Alanine Research Articles

Effects of intensified or conventional milk feeding on pre-weaning health and feeding behavior of Holstein female calves around weaning.

Health, inflammatory, and stress indices as well as feeding behavior around weaning were measured for Holstein female calves fed intensified milk or conventionally during the pre-weaning period. Calves (n ꞊ 48) were randomly assigned to one of two experimental treatments including a conventional (CF) or an intensified feeding (IF) groups. In CF group, calves (n ꞊ 24) received 0.52 kg of dry matter (DM) per day from pasteurized whole milk (23.00% crude protein (CP) and 27.00% fat) until day 50 of age. In IF group, calves (n = 24) fed 0.97 kg of DM per day on average for the first three weeks, and then, milk allowance decreased gradually to reach 0.52 kg DM per day and continued until day 50. All calves were gradually weaned from day 51 to 56. Blood samples were taken on days 14, 28, and 57 at 06:30 AM for serum amyloid A (SAA), cortisol, alanine aminotransferase (ALT), and iron analyses. Conventionally fed calves had more days with fever during the pre-weaning period. Blood SAA and cortisol levels were higher in CF calves on day 14. However, SAA levels were higher for IF calves on day 57. Intensified milk-fed calves spent more time for standing than CF calves. A trend to be significant was observed for non-nutritive oral behavior in IF calves. In summary, dairy calf health can be improved by intensified milk feeding during the pre-weaning period; however, this method has the potential to reduce calves welfare around weaning transition.

Relationship between fasting serum C-peptide level and heart function in patients with or without diabetes mellitus and chronic heart failure

Objective To evaluate the relationships between admission fasting serum C-peptide concentration and cardiac function status in chronic heart failure (CHF) patients with or without diabetes. Methods From July 2017 to December 2018, 262 CHF patients with or without diabetes in the Department of Cardiology of Pudong hospital in Shanghai were analyzed.Their cardiac function was classified as New York Heart Association (NYHA) grade Ⅱ to Ⅳ, and they were divided into diabetes group (80 cases) and non diabetes group (182 cases). At the same time, 62 subjects without diabetes and heart disease were randomly selected as the control group.To analyze the relationship between fasting serum C-peptide level and cardiac function in diabetic and nondiabetic CHF patients. Results (1)The fasting plasma glucose and serum C-peptide concentrations of diabetes group paitents were(8.7±2.9) mmol/L and(0.78±0.67) nmol/L respectively, the nondiabetes group paitents were(5.8±1.67) mmol/L and(0.56±0.61)nmol/L respectively, the control group were(5.1±0.69) mmol/L and(0.16±0.12)nmol/L respectively.The difference in the three groups was statistically significant(all P 0.05). (2) In all patients with heart failure, diabetes mellitus and non diabetes heart failure, the levels of serum C-peptide were (1.05±0.85), (1.17±0.82), (0.99±0.86) nmol/L in NYHA Ⅳ group, and (0.53±0.22), (0.52±0.20), (0.54±0.23) nmol/L in NYHA Ⅲ group, and (0.32±0.09), (0.32±0.11), (0.31±0.09) nmol/L in NYHA Ⅱ group.After adjustment of age, gender, smoking, insulin secretion and hypoglycemic drugs, body mass index, blood pressure, total bilirubin (TBIL), alanine aminotransferase (ALT), creatinine, blood glucose, blood lipid, white blood cell count (WBC) and hemoglobin level by covariance analysis, all patients with heart failure The level of serum C-peptide in NYHA Ⅳ group was significantly higher than that in Ⅲ group (all P 0.05) (3) Using multiple linear regression analysis, the adjustment factors included age, gender, smoking, BMI, blood pressure, TBIL, alt, creatinine, blood glucose, blood lipid, WBC and hemoglobin levels.The results showed that the serum C-peptide level was positively correlated with pro-BNP in all patients with heart failure, diabetes and non diabetes heart failure (β: 0.006, 95%CI -0.016-0.028 , P=0.007; β: 0.117, 95%CI-0.042-0.277 , P=0.006; β: 0.411, 95%CI-0.149-0.971 , P=0.023), negatively correlated with LVEF(β: -0.122, 95%CI-0.285-0.041, P=0.004; β: -0.008, 95%CI-0.032-0.016, P=0.010; β: -0.065, 95%CI-0.139-0.011, P=0.036). Conclusion The level of fasting serum C-peptide was significantly increased in patients with CHF and non-diabetic patients, and was related to the severity of heart failure. Key words: Chronic heart failure; Diabetes mellitus; Serum C-peptide; N-terminal B-type natriuretic peptide; Cardiac function

Kinetic study of immobilized ω-transaminase for the asymmetric synthesis of chiral amine

Biocatalysis is a powerful tool for the synthesis of high value products such as, chiral molecules and intermediates. Chiral amines can be synthesized by kinetic resolution of racemic amines or by the asymmetric synthesis from pro-chiral ketones. Kinetic parameter estimation for biocatalytic reaction is useful to evaluate process and technology options. In this work, the Michaelis–Menten kinetic parameters of immobilized ω-transaminase on methacrylate beads for the asymmetric synthesis of (R)-1-phenylethylamine (PEA) from acetophenone (ACP) and alanine (ALA) were determined. The parameters such as, MichaelisMenten constant (Km) and maximum rate of reaction (Vmax) were measured from initial rate experiments by varying ACP concentrations (2 mM to 10 mM) at a fixed 100 mM ALA under mild reaction conditions (pH 7.5 and temperature 30 °C). The concentration of ACP and PEA were measured by gas chromatography. Lineweaver-burk plot was used to estimate the Vmax and Km from the initial rate data. The results yielded a Vmax of 6.87 mM/min and a Km of 2.52 mM. The Michaelis-Menten model is useful for understanding the kinetic properties of immobilized enzymes.

Changes and significance of serum soluble programmed death-1 in patients with chronic hepatitis C

Objective To analyze the changes and significance of serum soluble programmed death-1 (sPD-1) in patients with chronic hepatitis C (CHC) and study its role in the progression of CHC. Methods Serum levels of sPD-1 in CHC patients and healthy controls (HC) were measured using ELISA and compared. Correlations of serum sPD-1 with peripheral hepatitis C virus (HCV) RNA, alanine aminotransferase (ALT), aspartate aminotransferase (AST) and liver fibrosis (indicated by APRI) were analyzed. Results The serum sPD-1 level in the CHC group was significantly higher than that in the HC group (P<0.05), and positively correlated with peripheral HCV RNA, ALT and AST (P<0.05). In addition, the serum sPD-1 levels in patients with APRI greater than 1.2 (indicating severe liver fibrosis) were higher than those in patients without or with mild liver fibrosis (P<0.05). Conclusions sPD-1 might be involve in the progression of CHC. Measuring serum sPD-1 in CHC patients would assist the prediction of disease progression and help to make the correct diagnosis and appropriate clinical therapy decision. Key words: Soluble programmed death-1; Chronic hepatitis C; Liver fibrosis

Hepatoprotective and antioxidant activities of Pterocarpus santalinoides methanol leaf extract

This study evaluated the hepatoprotective and antioxidant activities (AA) of Pterocarpus santalinoides methanol leaf extract (PSMLE) on carbon tetrachloride (CCl4)-induced hepatotoxicity in albino rats. Thirty male albino rats randomly assigned into 6 groups (A – F) of 5 rats each were used for the in vivo study. Hepatotoxicity was induced in groups A – E using CCl4. Group A served as negative control. Groups B, C and D were treated with 50, 250 and 500 mg/kg PSMLE, respectively. Group E was treated with 100 mg/kg Silymarin, while Group F served as normal control. Treatment was given orally twice daily for 15 days, after which markers of hepatotoxicity and oxidative stress were evaluated. The in vitro AA of PSMLE was also evaluated using 1, 1-diphenyl 2-picryl hydrazyl. Results showed that treatment with PSMLE at 250 and 500 mg/kg led to significantly (p<0.05) lower serum alanine aminotransferase and malondialdehyde, significantly (p<0.05) higher superoxide dismutase and glutathione peroxidase levels, while 250 mg/kg dose further led to significantly (p<0.05) lower serum aspartate aminotransferase and serum total bilirubin levels, and significantly (p<0.05) higher serum total protein and serum globulin levels. 500 mg/kg dose treatment additionally led to significantly (p<0.05) lower serum total cholesterol. Treatment at all doses led to significantly (p<0.05) lower liver weight and relative liver weights and significantly (p<0.05) higher catalase and total glutathione levels. The PSMLE exhibited significantly (p<0.05) higher AA at concentrations ≥50 µg/ml in vitro. It was concluded that PSMLE was hepatoprotective and possesses significant antioxidant activity in vivo and in vitro. Key words: Hepatotoxicity, oxidative stress, antioxidants, Pterocarpus santalinoides leaf extract, carbon tetrachloride.

Effect of sevoflurane maintenance anesthesia on liver ischemia-reperfusion injury in patients undergoing partial hepatectomy

Objective To investigate the effect of sevoflurane anesthesia on hepatic ischemia-reperfusion injury in patients undergoing partial hepatectomy. Methods A total of 86 patients undergoing partial hepatectomy were divided into sevoflurane group and isoflurane group according to random number table with 43 patients in each group. Both groups received continuous epidural block combined with general anesthesia, sevoflurane group took sevoflurane combined with remifentanil to maintain anesthesia, while isoflurane group took isoflurane remifentanil to maintain anesthesia. The mean arterial pressure (MAP) and heart rate(HR) of different moments, awakening (open-eye time, extubation time, listening to instruction time, orientation recovery time, time of Aldrete score up to 9 minutes), the serum levels of tumor necrosis factor alpha (TNF-α), interleukin 1 (IL-1), aspartate aminotransferase (AST), alanine aminotransferase (ALT), glutamate dehydrogenase (GLDH), alpha glutathione S transferase (α-GST) levels at different moments were compared between the two groups. Results The MAP and HR at T1, T2, T3 and T4 in both groups were significantly lower than those at T0 (P<0.05). The HR at T1 and T4 in sevoflurane group were significantly higher than those in isoflurane group (P<0.05). The open-eye time, extubation time, listening to instruction time, orientation recovery time in sevoflurane group were significantly shorter than the isoflurane group (P<0.05). The levels of serum TNF-α, IL-1, AST, ALT, GLDH and α-GST in the two groups at T2 and T3 were significantly higher than those at T0 (P<0.05), and began to fall back to T4. The levels of serum TNF-α, IL-1, AST, ALT, GLDH and α-GST in the sevoflurane group at T2 and T3 were significantly lower than those in the isoflurane group (P<0.05). Conclusions The hepatic hemodynamics in patients undergoing partial hepatectomy with sevoflurane is more stable better than isoflurane during operation, which has faster postoperative recovery and relieved hepatic ischemia-reperfusion injury. Key words: Hepatectomy; Sevoflurane; Reperfusion injury; Hemodynamics

The use of hydroxyurea in sickle cell disease: A single tertiary centre experience at the National Hospital, Abuja, Nigeria

Background. Hydroxyurea (HU) has been found to be beneficial in sickle cell disease (SCD), reducing the occurrence of severe manifestations of the disease such as painful crises and blood transfusions. Although a standard of care for SCD in the developed countries of the world, limited data are available on its use in Africa. Objectives. To review indications of the use of HU, laboratory monitoring and outcome in children with SCD. Methods. A retrospective review of 74 patients treated with HU (15 - 30 mg/kg/day) for a minimum of 6 months. The main outcome measures were indications for use of HU, haemoglobin level (Hb), packed cell volume (PCV), white cell count (WBC), absolute neutrophil count (ANC), serum alanine aminotransferase (ALT) and creatinine. Descriptive statistics were expressed as means ±2 standard deviations. Data were compared pre and post HU therapy, using the chi-square and Student’s t -test as appropriate. Results. The 74 patients constituted 7.26% of the SCD clinic population and were aged 2.25 - 16 years (mean (SD) 8.48 (3.67)) and were on HU therapy for 0.5 - 4.8 years (mean (SD) 1.72 (1.12)). The haemoglobin genotypes were Hb SS 72 (98.7%); Hb SC and Hb SS+F 1 (1.35%) each. Indications for HU use were abnormalities of transcranial Doppler ultrasound (TCD) 39 (52.7%), multiple vaso-occlusive crises (VOC) 18 (24.3%), strokes 14 (18.9%), as well as repeated blood transfusions 9 (12.2%) and hospital admissions 7 (9.5%). Some patients had more than one indication. There were significantly fewer TCD abnormalities, VOC, strokes, splenic sequestrations, blood transfusions and hospital admissions following use of HU. The mean Hb and PCV increased while WBC and ANC decreased. Occurrence of acute chest syndrome, priapism, serum creatinine, ALT and platelet levels were not affected. Conclusions. Hydroxyurea therapy reduces the occurrence of severe manifestations and improves laboratory parameters in children with SCD.

Clinical significance of aluminum phosphate gel in the prevention of gastrointestinal reactions caused by erythromycin in the treatment of Mycoplasma pneumonia

Objective To evaluate the clinical significance of aluminum phosphate gel in the early prevention of gastrointestinal reactions caused by erythromycin, in order to obtain better clinical treatment for children. Methods The clinical data of 110 children with Mycoplasma pneumonia from January 1, 2015 to December 31, 2016 in the pediatric ward of Anhui Provincial Hospital were collected.According to the treatment methods, the patients were divided into the observation group(60 cases) and the control group(50 cases). The observation group was mainly treated with erythromycin combined with aluminum phosphate gel, some of which were given cephalosporin anti-infection, montelustra sodium to reduce airway hyperreaction, hormone antiasthmatic, atomization inhalation and other supportive symptomatic treatment.The control group was mainly treated with erythromycin, some of which were given cephalosporin anti-infection, montelustra sodium to reduce airway hyperreaction, hormone antiasthmatic, atomization inhalation and other supportive symptomatic treatment.The age, body weight, pre-hospital course, white blood cell count(WBC), CRP, alanine aminotransferase(ALT), creatinine(Cr), urea nitrogen(BUN), length of stay, sex, montruster sodium granules, atomization, antibiotics, hormone use and gastrointestinal adverse reactions(abdominal pain, vomiting, nausea, diarrhea, inappetence) were compared between the two groups. Results A total of 110 children were selected, 60 cases in the treatment groups, including 38 males and 22 females, and the average age of children was (6.21 ± 2.26)years old.In the control group, there were 50 cases, including 23 males and 27 females, with an average age of (6.07 ± 2.61)years.The age, weight, pre-hospital course, WBC, CRP, ALT, Cr, BUN, days of hospitalization, etc.between the two groups had no statistically significant differences (all P>0.05). There were no statistically signifiant differences between the two groups in terms of sex, montruster sodium particles, atomization, antibiotics, hormone use, etc.(all P>0.05). The differences of abdominal pain, vomiting, nausea and diarrhea between the two groups were not statistically significant (all P>0.05). However, the difference of inappetence between the two groups was statistically significant (P<0.05). The incidence rate of gastrointestinal side effects(abdominal pain, vomiting, nausea, diarrhea, inappetence) of the observation group was 18.3 %(11/60), which of the control group was 48.0%(24/50), the difference was statistically significant between the two groups (χ2=11.064, P<0.05). Conclusion Aluminum phosphate gel can prevent gastrointestinal reactions induced by erythromycin in the treatment of Mycoplasma pneumonia, so that children get better treatment. Key words: Pneumonia; Mycoplasma; Universal precautions; Gastrointestinal tract; Aluminum phosphate gel; Erythromycin

Photoprotection But Not N-acetylcysteine Improves Intestinal Blood Flow and Oxidation Status in Parenterally Fed Piglets.

The purpose of the present study was to determine if protecting parenteral nutrition solutions from ambient light and supplementing with N-acetylcysteine (NAC) improves mesenteric blood flow, gut morphology, and oxidative status of parenterally fed neonates. Neonatal Yucatan miniature piglets (n = 23, 7-11 days old) were surgically fitted with central venous catheters and an ultrasonic blood flow probe around the superior mesenteric artery. Piglets were fed continuously for 7 days either light-protected (LP) or light-exposed (LE) complete parenteral nutrition that was enriched with either NAC or alanine (ALA). There were no differences in body weight or overall gut morphology among groups after 7 days. Plasma concentrations of NAC were greater and total homocysteine lower in NAC- versus ALA-supplemented pigs on day 7 (N-acetylcysteine: 94 vs 7 μmol/L; P < 0.001; homocysteine: 14 versus 21 μmol/L; P < 0.005); plasma total glutathione was not affected. Hepatic lipid peroxidation was reduced by 25% in piglets that received LP parenteral nutrition (P < 0.05). The mesenteric artery blood flow decreased in all pigs between days 2 and 6 (P < 0.001) because of parenteral feeding. Photoprotection alone (LP-ALA) attenuated the decrease in mesenteric blood flow to 66% of baseline on day 6 compared with LE-ALA (37%; P < 0.05) and LP-NAC pigs (43%; P = 0.062); LE-NAC piglets had intermediate reductions in blood flow (55%). Photoprotection of parenteral nutrition solutions is a simple, effective method to attenuate decline in blood flow to the gut and hepatic lipid peroxidation, which are both commonly associated with parenteral feeding.

Safety and efficacy of reduced-volume hepatectomy for advanced hepatic alveolar echinococcosis

Objective To evaluate the efficacy and safety of reduced volume hepatectomy in treatment of advanced hepatic alveolar echinococcosis. Methods The clinical data of 90 patients with advanced hepatic alveolar echinococcosis treated at the Qinghai Provincial People's Hospital from January 2017 to January 2019 were retrospectively analyzed. There were 41 males and 49 females, with an average age of 32 (range 11 to 58) years. The locations of the lesions, operations, complications and follow-up were analyzed. Results 90 patients were treated with reduced volume focal hepatectomy, 38 with radical resection and 52 with quasi radical resection. The operation time was (361±22) min. The hospital stay was (22±2) day, and the blood loss was (781±37) ml. Red blood cells were transfused in 19 patients and plasma in 39 patients. Pringle’s maneuver was used in 12 patients, regional hepatic blood flow occlusion in 42 patients, and Glisson sheath occlusion in 26 patients. The total bilirubin, alanine aminotransferase and aspartate aminotransferase returned to normal in 3 to 14 days after operation. There were 12 patients who developed bile leakage, 41 pleural effusion and 26 effusion in the operation sites. A total of ninety patients were followed up for 2 to 24 months. There was no recurrence of echinococcosis after radical resection and no enlargement of residual lesions after quasi-radical resection. Conclusion Reduced-volume hepatectomy reduced the risk and difficulty of operation. The follow-up results were good. This approach provides a feasible scheme for treatment of advanced hepatic alveolar echinococcosis. Key words: Echinococcosis, hepatic; Treatment outcome; Reduced-volume focal hepatectomy; Safety

Effects of nutritional interventions based on nutritional risk assessment strategies on nutritional status and liver function in patients with cirrhosis

Objective To investigate the effects of nutritional interventions based on nutritional risk assessment strategies on nutritional status and liver function in patients with cirrhosis. Methods Totally126 patients with cirrhosis admitted from July 2016 to October 2017 were enrolled. The prospective study was used and the patients were randomly divided into the treatment group and the control group with 63 cases in each group. The control group received routine nursing intervention, while the treatment group was combined nutritional intervention based on the nutritional risk assessment strategy. After 3 months of follow-up, serum nutrition indicators, liver function, and complications were compared between the two groups. Results The serum albumin, prealbumin and transferrin levels in the treatment group were (42.36±5.24) g/L, (0.37±0.08) g/L, and (3.01±0.42) g/L, which were significantly higher than those in the control group, which were (34.24±5.36) g/L, (0.30±0.07) g/L, (2.65±0.52) g/L (t=8.598, 5.227, 4.275, P<0.05 or 0.01); serum alanine aminotransferase and total bilirubin content were (95.32±12.45) μmol/L, (272.36±30.12) μmol/L, which were significantly lower than those of the control group [(114.21±13.20) μmol/L, (320.42±41.52) μmol/L]. The prothrombin time [(14.36±1.32) s] was significantly shorter than that of the control group [(16.12±1.20) s] (t=8.263, 7.437, 7.831, P<0.05); the complication rate of the treatment group was 7.94% (5/63), which was significantly lower than that of the control group (22.22%) (14/63)(χ2=5.020, P<0.05). Conclusions Nutrition intervention based on nutritional risk assessment strategy can improve nutritional status, relieve liver damage and reduce the incidence of complications such as peritonitis in liver cirrhosis patients. Key words: Cirrhosis; Nutritional risk; Nutritional intervention; Nutritional indicators; Liver function

Risk factors for pneumonia in children with Epstein-Barr virus infectious mononucleosis

Objective To investigate the risk factors for pneumonia in children with Epstein-Barr virus (EBV) infectious mononucleosis(IM). Methods The clinical data of children with EBV-IM from March 2015 to February 2018 in Children′s Hospital of Chongqing Medical University were retrospectively analyzed.The patients were divided into a pneumonia group and a non-pneumonia group.The difference between 2 groups was analyzed, including gender, age, duration of fever, the maximum temperature in disease duration, the size of liver, the size of spleen, tonsillopharyngitis, cervical lymphadenopathy, edema of the eyelids, white blood cell (WBC), lymphocyte, atypical-lymphocytes, C-reactive protein (CRP), procalcitonin (PCT), alanine transaminase (ALT), glutamic oxalacetic transaminas (AST), lactic dehydrogenase (LDH), cytomegalovirus (CMV) antibody, the titer of mycoplasma (MP) antibody, EBV DNA, length of stay, and hospitalization expenses.The single factor analysis was performed to analyze the above data between 2 groups, and the data with statistical significance were analyzed by the multifactor Logistic regression.The recei-ver operator characteristic (ROC) curve was drawn to evaluate the predicting ability of the indicators for IM combined with pneumonia. Results Among 923 cases, 133 cases(14.4%) EBV-IM patients were complicated with pneumonia.The findings of single factor analysis indicated that the risk factors were the duration of fever, the size of liver, the size of spleen, and the titer of MP antibody (all P<0.05). The multifactor Logistic regression showed that the duration of fever, the size of liver, the titer of MP antibody were the risk factors for EBV-IM children with pneumonia (P=0.013, 0.028, 0.014). The area under curve (AUC) of the duration of fever was 0.624, and the critical value was 7.5 d (P=0.000); the AUC of the size of liver was 0.590, and the critical value was 2.65 cm (P=0.003). Conclusions The incidence rate of EBV-IM children combined with pneumonia was high.With the presence of the titer of MP antibody ≥1∶160, the duration of fever≥7.5 days, and the size of liver>2.65 cm, it may be independent risk factors for pneumonia in IM children with EBV infection, which requires special attention clinically and earlier chest imageological examination are needed. Key words: Epstein-Barr virus; Infectious mononucleosis; Pneumonia; Risk factor; Child

Analysis of the autoantibodies characteristics of 77 anti-soluble liver antigen positive patients with liver diseases

Objective To understand the characteristics and clinical significance of anti-soluble liver antigen antibody (anti-SLA) in patients with liver diseases. Methods Serum samples from seventy-seven patients with anti-SLA were collected from Beijing You'An Hospital during the period between January 2010 and December 2018. Anti-SLA, anti-liver cytosol type 1 antibody (anti-LC1), anti-glycoprotein 210 antibody(anti-gp210) and anti-nuclear body protein sp100 antibody(anti-sp100) were detected by immunoblotting; indirect immunofluorescence assay used for detecting anti-nuclear antibody (ANA), anti-mitochondrial antibody (AMA), anti-smooth muscle antibody (SMA), and anti-liver kidney microsome antibody (anti-LKM). One-way analysis of variance was used to compare the ages of different anti-SLA groups. The non-parametric rank sum test was used to compare the liver function indexes and immunoglobulins in different intensity groups of anti-SLA. P<0.05 was considered statistically significant. Further comparisons were made between the two groups, the correction level α′=0.008 3, P<0.008 3 was considered statistically significant. Results The average age of 77 anti-SLA positive patients was (52.50±1.25) years old, 70 females (90.9%) and 7 males (9.1%). 80.5% of anti-SLA-positive patients (62/77 cases) were strongly positive at the time of initial diagnosis (+++ to ++++).The Alanine aminotransferase (ALT) level in the SLA++ group was higher than that in the SLA++++ group (232.7 U/L vs 65.6 U/L,χ2=7.751,P=0.005) and the immunoglobulin M(IgM) level in the SLA+++ group was lower than that in the SLA++++ group (1 270 mg/L vs 2 270 mg/L,χ2=8.337,P=0.004).There was no significant difference in age, other liver function and immunological indicators among the different groups.Seventy cases (90.9%) were both anti-SLA and ANA positive, 13 cases (16.9%) were positive with SMA, and none positive with anti-LKM and anti-LC1. Among anti-SLA positive patients, 58 cases were diagnosed with autoimmune hepatitis (AIH), 12 were AIH/primary biliary cholangitis (PBC) overlap syndrome (OS), 2 were drug-induced liver injury, 2 were chronic hepatitis B, and 3 were hepatitis A, hepatitis E and acquired immune deficiency syndrome (AIDS) with liver injury, respectively.Cases of AIH and AIH/PBC OS accounted for 90.9% (70/77 cases) of anti-SLA-positive patients, and 5 of 7 patients diagnosed with non-AIH (and OS) had elevated IgG, showing AIH feature.92.3% (12/13 cases) of anti-SLA with high titers of AMA were diagnosed as AIH/PBC overlap syndrome. Of the 77 anti-SLA-positive patients, 28 (36.4%) had advanced or end-stage liver disease, including decompensated cirrhosis (22 cases), chronic acute liver failure (4 cases), and liver transplantation (1 case) and death from liver failure (1 case). Conclusions Anti-SLA has high diagnostic specificity for AIH;anti-SLA positive in patients with PBC should be an important biomarker for the diagnosis of AIH/PBC overlap syndrome. Key words: Liver diseases; Hepatitis, autoimmune; Autoantibodies

Causes of natural regression of obstructive jaundice in rats and time for surgery to reduce yellowing

Objective to investigate the causes of spontaneous resolution of obstructive jaundice in rats, and to provide theoretical basis for rational selection of experimental model and duration of yellow reduction surgery. Methods 54 rats were randomly divided into the bile duct ligation and dissociation group (group A), the bile duct ligation group (group B) and the control group (group C), with 18 rats in each group. Serum total bilirubin (TBIL) and alanine aminotransferase (ALT) were detected on the first, 3, 7, 14 and 21 d after the operation, cholangiography was performed on the 21d with meglumine diatrizoate, and bile duct radionuclide imaging was performed on the 28 d. One-way anova was used to compare the laboratory results between groups and within groups. Results TBIL increased in group 1dA and group B, and peaked on day 7. On the 14th day after the operation, the icterus began to be separated from the two groups, 3 (16.7%) rats in group A and 14 (77.8%) rats in group B began to decline, and the comparison between groups A and B [ (136.5±14.3) mumol/L ratio (78.5±12.8) mumol/L, t=196.203, P<0.05]. After the operation, those in group 21dA and group B basically returned to normal level, and ALT showed the same rule (t=57.450, P<0.05). 21 d after the operation, cholangiography was performed with meglumine diatrizoate. The bile ducts above the ligation line were significantly dilated in group A, and the contrast agent did not spread to other sites. In group B, the proximal bile duct was slightly dilated, and contrast agent was observed to enter the intestinal cavity through the adhesion omentum duct at the hilum of liver. Radionuclide imaging and quantification of the proximal dilated bile duct 28 days after the operation, no radionuclide was discharged into the intestinal tract in the rats in group A, while the radionuclide was discharged into the intestinal tract from the liver through the attached omentum at the hilar of the liver in the rats in group B after 5min, and the radionuclide was developed. Conclusion the spontaneous resolution of obstructive jaundice in rats may be caused by the presence of small bile duct or adhesive retinal duct shunt in the hepatic hilum. Bile duct rupture should be the first choice for biliary obstruction model, and yellow reduction intervention can be conducted after modeling for 14 d. Key words: Rats; Spontaneous resolution of jaundice; Reason; Surgery reduces yellow time

Complement factor CD59 deficiency significantly aggravates cholestasis liver injury in mice

Objective To investigate the role of complement factor CD59 in cholestatic liver injury in mouse bile duct ligation (BDL) model. Methods The cholestasis model of mice was induced by BDL. The relevant indexes were detected 3 days after operation. Results Increased alanine aminotransferase [ALT: (730.67±104.50) U/L vs. (311.33±52.47) U/L, t=8.784, P 0.05] and C5a [(284.43±80.88) μg/L vs. (212.95±13.53) μg/L, t=1.743, P>0.05] levels between the two BDL groups, suggesting that CD59 deficiency did not impact in vivo generation of C3 and C5 activation products. An increased membrane attack complex (MAC) deposition in CD59 deficiency animals could be monitored. Conclusion The present study proves a functional role of CD59 during cholestasis. CD59 deficiency leads to aggravated cholestatic liver injury by up-regulating the expression of MAC. CD59 appears to be an attractive target for future therapeutic intervention in chronic cholestatic liver disease. Key words: Cholestatic liver injury; CD59; Complement; Bile duct ligation; Membrane attack complex

Gadolinium chloride alleviates partial warm ischemia-reperfusion injury of liver by suppressing kupffer cell function in mice

Objective To investigate the effect and mechanism of gadolinium chloride alleviates partial warm ischemia-reperfusion injury of liver by suppressing kupffer cell function in mice. Methods Forty-eight male C57BL/6 mice were randomly divided into sham-operated group (Sham), Hepatic ischemia-reperfusion injury (HIRI) group, gdolinium chloride groups (Gd+ IRI), and cobalt protoporphyrin (CoPP+ IRI) group (n=12). The rats were injected with the same dose of normal saline in Sham group and IRI group. Gd+ IRI group were intraperitoneally injected with GdCl3 (20 mg/kg) 24 hours before operation. At the same time, CoPP+ IRI group were intraperitoneally injected with CoPP (5 mg/kg). Except for Sham group, an 70% volume HIRI model was established by means of 60 minutes ischemia and then 6 hours reperfusion in the other groups. The levels of serum aspartate transaminase (AST) and alanine aminotransferase (ALT) in each group were compared. Enzyme-linked immunosorbent assay were used to test the levels of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) in the liver tissue. The level of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6, heme oxygenase-1 (HO-1), and protective factor IL-10 mRNA level were detected by real time quantitative polymerase Chain Reaction (RT-PCR). Immunohistochemical staining was used to measure Fas, FasL protein expression level of extrahepatic biliary epithelial cells. Results Respectively, the serum ALT level in the HIRI, Gd+ IRI and CoPP+ IRI groups was (1 236.7±62.4), (638.9±50.9), (740.3±53.1) U/L, and the AST level was (1 107.8±68.3), (568.5±42.7), (679.1±49.9) U/L, the serum level of ALT and AST in Gd+ IRI and CoPP+ IRI groups was lower than IRI group (t=6.721, P<0.01; t=4.732, P<0.05; t=5.984, P<0.01; t=2.691, P<0.05). Compared with IRI group, the activity of SOD and GSH-Px was promoted (t=7.301, P<0.01; t=1.937, P<0.05), whereas the levels of MDA was reduced (t=9.519, P<0.01; t=8.635, P<0.01). Simultaneously, the TNF-α, IL-1β and IL-6 mRNA level in Gd+ IRI and CoPP+ IRI groups were decreased (t=6.721, P<0.01; t=2.316, P<0.05), and the levels of IL-10 and HO-1 mRNA were increased (t=2.973, P<0.05; t=7.921, P<0.01). After hepatic artery reflow 6 h, the Fas expression levels on bile ducts epithelial cells in Gd+ IRI and CoPP+ IRI groups respectively was 22.4%, 29.7%, which was lower than IRI group (38.9%) (χ2=6.561, P<0.01; χ2=2.547, P<0.05). The FasL expression levels in Gd+ IRI and CoPP+ IRI groups respectively was 21.2%, 25.1%, which was lower than IRI group (36.5%) (χ2=5.982, P<0.05; χ2=3.188, P<0.05). Conclusion Gdolinium chloride shows an protective function aganist liver ischemia-reperfusion iniury in mice by Oxidative stress, inhibiting inflammation and cell apoptosis. The up-regulation of HO-1 by gdolinium chloride may be the possible mechanism. The up-regulation of HO-1 and inhibiting the Fas/FasL protein expression by gdolinium chloride may be the possible mechanism. Key words: Gdolinium chloride; Liver; Ischemia-reperfusion injury; Heme oxygenase-l

Effects of methanolic tuber extract of Cyperus esculentus Linn (tiger nuts) on sub-acute liver damage in albino rats

This study evaluated the effects of Cyperus esculentus methanolic tuber extract (CEME) on carbon tetrachloride (CCl4)-induced sub-acute liver damage in albino rats. Dried tubers of C. esculentus were pulverized and extracted by cold maceration, using 80% methanol. Thirty albino rats, randomly assigned to 6 groups (A–F) of 5 each were used for the study. Sub-acute liver damage was induced in Groups A-E rats using intra-peritoneal injections of CCl4. Group A was treated with distilled water placebo, while Groups B, C and D were treated with 200, 400 and 800 mg/kg CEME, respectively. Group E was treated with 100 mg/kg Silymarin and Group F was also given distilled water placebo. Treatment was done orally for 15 days, after which hepatocellular integrity and liver function were evaluated. Results showed that treatment with CEME (at all doses) led to significantly lower (p<0.05) serum alanine aminotransferase and aspartate aminotransferase activities, bilirubin levels and relative liver weight of the CEME-treated groups, when compared to Group A rats. It was concluded that administration of CEME as used in the study led to significant protection of hepatocellular integrity, enhancement of hepatic excretion of bilirubin and amelioration of CCl4-induced inflammatory enlargement of the liver. Key words: Cyperus esculentus, methanolic tuber extract, hepatoprotection, liver damage.

Analysis of influence factors of alanine transaminase in voluntary blood donors in Chengdu

Objective To explore the influence factors of unqualified alanine aminotransferase (ALT) of voluntary blood donors in Chengdu. Methods From June 1, 2012 to June 1, 2013, a total of 16 424 voluntary blood donors from a street blood collection point of Chengdu Blood Center were selected as subjects by random sampling method. Among them, there were 8 860 male and 7 564 female donors, aged from 18 to 55 years. Blood samples for ALT primary screening were detected by dry chemical method, and blood samples for ALT laboratory re-examination were detected by rate method. The ALT value > 40 U/L was determined to be unqualified for ALT blood screening or laboratory re-examination of blood donors. The information management system of Tangshan Qiao 5.0 was used to collect the data of blood donors including gender, age, height, weight, marital status, nationality, occupation, educational level and the seasons of blood donation. The ALT unqualified rates of blood donors with different demographic characteristics (gender, age, marital status, nationality, occupation and education level), seasons of blood donation and body mass index (BMI) were calculated respectively. Chi-square test was used to compare the ALT unqualified rates of blood donors with different demographic characteristics, seasons of blood donation and BMI. Multivariate unconditional logistic regression analysis was used to further study the independent influence factors of ALT disqualification in voluntary blood donors. The procedures followed in this study were in accordance with the requirements of the World Medical Association Declaration of Helsinki revised in 2013. And the Informed Consent of Blood Donors were signed with all blood donors before blood donation. Results ① Among the 16 424 voluntary donors in this study, and the unqualified rate of ALT was 14.4% (2 363/16 424). Among them, a number of 2 256 donors failed in ALT primary screening, accounting for 95.5% (2 256/2 363); and 107 donors failed in ALT laboratory re-examination, accounting for 4.5% (107/2 363). ② The results of univariate analysis for the influence factors of ALT disqualification in 16 424 voluntary blood donors in this study showed that there were significant differences in ALT unqualified rates among donors of different gender, age, marital status, occupation, education level, seasons of blood donation and BMI, respectively (χ2=872.65, 627.76, 575.94, 641.88, 150.64, 50.71, 2 152.05; P<0.001). ③ The results of multivariate unconditional logistic regression analysis showed that male (OR=3.52, 95%CI: 3.13-3.96, P<0.001), age of 26-35 years (OR=1.25, 95%CI: 1.07-1.46, P<0.001), 18.5 kg/m2 ≤ BMI<25.0 kg/m2 (OR=2.34, 95%CI: 1.24-4.45, P=0.010), 25.0 kg/m2≤BMI<28.0 kg/m2 (OR=7.51, 95%CI: 3.98-14.29, P<0.001) and BMI≥28.0 kg/m2 (OR=19.48, 95%CI: 10.13-37.45, P<0.001); married (OR=1.27, 95%CI: 1.09-1.47, P<0.001); blood donation in summer (OR=1.50, 95%CI: 1.26-1.79, P<0.001), blood donation in autumn (OR=1.79, 95%CI: 1.51-2.13, P<0.001), blood donation in winter (OR=1.27, 95%CI: 1.02-1.47, P<0.001) were the independent risk factors for ALT disqualification in blood donors. Student donor was the independent protective factor for ALT disqualification of blood donors (OR=0.31, 95%CI: 0.25-0.37, P<0.001). Conclusions The ALT unqualified rate of blood donors in Chengdu is at a high level. Independent risk factors for ALT disqualification in blood donors included age of 26-35 years, BMI≥18.5 kg/m2, married, and blood donation in summer, autumn and winter. In view of these independent risk factors, corresponding measures should be taken to reduce the ALT unqualified rate of voluntary blood donors in Chengdu. Key words: Blood donors; Alanine transaminase; Population structure; Influence factors; Unqualified rate

Therapeutic value of endoscopic ultrasonography-guided hepaticogastrostomy for high malignant biliary obstructive jaundice

Objective To study the therapeutic value of endoscopic ultrasonography-guided hepaticogastrostomy(EUS-HG) for patients with high malignant biliary obstructive jaundice. Methods A total of 56 patients with high malignant obstructive jaundice hospitalized at the Second Affiliated Hospital of Nanjing Medical University and the Second Affiliated Hospital of Xuzhou Medical University from January 2014 to December 2017 were included in the study. There were 29 males and 27 females with median age of 72 (60-82) years. Patients were randomized into two groups according to the random number table, the EUS-HG group (n=20) treated with EUS-HG and the percuteneous transhepatic cholangiodrainge(PTCD) group (n=36) treated with PTCD. The operative success rate, curative effect, complications and operation cost were compared between the two groups, and the median unblock period of plastic double pig tail stent was observed. Results (1)The success rates were 100% in both groups. (2) Preoperative and one-month postoperative levels of the following were tested and compared. Levels of total bilirubin were 362.15±138.27 μmol/L, 56.85±28.57 μmol/L in the EUS-HG group and 356.47±130.69 μmol/L, 60.93±25.79 μmol/L in the PTCD group, respectively. Levels of alkaline phosphatase were 896.57±357.29 U/L, 146.59±48.63 U/L in the EUS-HG group and 883.65±364.32 U/L, 151.57±49.73 U/L in the PTCD group, respectively. Levels of alanine aminotransferase were 252.36±38.77 U/L, 60.29±31.57 U/L in the EUS-HG group and 246.26±32.57 U/L, 62.56±32.87 U/L in the PTCD group. Levels of aspartate aminotransferase were 259.37±30.64 U/L, 62.28±26.58 U/L in the EUS-HG group and 242.37±29.52 U/L, 60.28±29.57 U/L in the PTCD group, and there was no significant difference between the two groups (P>0. 05). CRP levels were 52.57±31.95 mg/L, 16.95±8.77 mg/L in the EUS-HG group and 53.42±35.79 mg/L, 25.13±14.77 mg/L in the PTCD group (P 0.05]. (4) The incidence of total complications in the EUS-HG group (20.0%, 4/20) was significantly lower than that in the PTCD group (47.2%, 17/36, P 0.05). (6) The median unblock period of double pig tail plastic stents in EUS-HG group patients was 102 days. Conclusion EUS-HG is a safe and effective method for the treatment of high malignant biliary obstructive jaundice. It can be used as the first choice for treatment after failure of conventional ERCP. Key words: Jaundice, obstructive; Punctures; Drainage, postural; Endoscopic ultrasonography-guided hepaticogastrostomy

Related factors of prognosis for acute liver failure in critically ill children

Objective To analyze the clinical features of acute liver failure in critically ill children, to investigate the risk factors affecting the prognosis of acute liver failure in critically ill children, and to provide evidence for clinical diagnosis and prognosis. Methods The data of 85 children with acute liver failure who conformed to the diagnostic criteria from January 2011 to January 2017 at Hunan Children′s Hospital were analyzed.According to the prognosis of children with acute liver failure, all children were divided into the survival group (49 cases) and the death group (36 cases). Univariate and multivariate Logistic regression methods were used to analyze the risk factors affecting the prognosis of children with acute liver failure. Results There were statistically significant differences of enzyme bile isolation[26.5% (13/49 cases) vs.55.6%(20/36 cases), χ2=7.361, P=0.007], hepatic encephalopathy [16.3%(8/49 cases) vs.38.9%(14/36 cases), χ2=5.507, P=0.019], total bilirubin [72.30(3.93-428.80) μmol/L vs.153.08(3.23-776.26) μmol/L, U=-2.283, P=0.027], albumin [35.02(22.89-45.30) g/L vs.28.90(18.30-40.26) g/L, U=4.640, P=0.000], alanine aminotransferase [1 626.10(23.01-9 518.41) U/L vs.533.08(7.02-5 163.83) U/L, U=2.992, P=0.004], aspartate aminotransferase [1 611.20(34.51-15 850.02) U/L vs.715.54(60.06-10 280.42) U/L, U=2.312, P=0.023], blood ammonia [71.02(16.04-148.56) μmol/L vs.81.02(33.04-274.02) μmol/L, U=-2.057, P=0.046], prothrombin time [23.10(13.61-81.23) s vs.33.91(12.62-84.57) s, U=-2.364, P=0.022], activated partial prothrombin time [52.91(4.02-181.02) s vs.67.35(31.20-180.02) s, U=-2.226, P=0.029], and end-stage liver disease model score [13.00(-9.00-52.00) score vs.27.50(-9.00-88.00) score, U=-3.082, P=0.003] in the children with acute liver failure between the survival group and the death group.Multivariate Logistic regression analysis showed that total bilirubin (OR=0.236, 95%CI: 0.059-0.946, P=0.041), albumin(OR=0.854, 95%CI: 0.746-0.976, P=0.019), enzyme bile separation (OR=1.063, 95%CI: 1.031-1.119, P=0.005) and hepatic encephalopathy (OR=1.439, 95%CI: 1.021-2.043, P=0.017) were risk factors for the prognosis of children with acute liver failure. Conclusions The level of the total bilirubin and the ratio of enzyme bile isolation and hepatic encephalopathy are positively correlated but the level of albumin is negatively correlated with the prognosis of critically ill children with acute liver failure. Key words: Critically ill; Child; Acute liver failure; Prognosis