Clinical features of bone mass loss in liver cirrhosis and its association with sarcopenia / 临床肝胆病杂志

ObjectiveTo investigate the influence of sarcopenia on bone mass loss， the risk factors for bone mass loss in liver cirrhosis， and the correlation between body composition and bone mineral density （BMD） by comparing the clinical features of bone mass loss in patients with liver cirrhosis. MethodsA total of 92 patients who were hospitalized and diagnosed with liver cirrhosis in Department of Gastroenterology， The Second Affiliated Hospital of Kunming Medical University， from April to December of 2022 were enrolled， and based on the results of dual-energy X-ray absorptiometry， they were divided into bone mass loss group （osteopenia/osteoporosis） with 57 patients and normal bone mass group with 35 patients. The two groups were compared in terms of general data， laboratory examination， imaging data， and body composition analysis. The independent samples t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the continuity correction chi-square test was used for comparison of categorical data between two groups； Pearson correlation analysis and Spearman correlation analysis were used to investigate correlation； a binary logistic regression analysis was used to investigate the risk factors for bone mass loss in liver cirrhosis. ResultsCompared with the normal bone mass group， the bone mass loss group had significantly higher age （t=-3.597， P<0.05）， proportion of female patients （χ2=8.393， P<0.05）， N-terminal middle molecular fragment of osteocalcin （N-MID） （Z=-3.068， P<0.05）， β isomer of C-terminal telopeptide of type I collagen （β-CTX） （t=-2.784， P<0.05）， and proportion of patients with sarcopenia （χ2=13.884， P<0.05） and significantly lower calcitonin （CT） （Z=-2.340， P<0.05） and L3 skeletal muscle index （L3-SMI） （t=4.621， P<0.05）. Compared with the normal bone mass group， the bone mass loss group had significantly lower total muscle mass （Z=-2.952， P<0.05）， right upper limb muscle mass （Z=-2.929， P<0.05）， left upper limb muscle mass （Z=-2.680， P<0.05）， right lower limb muscle mass （Z=-3.366， P<0.05）， left lower limb muscle mass （Z=-3.374， P<0.05）， presumed bone mass （t=2.842， P<0.05）， body water mass （Z=-2.779， P<0.05）， basal metabolic rate （BMR） （Z=-3.153， P<0.05）， and BMD of L1— L4 and femoral neck （t=9.789， t=10.280， t=10.832， Z=-7.298， t=8.945， all P<0.05）. Total muscle mass， muscle mass of trunk and limbs， presumed bone mass， BMR， and body water mass in body component analysis were positively correlated with L1 — L4 BMD and femoral neck BMD （all P<0.05）， and fat mass was positively correlated with L1 — L4 BMD （all P<0.05）. Sarcopenia （odds ratio ［OR］=8.737， 95% confidence interval ［CI］： 2.237 — 34.129， P=0.002）， age （OR=1.094， 95%CI： 1.019 — 1.175， P=0.013）， and N-MID （OR=1.095， 95%CI： 1.019 — 1.176， P=0.014） were independent risk factors for bone mass loss in patients with liver cirrhosis. ConclusionOld age， female sex， sarcopenia， elevated N-MID， elevated β-CTX， reduction in CT， low muscle mass， low presumed bone mass， low BMR， and low body water mass are the features of bone mass loss in patients with liver cirrhosis， and sarcopenia， age， and N-MID are independent risk factors for bone mass loss in patients with liver cirrhosis. Detailed assessment of body composition changes can help to identify abnormal BMD in patients with liver cirrhosis.

Advances in the pathogenesis, diagnosis, and treatment of renal injury in liver cirrhosis / 临床肝胆病杂志

Patients with decompensated cirrhosis often have a reduction in renal function due to severe hepatic insufficiency which results in reduced inactivation of vasodilators, hemodynamic disorders, immune disorders, and infections, and without timely intervention, patients may gradually develop from early prerenal injury to late renal failure. Patients tend to have a low survival rate and great difficulties in treatment. With the gradual clarification of the classification and diagnostic criteria for kidney injury and the discovery of an increasing number of markers for kidney injury, early diagnosis and localization of kidney injury are of great importance for improving the prognosis of patients. This article analyzes the new advances in the pathogenesis, diagnostic criteria, and treatment of renal injury in cirrhotic patients in recent years, so as to provide help for the clinical diagnosis and treatment of cirrhotic patients with renal injury.

Advances in the risk factors, pathogenesis, and treatment of liver cirrhosis with osteoporosis / 临床肝胆病杂志

Osteoporosis is a common extrahepatic complication of liver cirrhosis, and it not only increases the economic burden of patients, but also brings adverse effects on their quality of life and prognosis. Recent studies have shown that sarcopenia, adiponectin, leptin, irisin, and inflammatory factors are involved in the development of osteoporosis in patients with liver cirrhosis, and commonly used anti-osteoporosis drugs include calcium supplement, vitamin D, and bisphosphonates. This article reviews the advances in the risk factors, pathogenesis, and treatment of liver cirrhosis with osteoporosis and points out that there are still controversies over the influence of some factors on osteoporosis, and further studies are needed to explore related pathogeneses and safe and effective treatment regimens.

Epidemiological characteristics of overseas imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021 / 预防医学

Objective@#To investigate the epidemiological characteristics of overseas imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021, so as to provide insights into the prevention and control of overseas imported arthropod-borne infectious diseases.@*Methods@#The data pertaining to imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021 were collected from the Chinese Disease Prevention and Control Information System, and the temporal distribution, regional distribution, population distribution, sources, diagnosis and treatment of imported dengue fever and malaria cases were descriptively analyzed.@*Results@#Totally 4 332 overseas imported dengue fever cases and 2 011 overseas imported malaria cases were reported in Yunnan Province form 2015 to 2021, which accounted for 30.09% of all reported dengue fever cases and 98.53% of all reported malaria cases. The number of overseas imported dengue fever and malaria cases peaked from August to November (83.13% of all imported dengue fever cases) and from April to July (59.08% of all imported malaria cases), and the cases were predominantly reported in Dehong Prefecture (50.99% and 58.88%), with farmers as the predominant occupation (40.21% and 67.93%). The dengue fever and malaria cases were mainly imported from Southeast Asia (99.04% and 88.21%), and the proportions of definitive diagnosis of dengue fever and malaria were 88.33% and 97.80% at township hospitals, respectively.@*Conclusions@#The number of overseas imported dengue fever and malaria cases peaked from August to November and from April to July in Yunnan Province from 2015 to 2021, and the cases were predominantly reported in Dehong Prefecture and imported from Southeast Asia, with farmers as the predominant occupation.

Current status of research on nutritional support in end-stage liver disease / 临床肝胆病杂志

There is a high prevalence rate of malnutrition in patients with end-stage liver disease, which often promotes disease progression and has a negative impact on the prognosis of patients. This article briefly describes the etiology of malnutrition in end-stage liver disease and introduces the research advances in nutrition screening, evaluation, and treatment in end-stage liver disease in China and globally, hoping to provide inspiration for nutritional support in patients with end-stage liver disease in China.

Mediating role of psychological capital on occupational stress and job satisfaction in disease prevention and control personnel / 中国职业医学

OBJECTIVE: To explore the mediating effect of psychological capital on occupational stress and job satisfaction in disease prevention and control personnel. METHODS: A cluster random sampling method was used to select 541 stuffs of the center of disease control( CDC) as the research subjects from Zhumadian City in Henan Province. The Effort-Reward Imbalance Questionnaire, Pychological Capital Questionnaire and Minnesota Satisfaction Questionnaire were used to investigate occupational stress,psychological capital and job satisfaction. RESULTS: The total scores of occupational stress,psychological capital and job satisfaction in the CDC staff were( 65. 9 ± 7. 3),( 100. 3 ± 14. 1),and( 70. 7 ± 13. 0),respectively. Both contribution and internal input were negatively correlated with job satisfaction( r were-0. 397 and-0. 158,P < 0. 05). Reward,self-efficacy,hope,tenacity and optimism were positively correlated with job satisfaction( r were 0. 210,0. 245,0. 485,0. 309 and 0. 332,P < 0. 05). The intermediary role of psychological capital between occupational stress and job satisfaction was-0. 10,accounting for 23. 2% of the total effect. CONCLUSION: Psychological capital plays a partial negative mediating role between occupational stress and job satisfaction.

Mediating effect of township leaders' perceived organizational support on occupational stress and job satisfaction / 中国职业医学

OBJECTIVE: To investigate the job satisfying degree of township leaders and to explore the mediating effect of perceived organizational support on occupational stress and job satisfaction.METHODS: A total of 1 545 township leaders from Huludao City,Fengcheng City and Fushun City in Liaoning Province were selected as study subjects by cluster random sampling method.The questionnaire of Effort-Reword Imbalance,the Minnesota Satisfaction Questionnaire and the Perceived Organizational Support were used to investigate their occupational stress,job satisfaction and perceived organizational support.RESULTS: The total score of occupational stress in township leaders was(66.1 ± 6.8),and job satisfaction was(71.1 ± 13.1).The score of perceived organizational support was(42.2 ± 9.9).Occupational stress and perceived organizational support had direct prediction role on job satisfaction(P<0.01).The mediation effect of perceived organizational support between occupational stress and job satisfaction was 0.190,accounting for 48.3% of the total effect.CONCLUSION: Organizational support plays a part of mediating role on occupational stress and job satisfaction.

Pharmaceutical Care for Drug-induced Liver Injury / 中国药师

Objective:To investigate the pharmaceutical care methods for the patients with drug-induced liver injury. Methods:The participation process of clinical pharmacists in 3 cases of typical drug-induced liver injury was with detailed introduction and analy-sis in the paper. Results:The case 1 indicated that new drugs probably with drug-induced liver injury should be warned in the process of clinical medication. The case 2 suggested that TDM, as a useful assessment weapon, could be fully used to find the source medi-cines when drug-induced liver injury occurred. The case 3 showed the specific cases, especially the patients with abnormal liver func-tion, should be focused on, the medicines with high liver toxicity should be avoided and the medicines with mild liver toxicity could be chosen. Conclusion:Clinical pharmacists should participate in the clinical practice of drug-induced liver injury with multi-channel and multi-link, and pay attention to the drugs with high risk of liver injury. Meanwhile, clinical pharmacists should perform TDM monito-ring to provide positive evidence for the diagnosis of drug-induced liver injury, and focus on the liver and kidney functions to provide better pharmaceutical care for the patients.

Effects of MCTP on production of nitric oxide and expression of eNOS protein of cultured pulmonary artery endothelial cells and contractility of cultured pulmonary artery smooth muscle cells / 中国药理学通报

Aim To investigate the effects of monocrotaline pyrrole on production of nitric oxide and expression of eNOS protein of cultured pulmonary artery endothelial cells and on contractility of cultured pulmonary artery smooth muscle cells.Methods DAF-2 fluorescence technique was used to determine NO level,Western blot analysis was performed to determine the level of eNOS protein,and collagen gel contraction system was adopted to analyze muscle contractility.Results NO production induced by ACh and expression of eNOS protein were obviously inhibited by monocrotaline pyrrole compared with those of control group and gel contraction area in MCTP-treated cells induced by Thapsigargin obviously decreased.Conclusions monocrotaline pyrrole could inhibit the level of the ACh-induced production of NO and expression of eNOS protein,and enhance the contractility of pulmonary artery smooth muscle cells,which may be one of the possible mechanisms of MCTP-induced pulmonary artery hypertension.