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Objective To investigate the association between metabolic associated fatty liver disease (MAFLD) and sleep disorders. Methods A total of 222 patients with MALFD who were admitted to Panjin Central Hospital from February 2020 to February 2021 and 270 healthy individuals were enrolled as subjects. According to age, the patients with MALFD were divided into youth group with 93 patients, middle-aged group with 76 patients, and elderly group with 53 patients; according to controlled attenuation parameter (CAP) of liver fat, the patients were divided into non-steatosis group with 23 patients, mild steatosis group with 85 patients, moderate steatosis group with 76 patients, and severe steatosis group with 38 patients; according to liver stiffness measurement (LSM), the patients were divided into non-progressive fibrosis group with 124 patients and progressive fibrosis group with 98 patients. Related data were collected, including general information such as age and sex and laboratory markers such as routine blood test results and biochemistry, and after informed consent was obtained, three sleep scales, i.e., Pittsburgh Sleep Quality Index (PSQI) scale, Epworth Sleepiness Scale (ESS), and Morningness-Eveningness Questionnaire (MEQ), were completed independently. The MAFLD group and the healthy control group were compared in terms of general information and laboratory markers to investigate the association between MAFLD and sleep disorders under different grouping criteria. The chi-square test was used for comparison of categorical data between two groups; the t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups; the Kruskal-Wallis H test was used for comparison between the groups of MAFLD patients with different ages and degrees of hepatic steatosis and pairwise comparison within each group. A logistic regression analysis was used to investigate the independent risk factors for MAFLD, and a Spearman correlation analysis was used to investigate the correlation of hepatic steatosis degree and fibrosis degree with sleep quality, somnolence, and circadian rhythm. Results There were significant differences in age, sex, hypertension, diabetes, and smoking between the MAFLD group and the healthy control group (all P < 0.05). Compared with the healthy control group, the MAFLD group had significantly higher hemoglobin, white blood cell count, lymphocyte percentage, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, serum uric acid, low-density lipoprotein, total bilirubin, total cholesterol, triglyceride, and body mass index and significantly lower albumin and high-density lipoprotein (all P < 0.05). Compared with the healthy control group, the MAFLD group had significantly higher PSQI score ( t =35.529, P < 0.001) and ESS score ( t =24.647, P < 0.001) and significantly lower MEQ score ( t =-22.416, P < 0.001) and sleep time ( t =-8.660, P < 0.001). With the increase in age in the MAFLD group, hepatic steatosis degree, liver fibrosis degree, and PSQI score showed an increasing trend, and pairwise comparison of each scoring factor between groups showed statistical significance (all P < 0.05). Compared with the healthy control group, the MAFLD group had a significantly higher proportion of patients with definitely evening type, moderately evening type, or intermediate type and a significantly lower proportion of patients with moderately morning type or definitely morning type (all P < 0.05), and MEQ score tended to decrease with the increase in hepatic steatosis degree and liver fibrosis degree, with significant differences between two groups (all P < 0.05). The multivariate logistic regression analysis showed that overweight/obesity (odds ratio [ OR ]=3.166, P =0.027), diabetes ( OR =6.811, P =0.045), increase in white blood cell count ( OR =2.301, P < 0.001), increase in lymphocyte percentage ( OR =1.316, P =0.002), poor sleep quality ( OR =8.493, P < 0.001), a high degree of somnolence ( OR =5.420, P < 0.001), and circadian rhythm disturbance ( OR =3.805, P < 0.001) were risk factors for MAFLD. The Spearman correlation analysis showed that in the MAFLD group, hepatic steatosis degree was positively correlated with PSQI score ( r =0.444, P < 0.001) and ESS score ( r =0.339, P < 0.001) and was negatively correlated with MEQ score ( r =-0.195, P =0.004), and liver fibrosis degree was positively correlated with PSQI score ( r =0.518, P < 0.001) and ESS score ( r =0.373, P < 0.001) and was negatively correlated with MEQ score ( r =-0.250, P =0.004). Conclusion Compared with healthy individuals, the patients with MAFLD often have sleep disorders, and the severity of sleep disorders increases with age, hepatic steatosis degree, and liver fibrosis degree. Obesity, diabetes, and sleep disorders are risk factors for the onset of MAFLD.
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Objective To investigate the effect of pseudolaric acid B(PAB) on the expression of vascular endothelial growth factor (VEGF) in human hepatoma BEL-7402 cells. Methods BEL-7402 cells were cultured with PAB (0, 0.5, 1.0, 2.0, 4.0 and 8.0μmol · L-1) for 6 h and stained with 0.4%trypan blue. The cell viability was observed and calculated under the microscope. The cell proliferation was detected by WST-8 analysis. The expression of VEGF mRNA in BEL-7402 cells was detected using RT-PCR method. The expression of VEGF protein in BEL-7402 cells was detected using Western blot assay. Results There was no significant difference in the cell proliferation of BEL-7402 cells between different PAB treat-ment groups and control group. With the increased concentration of PAB, the expressions of VEGF mRNA were significantly decreased in different PAB treatment groups (1.90±0.02,1.31±0.03,0.86±0.04,0.60±0.03 and 0.34±0.02) compared with that of control group (2.53±0.07, P＜0.01). The expressions of VEGF protein were significantly decreased in different PAB treat-ment groups (2.60±0.09, 2.42±0.07, 1.85±0.05, 0.92±0.05 and 0.60±0.04) compared with that of control group (3.06±0.15, P＜0.01). Conclusion PAB can inhibit the expressions of VEGF mRNA and protein in BEL-7402 cells.
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Objective To investigate the changes of endothelial function during myocardial ischemia and reperfusion (I/R) injury of rabbits, and the protection of ShenFu injection (SFI) for the injury, as well as the related mechanism. Methods Twenty one Japanese white rabbits were randomly divided into 3 groups (7 each): sham operated group (A), I/R group (B) and SFI-treated I/R group (C). The activity of serum endothelial nitric oxide synthase(eNOS), the concentrations of serum nitric oxide products (NOP) and plasma endothelin (ET) before ligation of coronary artery, 40min after ischemia and 40min after reperfusion were determined. The concentration of total superoxide dismutase (T-SOD) and malonyl-dialdehyde (MDA) in myocardial tissue were determined. Ultrastructure of myocardial cell was observed by electro microscope. Results 1) Serum eNOS and NOP decreased and plasma ET increased ingroup B than that ingroup A after 40min of ischemia (P<0.01), even more significant after 40min of reperfusion. NOP was correlated positively with ETafter 40min of ischemia (P<0. 05) and after 40min of reperfusion ( P<0. 01). In 40min after reperfusion, T-SOD was decreased and MDA was increased ingroup B than that in group A, significantly (P<0. 01). NOP were correlated positively with T-SOD, while were correlated negatively with MDA (P<0.05). ET was correlated positively with MDA, while was correlated negatively with T-SOD (P<0.05). Ultrastructure of myocardial cell changed abnormally. 2) SFI can increase eNOS and NOP after 40min ischemia and 40min reperfusion, and decrease ET after 40min reperfusion, significantly (P<0. 01). SFI can increase T-SOD and decrease MDA significantly (P<0. 01), the abnormality of myocardial cells can be relieved obviously. Conclusion SFI can improve the endothelial function in which free radicals are involved, and prevent myocardial tissue from I/R injury.
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BACKGROUND: With the extensive development of reperfusion treatment on acute myocardial infarction, myocardial ischemia/reperfusion (I/R) injury cause clinical concern intensively. In recent years, nitric oxide (NO) and endothelin (ET)are hot point of researches. Myocardial protective role of Chinese traditional medicine is highly regarded.OBJECTIVE: To study the change of endothelial function during myocardial I/R injury of rabbits, the effect of shenmai injection (SMI) and mechanism.DESIGN: Randomized controlled animal study.SETTING: The First Hospital Affiliated to China Medical University.MATERIALS: The experiment was carried out in Laboratory Animal Center, Department of Biochemistry and the Second Electron Microscope Room of China Medical University from September 2002 to January 2003. Twenty-one healthy female Japanese white rabbits weighing 1.5-2.5 kg were in this study. SMI was produced by the Three Nine Medicine Industry Co., Ltd., Yaan (batch number: 010110).METHODS: ① Grouping: The animals were randomly divided into three groups, 7 cases of each group. Sham-operation group: Rabbits were gone through thread only and were not ligated coronary artery; I/R group and I/R + SMI group:Coronary artery occlusion was maintained 40 minutes at the ligature was released and reperfusion continued for 40 minutes. ② Administration: Rabbits in I/R group were injected 20 mL saline through ear margin vein (injected one third of saline at 10 minutes before ligature, two thirds of saline when unloosing the ligature). Rabbits in I/R + SMI group were injected with SMI which was diluted with saline to 20 mL (1.5 mL/kg). The method of injection was as same as I/R group.③ Index observation: 4 mL venous blood samples were obtained before ligature, at 40 minutes of ischemia and 40minutes of reperfusion. Half of the blood samples were separated serum to detect NO production (NOP) by nitric acid deacidizing enzyme process; another were separated plasma to detect ET by radiation immunity process. In the experiment ends, NOP and ET of myocardial tissue were detected; total of superoxide dismutase (T-SOD) of myocardial tissue were detected by sulphur purine oxidase process and malondialdehyde (MDA) were detected by thiobarbituric acid development process. Myocardial ultrastructure was observed with transmission electro microscope.MAIN OUTCOME MEASURES: ① Contents of serum NO and plasma ET in each.group before ligature, at 40 minutes of ischemia and 40 minutes of reperfusion; ② contents of NOP, ET, T-SOD and MDA of myocardial tissue; ③ Myocardial ultrastructure.RESULTS: All 21 rabbits were involved in the final analysis. ① Content of serum NOP: Content of serum NOP was lower in I/R group than that in sham-operation group at 40-minute ischemia and 40-minute perfusion (P ＜ 0.01), but was higher in I/R +SMI group than that in I/R group (P＜ 0.01). ② Content of plasma ET: Content of plasma ET was higher in I/R group than that in sham-operation group at 40-minute ischemia and 40-minute perfusion (P ＜ 0.01), but was lower in I/R +SMI group than that in I/R group (P ＜ 0.01). ③ Content of NOP was negative correlation with that of ET 40-minute ischemia and 40-minute perfusion (P ＜ 0.05, P ＜ 0.01). ④ Content of NOP and activity of T-SOD: Those were lower in I/R group than those in sham-operation group at 40-minute perfusion (P ＜ 0.01), but were higher in I/R +SMI group than those in I/R group (P＜ 0.01). ⑤ Contents of ET and MDA: Those were higher in I/R group than those in sham-operation group (P ＜ 0.01), but were lower in I/R +SMI group than those in I/R group (P ＜ 0.01). ⑥ Content of NOP was positive correlation with T-SOD activity (P ＜ 0.05), and negative correlation with content of MDA (P ＜ 0.05). In addition, content of ET was negative correlation with T-SOD activity (P ＜ 0.05), and positive correlation with content of MDA (P ＜ 0.05).CONCLUSION: Myocardial I/R leads to abnormality of vascular endothelial function, and SMI can improve endotheliual function and relieve myocardial I/R injury.
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Objective To study the therapeutic effect of plasma exchange and plasma perfusion(PE+PP)on acute fatty liver of pregnancy.Methods Twenty-one patients with acute fatty liver of pregnancy were divided into two groups.In the treated group,the patients were treated with (PE+PP) on the basis of the conventional therapy,and the control group received the conventional therapy only?Liver function,kidney function and prothrombin activity(PTA) before treatment and 4 weeks,6 weeks after treatment were observed.Results After treatment with (PE+PA),the liver function,kidney function and PTA were ameliorated at 4 weeks and 6 weeks(P