid group lipids. Rapamycin alleviated lipid deposition caused by oleic acid and palmitic acid and inhibited their induction of increased expression of mTOR, S6K1, and SREBP-1c. QRT-PCR and Western blot results showed that mRNA and protein expressions of mTOR, S6K1, and SREBP-1c in oleic acid and palmitic acid group were significantly higher than the control group (P < 0.05). The increase was more pronounced in the palmitic acid group (P < 0.05); however, after rapamycin intervention, the expression of mRNA and protein in the three groups were significantly lower (P < 0.05), and the change in palmitic acid group was more pronounced (P < 0.05).@*Conclusion@#Oleic acid and palmitic acid can induce lipid deposition in HepG2 cells and increase expression of every component of mTOR/S6K1/SREBP-1c pathway; however, Oleic acid-induced lipid deposition is more pronounced, and the mTOR, S6K1, and SREBP-1c pathway change is more obvious in palmitic acid. Rapamycin has high potent inhibitory effect on palmitic acid-induced lipid deposition. These results specify that lipid synthesis involved in the mTOR/S6K1/SREBP-1c pathways are mainly associated to palmitic acid in HepG2 cells, whereas other signaling pathway may mediate oleic acid-induced lipid synthesis.
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Objective To present the status of smoking control in the Health and Family Planning System in Hubei Province, and to provide scientific basis for smoking control through secret investigations. Methods During the period from July to August in 2015, 168 sanitary Health and Family Planning institutions were chosen by stratified selection to make questionnaires based on Evaluation Standards for Smoke-free Health and Family Planning Institutions issued by the National Health and Family Planning Commission of the People's Republic of China. Secret investigations were conducted in 165 sampled institutions and comparisons were made between smoke-free environment establishment as well as execution processes according to the fraction after converting into centesimal system (actual score/reserved portion × 100). Results The overall score for smoking control in Health and Family Planning System of Hubei Province has climbed to 79.29 ± 12.40.compared to that of 2011 has increased, but 1.6 lower than the national comprehensive evaluated score of 2014. The score of the city (82.14 ± 10.51) proved to be higher than that of the province (66.51±19.69) and the county, (75.35±13.40);disease control institutions (84.77± 9.45) enjoyed a higher score that the others with lowest scores in medical institutions (72.80 ± 14.95);Xianning won the highest score (88.52±5.12);Jingmen (69.81±5.16) and Xiaogan (67.92±7.98) proved to be the lowest in their scores. Nine regions in 17 embraced a lowest discrepancy of over 30 scores and the highest discrepancy of 50.94 scores between the highest score and the lowest among different institutions;12.73% (21/165) medical institutions had no publicity materials; 5/17 municipal institutions and 3/10 county level institutions were still found selling cigarettes, with only 46.06%(76/165) institutions reaching the standard of banning smoking in indoor places, 21.21%(35/165) institutions still have indoor smoking in non-working places, 1.82%(3/165) institutions have indoor smoking in working places. Only 18 (32.14%) institutions out of 56 medical institutions investigated have established smoking cessation clinics. Conclusions Banning-smoking work is less optimistic in general for Health and Family Planning System in Hubei Province, especially for substratum health and family planning institutions. All kinds of departments should take drastic measures to guaranttee the establishment of smoking-free environment.
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The health education as part of the public health, largely using the research methods of social science, thus, the qualitative research and the quantitative research inevitably become the main research methods. With the develop-ment of the statistics and the wide application of statistical software, the quantitative research is becoming main part of health education survey work, and the qualitative research is often overlooked. In this paper, by comparing the charac-teristics of the quantitative research and qualitative research, using health education diagnosis, planning, intervention and evaluation of system thinking process, discusses the two methods of research the application at all stages of the health education work, it is concluded that health education work needs to be combined with the qualitative research and the quantitative research, multiple research methods, analyze and solve problems comprehensively in health educa-tion work, which provide reference to carry out health education for the future working.
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Objective To assess the prostaglandin E2 (PGE2) levels in tumor mass and peripheral blood of patients with gastric cancer and explore their clinical significance. Methods The PGE2 levels in tumor mass, tumor margins of excision and peripheral blood of 40 patients with gastric cancer were measured by a kit of PGE2 ELISA. Results The PGE2 levels were higher in the tissues of gastric cancer than in tumor margins of excision [(8.225?2.425) vs (1.669?0.287) ng/g, P