Correlation between noninvasive methods and liver pathology in patients with non-alcoholic fatty liver disease combined with type 2 diabetes mellitus / 国际生物医学工程杂志

Objective To evaluate the accuracy of different noninvasive methods for the diagnosis of nonalcoholic steatohepatitis(NASH) and hepatic fibrosis in patients with non-alcoholic fatty liver disease (NAFLD) combined with type 2 diabetes mellitus(T2DM). Method A prospective comparative study was performed for 91 patients with T2DM and NAFLD, which were diagnosed by glucose tolerance test and liver biopsy. The height and body mass of the patient were measured, and the body mass index(BMI) was calculated. The fasting venous blood of the patient was collected, and then the blood routine, liver function and ferritin were measured. NPS, neutrophil lymphocyte ratio(NLR), BARD score, FIB-4 index, APRI, and NAFLD fibrosis score(NFS) were calculated. All patients underwent transient elastography (Fibrotouch) to evaluate the degree of liver stiffness measurement (LSM) and controlled attenuation parameter. All the liver biopsy specimens were categorized by SAF as the gold standard for evaluating NASH and liver fibrosis NASH. Correlation analysis was applied to compare the correlation between the noninvasive methods and SAF. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to assess the diagnostic value of the noninvasive methods for NASH and liver fibrosis NASH. Results In T2DM combine with NAFLD patients, NPS, LSM, NFS, APRI, FIB4 and BMI scores were positively correlated with SAF (r value was 0.509, 0.508, 0.252, 0.396, 0.313 and 0.213, respectively; P value was <0.001, <0.001, 0.016,<0.001, 0.003 and 0.043, respectively). LSM, NPS, NFS and FIB4 scores were positively correlated with liver fibrosis (r value was 0.535, 0.337, 0.315 and 0.315, respectively; P value was <0.001, 0.001, 0.002, 0.002, respectively). The ROC curve shows that the area under the curve of NPS, LSM, APRI, FIB4 and BMI for diagnosing NASH was 0.838, 0.760, 0.734, 0.623 and 0.682, respectively, and P value was 0.000, 0.000, 0.000, 0.044 and 0.003, respectively. For the diagnosis of fibrotic NASH, that value of LSM, NFS, FIB4 and NPS was 0.795, 0.765, 0.686 and 0.623, respectively, and P value was 0.000, 0.001, 0.020 and 0.123, respectively. Conclusions NPS, LSM and APRI have good clinical diagnostic value for NASH. LSM and NFS have good diagnostic value for fibrotic NASH.

Effect of aerobic exercise and resistance exercise in improving non-alcoholic fatty liver disease: a randomized controlled trial / 中华肝脏病杂志

Objective@#To investigate the effect of dietary control combined with different exercise modes on plasma vaspin, irisin, and metabolic parameters in patients with non-alcoholic fatty liver disease (NAFLD) through a randomized open parallel-controlled study.@*Methods@#The patients aged 30-65 years who visited Tianjin Third Central Hospital from January 2013 to December 2014 and were diagnosed with NAFLD by liver ultrasound and fat content determination were screening, and 474 patients were enrolled in this randomized controlled trial and divided into aerobic exercise group, resistance exercise group, and control group. All patients received dietary intervention. The three groups were compared in terms of biochemical parameters, fat content, NFS score, energy metabolic parameters, body composition index, and levels of vaspin and irisin at baseline and after 6 months of intervention. SPSS 19.0 was used for statistical analysis. The t-test, the Mann-Whitney U test, the chi-square test, and an analysis of variance were used for comparison between groups. The multiple imputation method was used for missing data, and the results were included in the intention-to-treat analysis.@*Results@#There were no significant differences in age, sex, anthropometrical parameters, and biochemical parameters between the three groups at baseline. Compared with dietary control alone, aerobic exercise and resistance exercise helped to achieve significant reductions in waist circumference, diastolic pressure, percentage of body fat, volatile fatty acid, fasting blood glucose, homeostasis model assessment of insulin resistance, triglyceride, low-density lipoprotein cholesterol, free fatty acid, uric acid, alanine aminotransferase, and liver fat content after 6 months of intervention (P < 0.05). The aerobic exercise group had a significant increase in non-protein respiratory quotient and significant reductions in body mass index and aspartate aminotransferase after intervention, as well as a significant increase in resting energy expenditure and significant reductions in abdominal fat ratio and total cholesterol after 6 months of resistance exercise (P < 0.05). The aerobic exercise group and the resistance exercise group had a significant reduction in vaspin and a significant increase in irisin after intervention (P < 0.05), and the resistance exercise group had significantly greater changes in these two adipokines than the aerobic exercise group (P < 0.05).@*Conclusion@#Exercise therapy is an effective method for the treatment of metabolism-associated diseases, and a combination of resistance and aerobic exercises is more reasonable and effective in clinical practice. As a relatively safe exercise mode, resistance exercise can also effectively improve the metabolic state of NAFLD patients.

The relationship between progressive liver fibrosis and diabetic neuropathy / 天津医药

Objective To study the relationship between advanced liver fibrosis and peripheral neuropathy in patients with type 2 diabetes mellitus (DPN). Methods A total of 173 patients (89 men and 84 women) with type 2 diabetes who hos?pitalized in Tianjin Third Central Hospital within nearly three years (2013.02-2015.02) were divided into three groups ac?cording to non-alcoholic fatty liver disease (NAFLD) fibrosis score:group A (NFS≤-1.455), group B (-1.455

Evaluation of choroidal thickness and its related factors in diabetic patients with clinically significant diabetic macular edema / 国际生物医学工程杂志

Objective To evaluate the correlation of sub-foveal chomidal thickness (SFCT) variation in type 2 diabetic patients with clinically significant diabetic macular edema (CSME) and the related factors using enhanced depth imaging optical coherence tomography technique (EDI-OCT).Methods A total of 40 normal volunteers (group A), 49 type 2 diabetic patients without CSME(group B) and 37 type 2 diabetic patients with CSME (group C) were recruited, including 67 male and 59 female.All study subjects received EDI-OCT examination.The SFCT in A, B and C groups were compared using one-way ANOVA analysis.The correlations between SFCT and duration of diabetes, fasting blood glucose (FBG), glycoseylated hemoglobin HbAlc, low density lipopmtein (LDL), triglyceride (TG), total cholesterol (TC), high density lipopmtein (HDL), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were analyzed using logistic regression analysis.Results Average SFCT in group A was (271.49±36.18) μm.Average SFCT in group B was (260.48±35.27) μm, and compared with group A, the difference was not statistically significant (P＞ 0.05).Average SFCT in group C was (227.90±34.73) μm, and compared with group A, the difference was statistically significant (P＜0.01).There was a significant difference of SFCT between groups B and C (P＜0.01).There was no statistically correlation between average SFCT and duration of diabetes, FBG, HbA1c, TG, TC, HDL, creatinine, SBP and DBP (P＞0.05), while a statistically correlation between SFCT and LDL or urinary albumin excretion rate (UAER) was observed in the study (r=-0.609,-0.681, P＜0.01).Conclusions Compared with groups A and B, SFCT in type 2 diabetic patients with CSME was significantly thinner.UAER and LDL levels in type 2 diabetic patients with CSME were negatively correlated with SFCT, that is to say, with the increasing of UAER and LDL levels, SFCT in type 2 diabetic patients with CSME decreased.

Urinary albumin excretion rate: a risk factor for retinal hard exudates in macular region in type 2 diabetic patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The various risk factors for retinal hard exudates are still poorly understood in type 2 diabetic patients. The aim of this study was to determine the association between urinary albumin excretion rate (UAER) and hard exudates in macular region in north Chinese patients.</p><p><b>METHODS</b>A total of 272 patients (272 eyes) were enrolled for this study, including 154 subjects from group 1 (mild hard exudates), 91 subjects from group 2 (moderate hard exudates) and 27 subjects from group 3 (severe hard exudates) confirmed using colour fundus photography, optical coherence tomography (OCT) as well as slit-lamp biomicroscopy with 78 diopter (D) lens. Each participant underwent a comprehensive assessment that included biochemical, clinical characteristics test and detailed ophthalmic evaluation. One-way analysis of variance (ANOVA) test and chi-square test were performed to analyze the fasting blood glucose (FBG), glycated hemoglobin (HbA1c), total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TG), full blood counts, urinary albumin excretion rate (UAER), blood creatinine (CREA), duration of diabetes, body mass index (BMI), systolic blood pressures (SBP) and diastolic blood pressures (DBP) between groups. Ordinal logistic regression analysis was further performed in order to eliminating the possible confounding factors.</p><p><b>RESULTS</b>Three groups were matched in terms of age and gender. Risk factors which showed significant difference between groups include FBG (P < 0.001), HbA1c (P < 0.001), LDL (P < 0.001), UAER (P < 0.001), duration of diabetes (P = 0.001), TC (P = 0.005), SBP (P = 0.026), CREA (P = 0.004) and haemoglobin (Hb) (P = 0.012). There was no significant difference between groups for the TG, HDL, DBP, platelet, total white blood cells and BMI. Using ordinal Logistic regression analyses, of all the variables, HbA1c, LDL and UAER which were independent risk factor for hard exudates showed a significantly odds ratio of 1.25, 3.07, and 1.39, respectively. There were also significant differences in UAER level between patients with mild, moderate, severe hard exudates groups (P < 0.001).</p><p><b>CONCLUSIONS</b>UAER was an independent risk factor associated with retinal hard exudates in macular region in type 2 diabetic patients. This study highlights the need for close monitoring and fundus examination for hard exudates in patients with elevated UAER to prevent irreversible visual loss.</p>

Analysis on 154 ADR Cases Caused by Traditional Chinese Medicine in Our Hospital / 中国药房

OBJECTIVE:To investigate the status quo and causes of adverse drug reaction(ADR) caused by traditional Chinese medicine(TCM) in our hospital.METHODS:154 ADR cases reported in our hospital from Feb.2008 to Jun.2009 were analyzed statistically in respect of age and gender of patients,organs and systems involved in ADR and its clinical manifestation.RESULTS:Main clinical manifestations were lesion of skin and its appendents.Most of ADR cases were caused by TCM injections.CONCLUSION:Great importance should be attached to TCM injections and its monitoring to reduce the incidence of ADR.

Transcription expression and clinical significance of CK19 mRNA in pleural fluid of patients with lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>Conventional cytology is valuable in diagnosing the cancer cells in pleural fluid of patients with lung cancer. However, the diagnostic value of detecting pleura micrometastasis is limited. The aim of this study is to investigate clinical significance of CK19 mRNA expression in pleural fluid of patients with lung cancer.</p><p><b>METHODS</b>Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect CK19 mRNA in pleural fluid from 86 patients with lung cancer and 40 patients with benign lung diseases, and the results were compared with the results of conventional cytologic diagnosis.</p><p><b>RESULTS</b>The positive rates of CK19 mRNA in pleural fluid were 93.0%(80/86) from patients with lung cancer and 20.0% (8/40) from patients with benign lung diseases, which showed an obvious difference between two groups (Chi-square=65.69, P < 0.01). The positive rates of CK19 mRNA in pleural fluid of patients with lung cancer had no correlation with histopathology types (P > 0.05). The sensitivity and accuracy of CK19 mRNA were obviously higher than those of diagnosis of conventional cytology in pleural fluid of patients with lung cancer (P < 0.01).</p><p><b>CONCLUSIONS</b>CK19 mRNA can be taken for a molecular marker to detect pleura micrometastasis, it may be helpful to diagnose the cancer cells in pleural fluid of patients with lung cancer and evaluate the clinical staging more correctly.</p>