Value of blood ammonia and cholinesterase in the early diagnosis of liver cirrhosis with minimal hepatic encephalopathy / 临床肝胆病杂志

Objective To investigate the value of serum markers in the early diagnosis of liver cirrhosis with minimal hepatic encephalopathy (MHE). Methods A prospective analysis was performed for 81 patients who were hospitalized and treated in General Hospital of Ningxia Medical University from April 2020 to February 2022, and all these patients were diagnosed with hepatitis B cirrhosis based on clinical manifestation, laboratory examination, and radiological examination or liver biopsy. According to digital connection test A (NCT-A) and digital symbol test (DST), these patients were divided into simple cirrhosis group with 45 patients and MHE group with 36 patients. Related indices were measured, including liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and total bilirubin (TBil)], albumin, blood ammonia, cholinesterase, and prothrombin time. The independent samples t -test was used for comparison of normally distributed continuous data between two groups; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups; the chi-square test was used for comparison of categorical data between groups. The logistic regression analysis and the area under the ROC curve (AUC) were used to investigate the predictive factors for MHE. Results Compared with the simple cirrhosis group, the MHE group had a significant increase in NCT-A score ( Z =-7.110, P < 0.001) and a significant reduction in DST score ( t =12.223, P < 0.001). The univariate analysis showed that there were significant changes in AST, albumin, prothrombin time, cholinesterase, and blood ammonia in the patients with MHE ( Z =-2.319, -2.643, -1.982, -6.594, and -5.331, all P < 0.05), while the multivariate analysis showed that only cholinesterase and blood ammonia were significant predictive factors (all P < 0.05) and were correlated with Child-Pugh score (all P < 0.05). Cholinesterase, blood ammonia, and their combination had an AUC of 0.925, 0.845, and 0.941, respectively, in the diagnosis of MHE, with an optimal cut-off value of 2966, 60, and 0.513, respectively. Conclusion Blood ammonia, cholinesterase, and their combined measurement have a potential clinical value in the early diagnosis of liver cirrhosis with MHE.

Síndrome neuroléptico maligno asociado con intoxicación aguda por un organofosforado: reporte de caso / Neuroleptic malignant syndrome associated with acute organophosphate poisoning: Case report

El síndrome neuroléptico maligno es una condición clínica rara y potencialmente letal que frecuentemente se asocia con el uso de antipsicóticos. En la literatura especializada se encontró únicamente un reporte de caso relacionado con la ingestión de organofosforados. Se presenta un paciente con un cuadro clínico correspondiente al síndrome neuroléptico maligno posterior a la ingestión de clorpirifós. Como resultado de un intento de suicidio con el mencionado organofosforado, el hombre de 57 años presentó deterioro agudo del estado de consciencia, evolución neurológica tórpida e inestabilidad autonómica asociada a rigidez e hipertermia persistentes, así como incremento de la creatina-fosfocinasa (creatine phosphokinase, CPK). Se le administró tratamiento con bromocriptina, con lo cual el cuadro clínico remitió, y fue dado de alta sin secuelas. El diagnóstico del síndrome neuroléptico maligno es clínico y debe contemplarse en cualquier caso de exposición a sustancias que puedan resultar en una desregulación de la neurotransmisión dopaminérgica, con el fin de iniciar el tratamiento oportuno y contrarrestar efectivamente los efectos.

Neuroleptic malignant syndrome is a rare and potentially fatal clinical condition frequently associated with the use of antipsychotics. In the literature, there is only one case report associated with the intake of organophosphates. We present the case of a patient who presented with a clinical picture compatible with neuroleptic malignant syndrome, after the ingestion of an organophosphate (chlorpyrifos). A 57-year-old man who consulted for attempted suicide, acute deterioration of consciousness, torpid neurological evolution, and associated autonomic instability associated with rigidity, persistent hyperthermia, and elevated CPK. Bromocriptine treatment was offered, which resolved the clinical picture. The association with the ingestion of an organophosphate was established, and he was discharged without sequelae. The diagnosis of neuroleptic malignant syndrome is clinical and should be considered in any case of exposure to substances that may lead to dysregulation of dopaminergic neurotransmission in order to initiate timely therapy and impact outcomes.

Efficacy of hemoperfusion in the treatment of severe organophosphorus poisoning in patients and its effects on diaphragm function / 中国基层医药

Objective:To investigate the clinical efficacy of hemoperfusion in the treatment of severe organophosphorus poisoning and its effect on diaphragm function.Methods:Eighty-five patients with severe organophosphorus poisoning who received treatment in Affiliated Huxi Hospital of Jining Medical University (Shanxian Central Hospital), China between January 2018 and January 2020 were included in this study. They were randomly divided into treatment ( n = 43)and control ( n = 42) groups. The control group was given conventional treatment including gastric lavage, catharsis, and application of reactivators and anticholinergic drugs. The treatment group was subjected to three times of hemoperfusion, with an interval of 24 hours between two hemoperfusion interventions based on the conventional treatment used in the control group. Before and after three times of hemoperfusion, serum levels of cholinesterase (CHE), interleukin-6 (IL-6), arterial partial pressure of oxygen (PaO 2), and arterial partial pressure of carbon dioxide (PaCO 2) were measured. The Acute Physiology and Chronic Health Evaluation (APACHE) II score and oxygenation index (OI) in each group were calculated. Right diaphragmatic activity, diaphragmatic thickness at the end of inspiration (DTei) and diaphragmatic thickness at the end of expiration were measured by bedside ultrasound. The diaphragmatic thickening rate (DTF) and diaphragmatic rapid shallow breathing index (D-RSBI) were calculated. Serum CHE and IL-6 levels, OI, diaphragmatic activity, DTF and D-RSBI were compared between the treatment and control groups. The incidence of intermediate syndrome, tracheal intubation rate, 28-day mortality rate, and hospital stay were compared between the two groups. Results:Before hemoperfusion, there were no significant differences in serum levels of CHE and IL-6, OI, right diaphragmatic activity, DTF, and D-RSBI between the treatment and control groups (all P > 0.05). After three times of hemoperfusion, serum IL-6 level and D-RSBI in the treatment group were (37.9 ± 6.2) ng/L and (0.77 ± 0.20) times /min/mm, which were significantly lower than those in the control group [(45.9 ± 5.3) ng/L, (0.90 ± 0.16) times/min/mm ( t = -6.295, -3.382, P < 0.001, P = 0.001)]. Serum CHE level, OI, DE and DTF in the treatment group were (2.29 ± 0.52) kU/L, (264.5 ± 24.3) mmHg, (16.5 ± 1.9) mm, (27.2 ± 4.7) %, respectively, which were significantly higher than those in the control group [(1.96 ± 0.39) kU/L, (252.6 ± 27.2) mmHg, (14.3 ± 1.6) mm, (23.5 ± 4.1) %, t = 3.258, 2.141, 5.598, 3.877, all P < 0.05]. The incidence of intermediate syndrome, tracheal intubation rate, hospital stay in the treatment group were [4.7% (2/43)], [2.3% (1/43)] and [(11.8 ± 1.8) days], respectively, which were significantly lower than those in the control group [23.8% (10/42), 19.0% (8/42) and (12.9 ± 1.8) days, χ2 = 6.432, P = 0.011; χ2 = 6.276, P = 0.012; t = -2.932, P = 0.004]. There was no significant difference in 28-day mortality rate between the two groups ( P > 0.05). Conclusion:Hemoperfusion can improve diaphragmatic function, reduce inflammatory reaction and shorten hospital stay in patients with severe organophosphorus poisoning.

Effect of hemoperfusion on ChE activity and toxicant clearance in patients with organophosphorus poisoning / 中国基层医药

Objective To investigate the effect of hemoperfusion (HP) on the activity of ChE in blood ofpatients with organophosphorus poisoning,and its toxicant clearance effect.Methods From January 2017 to January 2019,60 patients with organophosphorus poisoning in Shengjing Hospital Affiliated to China Medical University were divided into observation group and control group according to random number table method , with 30 cases in each group.The control group was treated with routine treatment ,while the observation group was treated with HP on the basis of routinetreatment.Thetherapeuticeffectsof thetwogroupswerecompared.Results Thedurationof mechanical ventilation and conscious awakening in the observation group were (3.07 ±1.14) d and (1.42 ±0.37) d,respectively, which were significantly shorter than those in the control group [(4.15 ±1.22) d,(2.01 ±0.58)d](t=3.543, 4.697,all P<0.05).The dosage of atropine in the observation group [(252.57 ±28.44) mg] was significantly less than that in the control group [(282.61 ±29.82)mg](t=3.993,P<0.05).The activity of cholinesterase after 12 h and 24 h of treatment was significantly higher than those before treatment (all P<0.05).After 12 h and 24 h of treatment,the cholinesterase activities in the observation group were (1128.64 ±152.49) U/L and (1422.08 ± 184.68)U/L,respectively,which were higher than those in the control group[(912.73 ±144.61) U/L and (1165.32 ± 173.27)U/L](t=5.627,5.553,all P<0.05).After 1 d and 3 d of treatment,the concentrations of organophosphorus poisons in the observation group were (1.08 ±0.30) mg/L and (0.62 ±0.18) mg/L,respectively,which were significantly lower than those in the control group[(1.32 ±0.35)mg/L and (0.84 ±0.27)mg/L](t =2.852, 3.713,all P<0.05).The incidences of rebound ,intermediate syndrome and multiple organ failure in the observation group were 3.33％(1/30),6.67％(2/30) and 13.33％(4/30),respectively,which were lower than those in the control group［23.33％(7／30),23.33％(7／30),36.67％(11／30)］(χ2 ＝5.192,3.278,4.356,all P ＜0.05).Conclusion HP has obvious effect on the activity of ChE and the concentration of blood poisons in patients with organophosphorus poisoning.It is worthy of popularizing and applying in clinic.

Effect of hemoperfusion on ChE activity and toxicant clearance in patients with organophosphorus poisoning / 中国基层医药

Objective@#To investigate the effect of hemoperfusion (HP) on the activity of ChE in blood of patients with organophosphorus poisoning, and its toxicant clearance effect.@*Methods@#From January 2017 to January 2019, 60 patients with organophosphorus poisoning in Shengjing Hospital Affiliated to China Medical University were divided into observation group and control group according to random number table method, with 30 cases in each group.The control group was treated with routine treatment, while the observation group was treated with HP on the basis of routine treatment.The therapeutic effects of the two groups were compared.@*Results@#The duration of mechanical ventilation and conscious awakening in the observation group were (3.07±1.14) d and (1.42±0.37) d, respectively, which were significantly shorter than those in the control group[(4.15±1.22) d, (2.01±0.58)d](t=3.543, 4.697, all P<0.05). The dosage of atropine in the observation group[(252.57±28.44)mg]was significantly less than that in the control group[(282.61±29.82)mg](t=3.993, P<0.05). The activity of cholinesterase after 12 h and 24 h of treatment was significantly higher than those before treatment (all P<0.05). After 12 h and 24 h of treatment, the cholinesterase activities in the observation group were (1 128.64±152.49)U/L and (1 422.08±184.68)U/L, respectively, which were higher than those in the control group[(912.73±144.61)U/L and (1 165.32±173.27)U/L](t=5.627, 5.553, all P<0.05). After 1 d and 3 d of treatment, the concentrations of organophosphorus poisons in the observation group were (1.08±0.30)mg/L and (0.62±0.18)mg/L, respectively, which were significantly lower than those in the control group[(1.32±0.35)mg/L and (0.84±0.27)mg/L](t=2.852, 3.713, all P<0.05). The incidences of rebound, intermediate syndrome and multiple organ failure in the observation group were 3.33% (1/30), 6.67% (2/30) and 13.33% (4/30), respectively, which were lower than those in the control group[23.33% (7/30), 23.33% (7/30), 36.67% (11/30)](χ2=5.192, 3.278, 4.356, all P<0.05).@*Conclusion@#HP has obvious effect on the activity of ChE and the concentration of blood poisons in patients with organophosphorus poisoning.It is worthy of popularizing and applying in clinic.

Toxicidad cardiovascular por parches transdérmicos de rivastigmina. A propósito de dos casos clínicos / Cardiovascular toxicity by rivastigmine transdermal patches. Two case report / Toxicidade cardiovascular por adesivos transdérmicos de rivastigmina. Relato de dois casos

Resumen: La rivastigmina, fármaco anticolinesterásico, mejora la neurotransmisión colinérgica y es utilizado en el tratamiento de las enfermedades de Alzheimer y de Parkinson. En el Centro de Información y Asesoramiento Toxicológico se han registrado casos de intoxicación por el uso de parches transdérmicos de rivastigmina, los cuales han aumentado en número en el último tiempo. Presentamos dos casos clínicos de intoxicación aguda por parches transdérmicos de rivastigmina en los que se constataron arritmias cardíacas graves, asociando un descenso de colinesterasa plasmática. Se destacan los riesgos del uso de esta medicación con el fin de estar atentos a los primeros síntomas de intoxicación, poder actuar en forma oportuna y prevenir nuevos eventos.

Summary: Rivastigmine, an anticholinesterase drug, improves cholinergic neurotransmission and is used in the treatment of Alzheimer's and Parkinson's diseases. In the Center for Information and Toxicological Advice there have been cases of intoxication due to the use of transdermal rivastigmine patches, which have increased in recent times. We present two clinical cases of acute intoxication by transdermal patches of rivastigmine in which serious cardiac arrhythmias were found, associating a decrease in plasma cholinesterase. The risks of the use of this medication are highlighted in order to be attentive to the first symptoms of intoxication, to be able to act timely and to prevent new events.

Resumo: A rivastigmina, um anticolinesterásico, melhora a neurotransmissão colinérgica e é usada no tratamento das doenças de Alzheimer e Parkinson. No Centro de Informação e Conselhos Toxicológicos, houve casos de intoxicação devido ao uso de adesivos transdérmicos de rivastigmina, que aumentaram nos últimos tempos. Se apresentam dois relatos de caso de intoxicação aguda por adesivos transdérmicos de rivastigmina. Em ambos os casos, foram encontradas arritmias cardíacas graves, associando uma diminuição na colinesterase plasmática. Os riscos do uso desse medicamento são destacados para estar atento aos primeiros sintomas de intoxicação, para poder atuar de forma oportuna e prevenir novos eventos.

Chlorella sorokiniana and Chlorella minutissima exhibit antioxidant potentials, inhibit cholinesterases and modulate disaggregation of ß-amyloid fibrils

BACKGROUND: Microalgae are aquatic chlorophyll-containing organisms comprising unicellular microscopic forms, and their biomasses are potential sources of bioactive compounds, biofuels and food-based products. However, the neuroprotective effects of microalgal biomass have not been fully explored. In this study, biomass from two Chlorella species was characterized, and their antioxidant, anticholinesterase and anti-amyloidogenic activities were investigated. RESULTS: GC­MS analysis of the extracts revealed the presence of some phenols, sterols, steroids, fatty acids and terpenes. Ethanol extract of Chlorella sorokiniana (14.21 mg GAE/g) and dichloromethane extract of Chlorella minutissima (20.65 mg QE/g) had the highest total phenol and flavonoid contents, respectively. All the extracts scavenged 2,2-diphenyl-1-picrylhydrazyl, 2,2-azinobis (3-ethylbenzothiazoline-6-sulfonate) and hydroxyl radicals. The highest metal chelating activity of the extracts was observed in the ethanol extracts of C. minutissima (102.60 µg/mL) and C. sorokiniana (107.84 µg/mL). Furthermore, the cholinesterase inhibitory activities of the extracts showed that ethanol extract of C. sorokiniana (13.34 µg/mL) exhibited the highest acetylcholinesterase inhibitory activity, while dichloromethane extract of C. minutissima (11.78 µg/mL) showed the highest butyrylcholinesterase inhibitory activity. Incubation of the ß-amyloid protein increased the aggregation of amyloid fibrils after 96 h. However, ethanol extract of C. sorokiniana and C. minutissima inhibited further aggregation of Aß1­42 and caused disaggregation of matured protein fibrils compared to the control. This study reveals the modulatory effects of C. sorokiniana and C. minutissima extracts on some mediators of Alzheimer's disease and provides insights into their potential benefits as functional food, nutraceutics or therapeutic agent for the management of this neurodegenerative disease.

In vitro Anti-cholinesterase and Anti-oxidant Activity of Three Standardised Polyherbal Products Used for Memory Enhancing in Ethnomedicine of South-East Nigeria

Background: Polyherbal standardised extracts used in ethnomedicine of Eastern Nigeria for memory improvements were evaluated for anti-cholinesterases and anti-oxidant properties.Methods: Anti-cholinesterase, anti-oxidant, and total phenolic and flavonoid contents were established using standard procedures.Results: The three polyherbal extracts exhibited significant concentration dependent acetylcholinesterase (AChE) inhibitory activity (P = 0.001). The highest AChE inhibition was observed with the Neocare Herbal Tea (NHT) with 99.7% (IC50 = 324 μg/mL); whereas the Herbalin Complex Tea (HCT) and Phytoblis Herbal Tea (PHT) exhibited 73.8% (IC50 = 0.2 μg/mL) and 60.6% (IC50 = 0.7 μg/mL) inhibition, respectively, relative to eserine at 100% inhibition (IC50 = 0.9 μg/mL) at 200 μg/mL. The order of percentage increase in inhibition of AChE was NHT > HCT > PHT; while the order of decrease in potency was HCT > PHT > NHT.Radical scavenging activities of HCT, NHT and PHT were 82.13% (IC50 = 0.08 μg/mL), 77.43% (IC50 = 0.01 μg/mL) and 76.28% (IC50 = 0.3 μg/mL), respectively, at 1 mg/mL concentrations. The reducing power revealed a dose-dependent effect, with NHT > PHT > HCT. The order of total phenolics content in the extracts were PHT > HCT > NHT, and for total flavonoids content: PHT > NHT > HCT.Conclusion: The three polyherbal standardised products possess significant acetylcholinesterase inhibitory activity and secondary metabolites that could collectively contribute to their memory-enhancing effects.

The relation between serum cholinesterase level and both the disease progress and prognosis of massively burned patients:a retrospective study / 解放军医学杂志

Objective To observe the dynamic change of serum cholinesterase (ChE) activity in severely burned patients,analyze the correlation between serum cholinesterase activity and both the severity and prognosis of burn injury.Methods The clinical data of 203 patients with large area burn (TBSA ＞30％) were collected from the Department of Burns and Plastic Surgery,First Affiliated Hospital of PLA General Hospital from January 2014 to December 2016 and the data of 30 healthy subjects as control group were retrospectively analyzed.According to the total burn area,these patients were divided into 3 groups:30％-49％ TBSA group (n=77),50％-79％ TBSA group (n=70),more than 80％ TBSA group (n=56).The serum was extracted from the two groups at 1,3,5,7,9,11,14,21,28,35 and 42 days after injury.Serum ChE activity was compared between the patients and the controls,and between the patient groups.The comparisons were also conducted between the 3 patient groups on the altitude of the decrease in serum ChE activity 21 days after injury,when the serum ChE activity reached the lowest level after injury,and the correlation between the burn area and the serum ChE activity was analyzed at each time point.In addition,according to the prognosis,the patients were divided into the survival group (n=172) and the death group (n=31).The serum ChE activity at each time point and the range of serum ChE activity decrease on day 21 and day 28 after injurywere compared between the two groups.Results 1)The serum ChE activity was lower in the patient groups than in the control group (8.18 ± 1.15kU/L) at all the time points observed except the first day after injury (P＜0.01).2) On the 21st and 28th days after injury,the serum AhE activity was higher in 30％-49％TBSA group than in the 50％-79％ TBSA group and in ≥ 80％ TBSA group,and the activity was higher in 50％-79％ TBSA group than in ≥ 80％ TBSA group (P＜0.05).Pearson correlation analysis on the serum ChE activity and burn area showed a significant positive correlation on day 3,5 and 7 after injury (P＜0.01) and a significant negative correlation on day 14,21 and 28 day after the injury (P＜0.05,P＜0.01),and no significant correlation at the remaining time points (P＞0.05).Up to the 21st day after injury,serum ChE decreased less significantly in 30％-49％ TBSA group (1.18 ± 1.70kU/L) than in 50％-79％ TBSA group (2.20 ± 2.01kU/L)and in ≥80％ TBSA group (3.35 ± 1.89kU/L),and less significantly in 50％-79％ TBSA group than in ≥80％ TBSA group,with statistically significant differences (P＜0.05).3) The serum ChE activity decreased to the lowest value (4.89 ± 1.48kU/L) on day 21 after burn in the survival group and to the lowest value (4.21 ± 1.37kU/L) on day 28 in the death group,with statistically significant difference (P＜0.05).On day 28 after injury,the serum ChE activity was significantly higher (4.92 ± 1.46kU/L) in the survival patients than in the patients died (4.21 ± 1.37kU/L) at the 21st day after injury.On day 21 and 28 after injury,the magnitude of decrease in serum ChE activity was less significant in the survival group (2.26 ± 1.93kU/L and 2.43 ± 1.87kU/L respectively) than in the death group (3.61 ± 2.20kU/L and 4.22 ± 1.94kU/L) (P＜0.05).Conclusions After burn,the activity of serum ChE decreased significantly,and there was a tendency to decrease firstly and increase aftetwards.The activity reached the lowest value on day 21 after injury.The area of burn was negatively correlated with the activity of serum ChE,and this relation was more remarkable on day 14,21 and 28 after injury.The greater the decrease of serum ChE activity,the worse the prognosis of the patients.As such,serum ChE activity has a certain value in reflecting the severity of burn injury and predicting the prognosis of patients.

Relationship between the level of serum CA125, prealbumin, cholinesterase and cirrhosis degree by Child-Pugh score / 中华老年医学杂志

Objective To evaluate the relationship between cirrhosis degree and the level of serum CA125,pre-albumin (PA) and cholinesterase (CHE) in aged patients with cirrhosis.Methods One hundred and fifty-five patients with liver cirrhosis admitted to the Second People's Hospital of Tongxiang from December 1st 2013 to December 1st 2015 were selected as the observation group.The age of the patient was 61～81 years,with an average age of (65.5±6.2) years.The degree of patient liver cirrhosis was graded by Child-Pugh (CP) score.Fifty healthy individuals from 60 to 79 years old,average (67.3±5.2) years were selected as the control group.Four indicators were detected in all research objects,including CA125,PA and CHE.Spearman correlation analysis was carried out between liver cirrhosis grading and each index changes.Results Compared to the healthy groups,the patients with liver cirrhosis had a higher levels of CA125,which was a positively correlated with cirrhosis degree.Patients with CP score A,B,C liver function had significantly different levels of CA125 [(43.55± 23.71) μg/L,(157.22 ± 57.18) μg/L,(261.28 ± 131.98) μg/L,respectively,F=102.33,P=0.000],PA [(176.81±55.18) mg/L,(135.23 ± 39.98) mg/L,(89.27 ±49.11) mg/L,respectively,F=177.61,P=0.000] and CHE [(4 727.46±998.10) U/L,(2 451.016±528.81) U/L,(1 962.58±439.14) U/L respectively,F=208.95,P=0.000].Patients with liver cirrhosis were associated with lower levels of PA and CHE than those in the healthy participants,which were negatively correlated with cirrhosis degree.Conclusions The CA125,PA and CHE have an important clinical significance in diagnosis,conditions' evaluation and prognosis' assessment for cirrhosis.

Study on the application value of combined detection of serum hepatitis C virus-RNA level and liver function indices in diagnosis and treatment of hepatitis C patients / 中国医师进修杂志

Objective To explore the correlation between serum hepatitis C virus (HCV)-RNA level with cholinesterase (CHE), albumin (ALB) and prealbumin (PA) in patients with hepatitis C, and provide the references for the early diagnosis and the prognosis monitoring of hepatitis C. Methods Four hundred and fifty-five patients with hepatitis C were selected. The serum level of HCV-RNA was determined by quantitative real-time polymerase chain reaction (real-time PCR), and serum levels of CHE, ALB and PA were detected using the automatic biochemistry analyzer. The patients were divided into 6 group according to the result of HCV-RNA level:HCV-RNA<103 kU/L group (group A, 52 cases), 103 kU/L≤HCV-RNA<104 kU/L group (group B, 77 cases), 104 kU/L≤HCV-RNA<105 kU/L group (group C, 81 cases), 105 kU/L≤HCV-RNA<106 kU/L group (group D, 92 cases), 106 kU/L≤HCV-RNA<107 kU/L group (group E, 87 cases) and HCV-RNA≥107 kU/L group (group F, 66 cases). Moreover, the patients were divided into 3 groups according to the result of serum CHE: CHE normal group (> 5000 U/L, 321 cases), CHE mild abnormal group (4000- 5000 U/L, 56 cases) and CHE abnormal group (<4000 U/L, 78 cases). Results With the rising level of serum HCV-RNA from group A to group F, the serum levels of CHE, ALB and PA were all gradually decreased in hepatitis C patients, CHE: (7288 ± 2817), (6316 ± 2341), (6103 ± 2596), (5208 ± 2222), (4282 ± 2173) and (3905 ± 1378) U/L; ALB: (46.3 ± 9.9), (44.0 ± 8.4), (43.1 ± 7.6), (42.6 ± 7.1), (41.1 ± 5.4) and (39.3 ±5.1) g/L;PA:(212.1 ± 67.8), (179.9 ± 72.8), (163.4 ± 57.5), (137.4 ± 60.3), (120.6 ± 45.0) and (112.5 ± 42.0) mg/L, and there were statistical differences (F=21.08, 6.08 and 27.54;P<0.01). With the decreasing level of serum CHE, the serum levels of ALB and PA were all gradually decreased, ALB:(45.4 ± 10.1), (33.1 ± 4.2) and (31.5 ± 8.8) g/L;PA:(209.3 ± 56.4), (108.4 ± 44.1) and (81.5 ± 49.6) mg/L, and there were statistical differences (F = 70.23 and 152.57, P<0.01). The bivariate Spearman correlation analysis result showed that the serum HCV-RNA level was negatively correlated with serum CHE, ALB and PA (r =-0.357, -0.326 and-0.471; P<0.05), and the serum CHE was positively correlated with serum ALB and PA (r=0.726 and 0.807, P<0.05). Conclusions The serum HCV-RNA level is closely related to liver function indices. Performing simultaneous detection of serum HCV-RNA level and serum PA is helpful in the early diagnosis and treatment of Hepatitis C.

Value of serum cholinesterase in diagnosis/treatment and prognostic evaluation of liver diseases / 临床肝胆病杂志

Serum cholinesterase (ChE) is synthesized by hepatic parenchymal cells and is released into blood immediately after synthesis,and therefore,serum ChE can be used as an objective and sensitive indicator of liver function.Serum ChE has been used as an independent factor for the evaluation of liver function for a long time and can reflect the synthetic function of the liver and help to determine the severity of liver diseases.Combined measurement of serum ChE and serum prealbumin,total cholesterol,total bile acid,and prothrombin time has an important value in the diagnosis and treatment of liver diseases.At the same time,serum ChE combined with Child-Turcotte-Pugh score or MELD score can accurately evaluate liver reserve function,which may help with the prognostic evaluation of patients with liver diseases.

Nitric oxide synthase inhibitors protect against brain and liver damage caused by acute malathion intoxication

OBJECTIVE@#To investigate the effect of N-nitro-l-arginine methyl ester (l-NAME), a non-selective nitric oxide synthase (NOS) inhibitor, and 7-nitroindazole (7-NI), a selective neuronal NOS inhibitor, on oxidative stress and tissue damage in brain and liver and on DNA damage of peripheral blood lymphocytes in malathion intoxicated rats.@*METHODS@#Malathion (150 mg/kg) was given intraperitoneally (i.p.) along with l-NAME or 7-NI (10 or 20 mg/kg, i.p.) and rats were euthanized 4 h later. The lipid peroxidation product malondialdehyde (MDA), nitric oxide (nitrite), reduced glutathione (GSH) concentrations and paraoxonase-1 (PON-1) activity were measured in both brain and liver. Moreover, the activities of glutathione peroxidase (GPx) acetylcholinesterase (AChE), and butyrylcholinesterase (BChE), total antioxidant capacity (TAC), glucose concentrations were determined in brain. Liver enzyme determination, Comet assay, histopathological examination of brain and liver sections and inducible nitric oxide synthase (iNOS) immunohistochemistry were also performed.@*RESULTS@#(i) Rats treated with only malathion exhibited increased nitric oxide and lipid peroxidation (malondialdehyde) accompanied with a decrease in GSH content, and PON-1 activity in brain and liver. Glutathione peroxidase activity, TAC, glucose concentrations, AChE and BChE activities were decreased in brain. There were also raised liver aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities and increased DNA damage of peripheral blood lymphocytes (Comet assay). Malathion caused marked histopathological changes and increased the expression of iNOS in brain and liver tissues. (ii) In brain of malathion-intoxicated rats, l-NAME or 7-NI resulted in decreased nitrite and MDA contents while increasing TAC and PON1 activity. Reduced GSH and GPx activity showed an increase by l-NAME. AChE activity increased by 20 mg/kg l-NAME and 10 mg/kg 7-NI. AChE activity decreased by the higher dose of 7-NI while either dose of 7-NI resulted in decreased BChE activity. (iii) In liver of malathion-intoxicated rats, decreased MDA content was observed after l-NAME or 7-NI. Nitrite level was unchanged by l-NAME but increased after 7-NI which also resulted in decreased GSH concentration and PON1 activity. Either inhibitor resulted in decreased liver ALT activity. (iv) DNA damage of peripheral blood lymphocytes was markedly inhibited by l-NAME or 7-NI treatment. (v) iNOS expression in brain and liver decreased by l-NAME or 7-NI. (vi) More marked improvement of the histopathological alterations induced by malathion in brain and liver was observed after 7-NI compared with l-NAME.@*CONCLUSIONS@#In malathion intoxicated rats, the neuronal NOS inhibitor 7-NI and to much less extent l-NAME were able to protect the brain and liver tissue integrity along with improvement in oxidative stress parameters. The decrease in DNA damage of peripheral blood lymphocytes by NOS inhibitors also suggests the involvement of nitric oxide in this process.

Study on the application value of combined detection of serum hepatitis C virus-RNA level and liver function indices in diagnosis and treatment of hepatitis C patients / 中国医师进修杂志

Objective To explore the correlation between serum hepatitis C virus (HCV)-RNA level with cholinesterase (CHE), albumin (ALB) and prealbumin (PA) in patients with hepatitis C, and provide the references for the early diagnosis and the prognosis monitoring of hepatitis C. Methods Four hundred and fifty-five patients with hepatitis C were selected. The serum level of HCV-RNA was determined by quantitative real-time polymerase chain reaction (real-time PCR), and serum levels of CHE, ALB and PA were detected using the automatic biochemistry analyzer. The patients were divided into 6 group according to the result of HCV-RNA level:HCV-RNA<103 kU/L group (group A, 52 cases), 103 kU/L≤HCV-RNA<104 kU/L group (group B, 77 cases), 104 kU/L≤HCV-RNA<105 kU/L group (group C, 81 cases), 105 kU/L≤HCV-RNA<106 kU/L group (group D, 92 cases), 106 kU/L≤HCV-RNA<107 kU/L group (group E, 87 cases) and HCV-RNA≥107 kU/L group (group F, 66 cases). Moreover, the patients were divided into 3 groups according to the result of serum CHE: CHE normal group (> 5000 U/L, 321 cases), CHE mild abnormal group (4000- 5000 U/L, 56 cases) and CHE abnormal group (<4000 U/L, 78 cases). Results With the rising level of serum HCV-RNA from group A to group F, the serum levels of CHE, ALB and PA were all gradually decreased in hepatitis C patients, CHE: (7288 ± 2817), (6316 ± 2341), (6103 ± 2596), (5208 ± 2222), (4282 ± 2173) and (3905 ± 1378) U/L; ALB: (46.3 ± 9.9), (44.0 ± 8.4), (43.1 ± 7.6), (42.6 ± 7.1), (41.1 ± 5.4) and (39.3 ±5.1) g/L;PA:(212.1 ± 67.8), (179.9 ± 72.8), (163.4 ± 57.5), (137.4 ± 60.3), (120.6 ± 45.0) and (112.5 ± 42.0) mg/L, and there were statistical differences (F=21.08, 6.08 and 27.54;P<0.01). With the decreasing level of serum CHE, the serum levels of ALB and PA were all gradually decreased, ALB:(45.4 ± 10.1), (33.1 ± 4.2) and (31.5 ± 8.8) g/L;PA:(209.3 ± 56.4), (108.4 ± 44.1) and (81.5 ± 49.6) mg/L, and there were statistical differences (F = 70.23 and 152.57, P<0.01). The bivariate Spearman correlation analysis result showed that the serum HCV-RNA level was negatively correlated with serum CHE, ALB and PA (r =-0.357, -0.326 and-0.471; P<0.05), and the serum CHE was positively correlated with serum ALB and PA (r=0.726 and 0.807, P<0.05). Conclusions The serum HCV-RNA level is closely related to liver function indices. Performing simultaneous detection of serum HCV-RNA level and serum PA is helpful in the early diagnosis and treatment of Hepatitis C.

Value of serum cholinesterase in diagnosis/treatment and prognostic evaluation of liver diseases / 临床肝胆病杂志

Serum cholinesterase (ChE) is synthesized by hepatic parenchymal cells and is released into blood immediately after synthesis,and therefore,serum ChE can be used as an objective and sensitive indicator of liver function.Serum ChE has been used as an independent factor for the evaluation of liver function for a long time and can reflect the synthetic function of the liver and help to determine the severity of liver diseases.Combined measurement of serum ChE and serum prealbumin,total cholesterol,total bile acid,and prothrombin time has an important value in the diagnosis and treatment of liver diseases.At the same time,serum ChE combined with Child-Turcotte-Pugh score or MELD score can accurately evaluate liver reserve function,which may help with the prognostic evaluation of patients with liver diseases.

Nitric oxide synthase inhibitors protect against brain and liver damage caused by acute malathion intoxication

Objective To investigate the effect of N

Acetylcholinesterase, butyrylcholinesterase and paraoxonase 1 activities in rats treated with cannabis, tramadol or both

OBJECTIVE@#To investigate the effect of Cannabis sativa resin and/or tramadol, two commonly drugs of abuse on acetylcholinesterase and butyrylcholinesterase activities as a possible cholinergic biomarkers of neurotoxicity induced by these agents.@*METHODS@#Rats were treated with cannabis resin (5, 10 or 20 mg/kg) (equivalent to the active constituent Δ-tetrahydrocannabinol), tramadol (5, 10 and 20 mg/kg) or tramadol (10 mg/kg) combined with cannabis resin (5, 10 and 20 mg/kg) subcutaneously daily for 6 weeks. Acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) activities were measured in brain and serum. We also measured the activity of paraoxonase-1 (PON1) in serum of rats treated with these agents.@*RESULTS@#(i) AChE activity in brain increased after 10-20 mg/kg cannabis resin (by 16.3-36.5%). AChE activity in brain did not change after treatment with 5-20 mg/kg tramadol. The administration of both cannabis resin (5, 10 or 20 mg/kg) and tramadol (10 mg/kg) resulted in decreased brain AChE activity by 14.1%, 12.9% and 13.6%, respectively; (ii) BChE activity in serum was markedly and dose-dependently inhibited by cannabis resin (by 60.9-76.9%). BChE activity also decreased by 17.6-36.5% by 10-20 mg/kg tramadol and by 57.2-63.9% by the cannabis resin/tramadol combined treatment; (iii) Cannabis resin at doses of 20 mg/kg increased serum PON1 activity by 25.7%. In contrast, tramadol given at 5, 10 and 20 mg/kg resulted in a dose-dependent decrease in serum PON1 activity by 19%, 36.7%, and 46.1%, respectively. Meanwhile, treatment with cannabis resin plus tramadol resulted in 40.2%, 35.8%, 30.7% inhibition of PON1 activity compared to the saline group.@*CONCLUSIONS@#These data suggest that cannabis resin exerts different effects on AChE and BChE activities which could contribute to the memory problems and the decline in cognitive function in chronic users.

Acetylcholinesterase, butyrylcholinesterase and paraoxonase 1 activities in rats treated with cannabis, tramadol or both

Objective To investigate the effect of Cannabis sativa resin and/or tramadol, two commonly drugs of abuse on acetylcholinesterase and butyrylcholinesterase activities as a possible cholinergic biomarkers of neurotoxicity induced by these agents. Methods Rats were treated with cannabis resin (5, 10 or 20 mg/kg) (equivalent to the active constituent Δ

Actividad enzimática colinesterasa en muestras de sangre humana: efecto de las condiciones de almacenamiento / Cholinesterase enzyme activity in human blood samples: effects of the store conditions

Introducción: La determinación de la actividad enzimática colinesterasa (ChE) es el principal biomarcador de efecto de la exposición a los plaguicidas organofosforados y carbamatos. Por lo tanto, la estabilidad de la actividad de las ChEs en muestras de sangre es un parámetro pre-analítico importante que necesita ser considerado en términos de la seguridad diagnóstica. Objetivo: Determinar el efecto del tiempo y de la temperatura de almacenamiento sobre la actividad de las ChEs en muestras de sangre humana. Metodología: Muestras de sangre entera y suspensiones de eritrocitos (eritrocitos + solución salina 0.9% proporción 1:1) fueron almacenados a -20°C, 4°C y 25°C. Las determinaciones enzimáticas se realizaron una hora después de la toma de la muestra y se repitieron entre el día 1 hasta el día 90. La actividad enzimática ChE total y Acetil-ChE se determinaron respectivamente mediante el método colorimétrico de Limperos & Ranta y mediante el método potenciométrico de Michel. Resultados: La máxima estabilidad de la actividad ChE total se observó a -20°C hasta por 60 días, además, dicha estabilidad perduró hasta por el tiempo máximo del estudio a 4°C para la Acetil-ChE. Una considerable disminución de la actividad Acetil-ChE se observó después de los días 7 a 25°C y 4 a -20°C. Conclusión: Considerando la seguridad diagnóstica, nosotros recomendamos almacenar las muestras de sangre entera a -20°C por un tiempo máximo de 30 días para la determinación de la actividad ChE total y la suspensión de eritrocitos en 0.9% de NaCl a 4°C por 14 días máximo para la determinación de la Acetil-ChE.

Introduction: Determination of cholinesterase (ChE) enzyme activity is the main biomarker of exposure to pesticides organophosphorus and carbamate. Therefore, the enzyme stability of ChEsin blood samples is an important pre-analytical factor to take into account in the diagnosis. Objective: To determine the effect of storage time and temperature on ChEs enzyme activity in human blood samples. Methodology: Whole-blood samples and erythrocyte suspensions (erythrocyte + 0.9% saline solution; ratio 1:1) were stored at -20°C, 4°C and 25°C. Enzyme activity measurements were performed at one hour after the blood samples have been obtained and then were repeated between days 1 and 90. Total ChE and Acetyl-ChE activities were determined using the Limperos & Ranta colorimetric method and the potentiometric method of Michel respectively. Results: The maximum stability of the total ChE enzyme activity was achieved at -20°C for 60 days and, in the case of Acetyl-ChE, at 4°C for the time the study was conducted. A decrease of Acetyl-ChE activity was shown after 7 days at 25°C and 4 days at -20°C. Conclusion: In terms of diagnosis, we recommend that in order to measure the total ChE activity the wholeblood samples should be stored at -20°C for 30 days, whereas to measure the Acetyl-ChE activity the erythrocyte suspensions in 0.9% NaCl at 4°C for 14 days.

The change of plasma cholinesterases in the people with metabolic disorder / 中国医师杂志

Objective To investigate the change of plasma cholinesterases (CHEs) in the people with diabetes or fatty liver or overweight , and explore the role of CHE in these diseases .Methods The plasma CHEs in 2834 subjects were detected , and these subjects were divided into five groups , including diabetes , fatty liver , overweight , diabetes with fatty liver , and the normal groups . Results The plasma CHE activities in diabetes group , fatty liver group , overweight group , and diabetes with fatty liver group were all higher than the normal group [(8943 ±1896)U/L, (9716 ±1673)U/L, (8798 ±1710)U/L, (9385 ±1687)U/L vs (8028 ±1621) U/L], and the CHE level in the fatty liver group was highest among five groups .However, the CHE level in diabetes group or fatty liv-er group was not significantly different from that in the diabetes with fatty liver group .The CHE level of the people with components of metabolic syndrome (MS) was significantly higher than that without MS component [(8786 ±1514)U/L, (9141 ±1771)U/L, (9705 ±1628)U/L, (9138 ±1768)U/L, (9530 ±1607)U/L vs (7821 ±1324)U/L]),but the CHE level was not increased gradually with the increased MS component.The plasma CHE had a negative correlation with age ( P =0.00),but it had a positive correlation with triglyceride (TG), total cholesterol (TC), and body mass index (BMI)( P =0.00).Conclusions The plasma CHE activity was el-evated in diabetes group , fatty liver group , and overweight group , which might be a risk factor in these diseases .Controlling the plas-ma CHE might help to treat the metabolism diseases .