Advance in Gait Adaptability Training for Rehabilitation of Stroke (review) / 中国康复理论与实践

Gait adaptability refers to adjustments of gait to accomplish walking and to overcome environmental difficulties. According to the training environment, gait adaptability training in stroke rehabilitation can be divided into two categories: real environment and simulated environment. The simulated environment is divided into simple indoor and multimoding environment. Some technologies, such as virtual reality and augmented reality may provide safer and more efficient methods for gait adaptability training. Gait adaptability training can improve walking function and confidence of hemiplegic patients, and help them to return to community life and social participation.

Short-term Effect of Hip Muscles Strengthening on Knee Osteoarthritis / 中国康复理论与实践

Objective:To compare the short-term effects of hip muscles strengthening and quadriceps strengthening on knee osteoarthritis (KOA), and discuss the advantages of hip muscles strengthening. Methods:From October, 2015 to May, 2016, 42 old females with KOA were divided into two groups equally. They received hip strengthening (HS group) and quadriceps strengthening (QS group) for two weeks, respectively. The pain, stiffness and physical function scores of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were measured. Isokinetic strength peak torque (PT) was assessed for knee extensors and flexors, and 6-minute Walk Test was also evaluated. They were followed up two months later. Results:Before exercise, there was no significant difference in all the indexes between two groups (P > 0.05). Two weeks after exercise, the knee flexor PT (t = -4.038, P = 0.001) and 6-minute walk distance (t = -2.474, P = 0.022) increased in QS group; the pain, stiffness and physical function scores of WOMAC (t > 2.487, P < 0.05), the knee extensor and flexor PT (|t| > 6.370, P < 0.001), and 6-minute walk distance (t = -2.241, P = 0.037) improved in HS group; the scores of WOMAC were lower (t > 2.087, P < 0.05) and the knee extensor PT was higher (t = -5.028, P < 0.001) in HS group than in QS group. At two-months' follow-up, the drop-out rate was significantly lower in HS group than in QS group (χ2 = 13.480, P < 0.001). Conclusion:Hip muscles strengthening is a good choice for KOA in the early stage of treatment, which could avoid the pain in quadriceps training, increase quadriceps strength and improve physical function.

Balance and Stability for Patients with Idiopathic Normal Pressure Hydrocephalus / 中国康复理论与实践

@#Objective:To observe the features of posture control in patients with idiopathic normal pressure hydrocephalus (iNPH). Methods:From May, 2017 to May, 2018, patients with iNPH in our hospital (<italic>n</italic> = 13) and healthy controls (<italic>n</italic> = 15) were measured with sensory organization test on Balance Manager. The balance scores and strategy scores under six conditions were recorded and the comprehensive balance scores were calculated. Results:The balance scores decreased in the patients in the conditions of eyes-open/stable-support, eyes-close/stable-support, eyes-close/unstable-support and eyes-disturb/unstable-support compared with those of the controls (|<italic>Z</italic>| > 2.042, <italic>P</italic> < 0.05), as well as the comprehensive balance scores (<italic>Z</italic> = -3.617, <italic>P</italic> < 0.001); while the strategy scores increased in the conditions of eyes-close/stable-support, eyes-open/unstable-support, eyes-close/unstable-support and eyes-disturb/unstable-support (|<italic>Z</italic>| > 2.333, <italic>P</italic> < 0.05). Conclusion:There are balance disorders in the patients with iNPH, mainly associating with the disorders of proprioceptive and vestibular senses, and application of hip strategy.

Analysis of clinical characteristics of lung adenocarcinoma patients with exon 21 L858R deletion mutation / 肿瘤研究与临床

Objective:To explore the clinical characteristics of lung adenocarcinoma patients with exon 21 L858R deletion mutation.Methods:The data of 112 patients who were diagnosed with lung adenocarcinoma and positive genetic mutations in the People's Hospital of Xinjiang Uygur Autonomous Region from January 2015 to December 2018 was retrospectively analyzed, and the patients were divided into the exon 21 L858R deletion mutation group (52 cases) and the non-exon 21 L858R deletion mutation group (60 cases). The clinical characteristics, imaging characteristics, expressions of tumor markers and smoking history of patients were compared between the two groups.Results:There was no statistical difference in the gender, age and ethnicity between the exon 21 L858R deletion mutation group and the non-exon 21 L858R deletion mutation group (P values were 0.488, 0.238 and 0.191). There was no statistical difference in the imaging features (including primary tumor site, lobulation, burr, pleural depression and small vacuoles) between the two groups (all P > 0.05). There was no statistical difference in the expressions of tumor markers (including carcinoembryonic antigen, squamous cell carcinoma antigen, neuron-specific enolase, cytokeratin 19 fragment, and gastrin-releasing peptide precursor) between the two groups (all P > 0.05). There were 20 patients (38.5%, 20/52) with smoking history in the exon 21 L858R deletion mutation group, and 4 patients (6.7%, 4/60) with smoking history in the non-exon 21 L858R deletion mutation group, the difference between the two groups was statistically significant (χ 2 = 4.182, P = 0.041). Conclusions:There is no significant difference in clinical characteristics, imaging features and expressions of tumor markers between the patients with exon 21 L858R deletion mutation and the patients without exon 21 L858R deletion mutation. Smoking may be the influencing factor of exon 21 L858R deletion mutation.

Research on Rehabilitation Guidelines Using World Health Organization Family International Classifications Framework and Approaches / 中国康复理论与实践

@#Objective To use World Health Organization Family International Classifications (WHO-FICs) to explore the framework and approaches of development and research of guidelines of rehabilitation at levels of policies, community and services.Methods The important documents and tools of rehabilitation at international level, including United Nations Convention on the Rights of Persons with Disabilities, WHO World Report on Disability, Community-based Rehabilitation Guideline, Rehabilitation in Health Service System, and International Classification of Diseases (ICD), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Intervention (ICHI) of WHO-FICs, had been discussed.Results The framework, classifications, diagnosis and description of diseases and functioning, coding, intervention and functioning evaluation based on ICD-11, ICF and ICHI-β-2 had been established for development and implementation of rehabilitation guidelines and Cochrane rehabilitation.Conclusion The framework and systematic approaches of ontology, classification, terminology, coding, diagnosis and description of diseases and functioning, interventions and evaluations for the development and implementation of rehabilitation guidelines had been developed.

WHO Rehabilitation in Health System: Background, Framework and Approach, Contents and Implementation / 中国康复理论与实践

This paper explored the background, framework and approach, contents and implementation of WHO Rehabilitation in Health System using approaches of ICF and WHO Handbook for Guideline Development. The actions and significances of implementations of seven recommendations and one good practice statements on assistive products had been discussed.

Advance in Repetitive Transcranial Magnetic Stimulation for Patients with Upper Extremity Motor Dysfunction after Stroke (review) / 中国康复理论与实践

Repetitive transcranial magnetic stimulation (rTMS) can achieve neuroplasticity through repeated stimulation of specific cortex, and may be in the ways of inter-hemisphere inhibition or compensation, or both. The various combination of frequency, intensity and duration of stimulation may effect the upper limb function after stroke in different ways.

Systematic Implementation of World Health Organization Family International Classifications in Rehabilitation: Protocol and Roadmap / 中国康复理论与实践

Objective:To explore systematic implementation of World Health Organization Family International Classifications (WHO-FICs) in the field of rehabilitation: the theoretical and policy framework at macro level, governance and management mechanism at meso level, and implementation modules at micro levels, respectively. Methods:The policy and theoretical framework of rehabilitation development was discussed based on the international rehabilitation policy documents of WHO, mainly as World Report on Disability, Global Action Plan on Disability and Rehabilitation in Health Service System. Protocol and roadmap of systematic implementation of WHO-FICs, including International Classification of Diseases (ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Intervention (ICHIβ-2) was proposed. Results:With the use of WHO-FICs, the theoretical and policy framework of rehabilitation was constructed, and the contents and principles of modern rehabilitation services were clarified at macro-level. Rehabilitation is an important part of health service, there are six building blocks: i.e. leadership and governance, financing, human resources for health, service providing, medical technology and health information system. It proposed to use knowledge management system of WHO-FICs, including the classification, nomenclature, definitions, descriptions, terminology and coding systems, to standardize rehabilitation evaluation and statistics. The management and governance system of rehabilitation should be implemented using WHO-FICs. Rehabilitation services are based on the bio-psycho-social model and implemented the principles of people-centered and functioning-oriented. The systematic implementation of WHO-FICs in rehabilitation abide by the model of "Evaluation (ICHI)－Evaluation, Description, Classification and Coding of Functioning (ICF)－Disease Classification, Diagnosis and Coding (ICD)－Rehabilitation Intervention (ICHI)", and with the standardized process of "Evaluation (Functioning and unmet needs)－Diagnose (Disease and Functioning)－Planning of Rehabilitation－Intervention－Evaluation of Outcome". The mic-modules of implementation of WHO-FICs in rehabilitation had been constructed. There were 28 categories of diseases, 7 categories of functioning and 6 categories of rehabilitation interventions in rehabilitation proposed by International Society of Physical and Rehabilitation Medicine. According to ICD-11 and ICF, it proposed to use WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), Brief Model Disability Survey (MDS-B) and VB40 Generic Functioning Domains (VB40), and the ICF core-sets in evaluation of functioning and rehabilitation outcome. The implementation of WHO-FICs in management of medical records and reporting realized the standardized management of medical record, encoding of diseases, functioning and intervention, reporting of performance, and provided tools for billing, reimbursement and payment management of rehabilitation. It proposed to develop WHO-FICs based clinical data sets and big data to implement functioning-related Diagnosis Related Groups and case-mix statistics. Conclusion:With the systematic implementation of WHO-FICs in rehabilitation, the policy and theoretical framework at macro level had been developed. The mechanism of management and governance at meso level had been explored. The application modules and approaches at micro level had been established. A scientific and effective overall solution had been proposed to enhance the scientific, standardized, refined and informatization level, strengthen the level and governance capacity, and improve the quality, safety and the coverage of rehabilitation services.

Investigatation of Rehabilitation Human Resources in Shanghai, China / 中国康复理论与实践

Objective:To investigate the rehabilitation human resources in Shanghai. Methods:Based on World Health Orgnization Rehabilitation in Health Service System: Action Guide, Rehabilitation Information Collection Template of Supporting Tools for Systematic Assessment of Rehabilitation Status was implemented by Shanghai Rehabilitation Medical Association in accordance with the requirements of Shanghai Rehabilitation Treatment Quality Control Center to investigate the number and knowledge structure of rehabilitation-related practitioners in Shanghai. Results:Totally, 311 medical institutions were investigated and 254 institutions set up rehabilitation medicine department, accounting for 82.47%. There were 1414 rehabilitation practitioners and 528 registered rehabilitation physicians, accounting for 37.34%; among them, senior, intermediate and junior professional titles were 142 (26.89%), 262 (49.62%) and 124 (23.48%), respectively. There were 2668 rehabilitation therapists, among which the senior, intermediate and junior professional titles were 11 (0.41%), 461 (17.28%) and 2196 (82.31%), respectively. There were 1614 rehabilitation nurses, among which the senior, intermediate and junior professional titles were 13 (0.81%), 476 (29.49%) and 1125 (69.70%), respectively. There were 2.17 rehabilitation physicians, 11.11 rehabilitation therapists and 6.65 nurses per 100 000 population, which is nearly 1/5 of the international level. There were 121 institutions without rehabilitation medical practitioners and 40 multi-point rehabilitation medical practitioners. Conclusion:There is a big gap in rehabilitation physicians, therapists and nurses in Shanghai, compared with the international level. Based on the imperfect occupational series and qualification certification of physiotherapists, occupational therapists, speech therapists and other specialties, it is suggested to conduct targeted job training in multiple channels and forms, especially to strengthen standardized job training and rehabilitation transformation training for rehabilitation practitioners. It is needed to promote the standardized training of resident and specialist rehabilitation practitioners more quickly to meet the needs of clinical rehabilitation work.

Advance in Biomechanical Parameters of Knee Osteoarthritis (review) / 中国康复理论与实践

Knee osteoarthritis is a common chronic degenerative disease in the elderly. Its occurrence and development are closely related to biomechanical factors. The force of knee joint is affected by different factors, such as joint morphology, lower limb alignment, muscle contractions, external load, soft tissue traction and so on. Due to the limitation of in vivo measurement, biomechanical parameters based on motion analysis techniques have been widely used in clinical research. At present, biomechanical parameters which are widely studied and applied in clinical research include knee adduction moment, knee adduction impulse, knee flexion moment, and knee varus thrust. It is important to observe the changes of knee joint biomechanical parameters during the occurrence and development of knee osteoarthritis for researching etiology, diagnosis, intervention and treatment.

Intestinal microbiota composition in patients with amyotrophic lateral sclerosis: establishment of bacterial and archaeal communities analyses / 中华医学杂志(英文版)

BACKGROUND@#Emerging evidences have indicated that the composition of gut microbiota was significantly influenced by central nervous system diseases. The digestion and metabolism disturbances of patients with amyotrophic lateral sclerosis (ALS) might be strongly associated with ALS; however, this has rarely been evaluated in these populations. This study was to evaluate bacterial and archaeal composition of gut flora and the corresponding metabolism performance of these micro-organisms in fecal samples of patients with ALS.@*METHODS@#A comparative study was performed on the intestinal microbiota from eight patients with ALS and eight healthy individuals at Huadong Hospital during November 2017 to April 2018; meanwhile, the metabolite concentrations of human endotoxin, short-chain fatty acids (SCFA), NO2-N/NO3-N, and γ-aminobutyric acid were also evaluated by spectrophotometry methods. The correlations between intestinal microbiota and metabolite concentration were compared between the two groups using one-way analysis of variance; the relative abundance of beneficial and harmful micro-organisms in fecal samples was also analyzed.@*RESULTS@#In general, the richness and evenness of bacterial and archaeal communities of healthy individuals were healthier than that of patients with ALS. The phylum Firmicutes/Bacteroidetes ratio, genus Methanobrevibacter showed an enhancive tendency in patients with ALS, whereas the relative abundance of beneficial micro-organisms (genera Faecalibacterium and Bacteroides) presented a significant decrease tendency in patients with ALS. In addition, the average concentrations of human endotoxin, SCFA, NO2-N/NO3-N, and γ-aminobutyric acid in patients with ALS and healthy individuals were 64.2 vs. 65.3 EU/mL, 57.5 vs. 55.3 μg/mL, 5.7 vs. 5.3 ng/mL, and 6.1 vs. 5.4 μmol/L, respectively, indicating that the digestion and metabolism functions of gastrointestinal tract of patients might decline with this disease.@*CONCLUSIONS@#The relative abundance of beneficial and harmful micro-organisms respectively showed decrease and increase tendency in patients with ALS.

Advance in Mechanism of Hip Muscle Training for Knee Osteoarthritis (review) / 中国康复理论与实践

Knee osteoarthritis (KOA) is a common chronic degenerative joint disease. Hip muscle training, with the advantage of convenience and non-invasion, has been attached great importance by people gradually. Hip muscle training may affect keen medial compartment load, the strength and the electromyography signal of the muscle around the knee joint, and strong hip abductor can protect cartilage, which leads to change the load of the knee joint, and alleviate clinical symptoms. This article reviewed the mechanism of hip muscle training for knee osteoarthritis from the views of biomechanical simulation and electromyography.

Advance in Posture Control for Chronic Ankle Instability (review) / 中国康复理论与实践

This article reviewed the main clinical manifestations, posture stability assessment and treatment progress of chronic ankle instability. In recent years, the evaluation methods of posture stability of chronic ankle instability has gradually adopted biomechanical testing and computerized dynamic balance test, which is more and more objective and accurate. The training method has also evolved from simple static balance training to targeted dynamic posture stability training.

Effects of Attentional Distribution on Balance and Arithmetic Ability of Dual Task Model / 中国康复理论与实践

Objectives:To explore the impact of attentional distribution principle on balance and arithmetic ability when performing calculation-balance dual task. Methods:From October, 2016 to December, 2017, 20 healthy young subjects were selected, and asked to perform eyes opened + calculation and eyes closed + calculation tests under sitting position, and perform single leg standing + eyes opened, single leg standing + eyes closed, single leg standing + eyes opened+ calculation and single leg standing + eyes closed + calculation tests in the static balance instrument. The maximum displacement in mediolateral direction and anteroposterior direction of center of gravity, sway area and sway path length were recorded, as well as the accuracy of counting backwards in steps of seven. Results:The maximum displacement in mediolateral direction and anteroposterior direction, sway area, sway path length were significantly less when eyes opened than eyes closed (t > 8.775, P < 0.001). The maximum displacement in mediolateral direction and anteroposterior direction, and sway area were less when eyes closed during the dual task than single task (t > 2.276, P < 0.05). There was no statistical difference in the maximum displacement in mediolateral direction and anteroposterior direction, and sway area and sway path length when eyes opened during the dual task compared with single task (t < 1.379, P > 0.05). There was no significant difference in the calculation accuracy among the eyes opened + sitting group, the eyes closed + sitting group, the eyes opened + balance test group and the eyes closed + balance test groups (P > 0.05). Conclusion:The low-difficult cognitive dual task does not affect the balance stability and arithmetic ability through the attentional distribution principle, on the contrary, the arithmetic task improves the static balance ability of single leg standing when eyes closed, however, it has no effect on the static balance ability of single leg standing when eyes opened.

Advance in Baduanjin for Rehabilitation of Stroke (review) / 中国康复理论与实践

Baduanjin is a kind of traditional Chinese medical gymnastics. This paper reviewed the effect of Baduanjin exercise on the primary prevention of stroke, as well as on motor function, activities of daily living, quality of life and cognitive function of stroke patients and the related mechanisms.

Functioning Evaluation for Patients with Chronic Diseases Using World Health Organization Disability Assessment Schedule 2.0 / 中国康复理论与实践

Objective:To test the reliability and validity of World Health Organization Disability Assessment Schedule (WHODAS 2.0) for assessment of functioning for people with chronic diseases. Methods:From December, 2017 to June, 2018, 346 patients with chronic diseases who received rehabilitation interventions in Huadong Hospital-Jing'an District Rehabilitation Medical Association were selected and evaluated with WHODAS 2.0, and re-evaluated after two weeks. According to the actual use of clinical rehabilitation, in order to improve the accuracy of functional measurement, the items had been added in the second domain Getting Around including Handling, Moving and Manipulating Objects, while added in the third domain Self Care including Caring for Body Parts and Toileting, and added in the fourth domain Getting Along with People including Establishing Formal Social Interpersonal Relationship, with a total of 40 items. The content reliability and structural validity of the scale with four items added were verified by internal consistency reliability, test-retest reliability and confirmatory factor analysis. Results:The Cronbach's α coefficient of the internal consistency reliability was 0.981, the Pearson coefficient of the test-retest reliability was 0.977 (P < 0.001). The final model of the scale with confirmatory factor analysis had good structural validity: the standardized factor loads between potential variables and corresponding measurement indicators were 0.710-0.960, and the standard errors were 0.023-0.066; Chi square degrees of freedom < 5, root-mean-square error of approximation < 0.1, standardized root mean square residual < 0.08, the comparatice fit index, normal of fit index, relative fit index, incremental fit index and Tucker-Lewis index all > 0.9; the reliability coefficients of the observed variables were > 0.5, the combined reliability of each potential variable > 0.6, and all the average variance extraction of each potential variable > 0.5, all P < 0.001, absolute value of the standardized residual < 3, Modification Index < 4. There was significant difference in the total score and scores of domains among the patients with different diseases (F > 10.21, P < 0.001) Conclusion:WHODAS 2.0 can be used as an assessment tool for the overall health and functioning for people with chronic diseases. Each item, including four new items added, had good content reliability and structural validity.

Intestinal microbiota composition in patients with amyotrophic lateral sclerosis: establishment of bacterial and archaeal communities analyses / 中华医学杂志(英文版)

Background@#Emerging evidences have indicated that the composition of gut microbiota was significantly influenced by central nervous system diseases. The digestion and metabolism disturbances of patients with amyotrophic lateral sclerosis (ALS) might be strongly associated with ALS; however, this has rarely been evaluated in these populations. This study was to evaluate bacterial and archaeal composition of gut flora and the corresponding metabolism performance of these micro-organisms in fecal samples of patients with ALS.@*Methods@#A comparative study was performed on the intestinal microbiota from eight patients with ALS and eight healthy individuals at Huadong Hospital during November 2017 to April 2018; meanwhile, the metabolite concentrations of human endotoxin, short-chain fatty acids (SCFA), NO2-N/NO3-N, and γ-aminobutyric acid were also evaluated by spectrophotometry methods. The correlations between intestinal microbiota and metabolite concentration were compared between the two groups using one-way analysis of variance; the relative abundance of beneficial and harmful micro-organisms in fecal samples was also analyzed.@*Results@#In general, the richness and evenness of bacterial and archaeal communities of healthy individuals were healthier than that of patients with ALS. The phylum Firmicutes/Bacteroidetes ratio, genus Methanobrevibacter showed an enhancive tendency in patients with ALS, whereas the relative abundance of beneficial micro-organisms (genera Faecalibacterium and Bacteroides) presented a significant decrease tendency in patients with ALS. In addition, the average concentrations of human endotoxin, SCFA, NO2-N/NO3-N, and γ-aminobutyric acid in patients with ALS and healthy individuals were 64.2 vs. 65.3 EU/mL, 57.5 vs. 55.3 μg/mL, 5.7 vs. 5.3 ng/mL, and 6.1 vs. 5.4 μmol/L, respectively, indicating that the digestion and metabolism functions of gastrointestinal tract of patients might decline with this disease.@*Conclusions@#The relative abundance of beneficial and harmful micro-organisms respectively showed decrease and increase tendency in patients with ALS.

Changes of Serum Biomarkers levels in Early Stage of Alcohol-induced Liver Injury in Rats / 中国实验方剂学杂志

Objective:To investigate the dynamic changes of the biomarkers of alcoholic liver injury, including glutamate dehydrogenase(GLDH), α-glutathione-S-transferase(α-GST), purine nucleotide phosphorylase(PNP), and arginine enzyme 1(Arg1), and clarify whether these indexes can be used as early diagnostic biomarkers for alcoholic liver injury. Method:48 Wistar rats were randomly divided into a blank group and a model group, 24 rats in each group, half male and half female. After fasting but except water for 7 h, 50% ethanol/10 mL·kg-1 was given to the model group by intragastric administration and the same volume of normal saline was administered to the blank group. After 1 h, 50% ethanol was again given for once by intragastric administration according to the previous dosage. In the blank group, the same volume of normal saline was administered. After modeling and administration for 6 d, acute alcoholic liver injury model was established. 3 h after the last intragastric administration of alcohol at day 2, 3, 4, 6, six rats (half male and half female) in each group were randomly selected. All the animals were sacrificed to determine the aspartate aminotransferase(AST), alanine aminotransferase(ALT), alkaline phosphatase(ALP), bilirubin(TBIL), GLDH, α-GST, PNP, and Arg1 levels. Result:As compared with the blank group, the levels of ALT, AST, ALP, TBIL, GLDH, PNP, α-GST and Arg1 in the model group were significantly different (Pα-GST and Arg1 levels were increased earlier and more significantly than ALT and AST levels. Conclusion:GLDH, PNP, α-GST and Arg1 can be used as biomarkers for early detection of alcoholic liver injury.

Changes of CCl4-induced of Liver Injury in Rats for 24 Hours / 中国实验方剂学杂志

Objective:To replicate the animal model of liver injury in rats by using carbon tetrachloride (CCl4), investigate the dynamic changes of early biomarkers of liver injury, namely glutamate dehydrogenase (GLDH), purine nucleotide phosphorylase(PNP), α-dynamic changes of glutathione-S-transferase (α-GST) and arginase 1(Arg1), and provide experimental evidence for early detection of acute liver injury. Method:Forty-eight Wistar rats were randomly divided into a blank group and a model group. The model group was intraperitoneally injected with 10 mL·kg-1 10% CCl4 olive oil solution, fasting but except water. Animals were sacrificed at 3, 6, 12, and 24 h. The serum liver function alanine aminotransferase(ALT), aspartate aminotransferase (AST), bilirubin (TBIL), alkaline phosphatase (ALP) levels, α-GST, Arg1, GLDH, PNP levels, and liver homogenate superoxide dismutase (SOD), glutathione (GSH), malondialdehyde (MDA) levels were then detected. Result:As compared with blank group, the levels of ALT, AST, TBIL, α-GST, Arg1, GLDH, PNP and MDA were increased significantly 3 h after administration, and SOD was decreased significantly(Pα-GST, ARG-, GLDH, TBIL, ALP and MDA were increased significantly, while GSH and SOD were decreased significantly (PPα-GST, Arg1, TBIL, ALP and MDA were significantly increased, while GSH and SOD were significantly decreased (PConclusion:α-GST, Arg1, GLDH and PNP have better sensitivity than traditional liver function test indicators, and can be used for early detection of liver injury induced by CCl4 in rats.

Dynamic Changes of Biomarker Levels in Early Stage of Acetaminophen-induced Liver Injury / 中国实验方剂学杂志

Objective:To determine whether glutathione dehydrogenase (GLDH), purine nucleotide phosphorylase (PNP), α-glutathione-S-transferase (α-GST), and arginase 1 (Arg1) can be used as the early biomarkers of drug-induced liver injury by comparing the changes of traditional biomarkers alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP), total bilirubin (TBIL) and potential biomarkers GLDH, PNP, α-GST and Arg1 in acetaminophen (APAP)-induced liver injury model rats. Method:The 48 rats were randomly divided into two groups:blank group and model group. 24 rats in each group, half male and half female. The model group received 1 250 mg·kg-1 APAP solution by intragastric administration to establish the drug-induced liver injury. 6 rats (half male and half female) were randomly selected from each group at 3, 6,12 and 24 h after APAP was given to the model group, to detect the levels of ALT, AST, ALP, TBIL, GLDH, PNP, α-GST, Arg1 in serum and levels of GLDH, PNP, α-GST, Arg1 in liver tissue homogenate at each time point Histopathological changes of liver tissues were observed by hematoxylin-eosin (HE) staining. Result:As compared with the blank group, the levels of ALT, AST, ALP, TBIL, GLDH, PNP, α-GST and Arg1 in serum and liver homogenates were significantly increased in model group(PPα-GST and Arg1 levels in serum and liver tissues of rats in the model group were increased earlier and more significantly than ALT and AST levels. Conclusion:GLDH, PNP, α-GST and Arg1 can be used as biomarkers for early detection of drug-induced liver injury.