Abnormal Liver Function Research Articles

The efficacy and safety of sodium tanshinone ⅡA sulfonate injection in the treatment of unstable angina pectoris: A systematic review and meta-analysis.

To systematically evaluate the efficacy and safety of Sodium tanshinone ⅡA sulfonate injection (STS) in the treatment of unstable angina pectoris (UAP). CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, Web of Science, Embase were searched by computer. The research covers the clinical randomized controlled trials of STS in the treatment of unstable angina pectoris published from the establishment of the library to January 31, 2023. Two researchers independently screened the literature, extracted data and evaluated the risk of research bias, and then conducted meta-analysis with RevMan5.3 software. A total of 37 randomized controlled trials were included, involving 3926 patients in total. Meta analysis results showed that, compared with conventional western medicine alone, STS combined with conventional western medicine could reduce the frequency (SMD = -2.61, 95%CI[-4.27, -0.96], P = 0.002) and duration (SMD = -4.01, 95%CI[-6.18, -1.84], P = 0.0003) of angina pectoris, improve ECG efficacy (OR = 3.61, 95%CI[2.79, 4.68], P<0.00001) and clinical symptom efficacy (OR = 4.02, 95%CI[3.32, 4.87], P<0.00001), reduce TG(SMD = -0.60, 95%CI[-1.04, -0.16], P = 0.008), TC(SMD = -3.86, 95%CI[-6.37, -1.34], P = 0.003), and LDL-C(SMD = -1.54, 95%CI[-2.67, -0.42], P = 0.007), decrease plasma viscosity(SMD = -1.02, 95%CI[-1.58, -0.47], P<0.0003), whole blood low shear viscosity(SMD = -0.85, 95%CI[-1.21, -0.49], P<0.00001), whole blood high shear viscosity(SMD = -0.82, 95%CI[-1.44, -0.20], P = 0.009), and erythrocyte aggregation index(SMD = -1.00, 95%CI[-1.75, -0.25], P = 0.009), and bring down CRP(SMD = -1.39, 95%CI[-1.91, -0.86], P<0.00001). The incidence of adverse reactions in the treatment group was higher than that in the control group (OR = 2.26, 95%CI[1.06, 4.85], P = 0.04). Neither of the two groups suffered from abnormal liver and kidney function during the study process. STS combined with routine treatment has a definite clinical efficacy and certain safety in the treatment of UAP, but it needs to be further confirmed by high-quality and low-bias randomized controlled trials in the future.

Prognosis after splenectomy plus pericardial devascularization vs transjugular intrahepatic portosystemic shunt for esophagogastric variceal bleeding.

Portal hypertension combined with esophagogastric variceal bleeding (EGVB) is a serious complication in patients with hepatitis B virus (HBV)-related cirrhosis in China. Splenectomy plus pericardial devascularization (SPD) and transjugular intrahepatic portosystemic shunt (TIPS) are effective treatments for EGVB. However, a comparison of the effectiveness and safety of those methods is lacking. To compare the prognosis after SPD vs TIPS for acute EGVB after failure of endoscopic therapy or secondary prophylaxis of variceal rebleeding (VRB) in patients with HBV-related cirrhosis combined with portal hypertension. This retrospective cohort study included 318 patients with HBV-related cirrhosis and EGVB who underwent SPD or TIPS at West China Hospital of Sichuan University during 2009-2013. Propensity score-matched analysis (PSM), the Kaplan-Meier method, and multivariate Cox regression analysis were used to compare overall survival, VRB rate, liver function abnormality rate, and hepatocellular carcinoma (HCC) incidence between the two patient groups. The median age was 45.0 years (n = 318; 226 (71.1%) males). During a median follow-up duration of 43.0 mo, 18 (11.1%) and 33 (21.2%) patients died in the SPD and TIPS groups, respectively. After PSM, SPD was significantly associated with better overall survival (OS) (P = 0.01), lower rates of abnormal liver function (P < 0.001), and a lower incidence of HCC (P = 0.02) than TIPS. The VRB rate did not differ significantly between the two groups (P = 0.09). Compared with TIPS, SPD is associated with higher postoperative OS rates, lower rates of abnormal liver function and HCC, and better quality of survival as acute EGVB treatment after failed endoscopic therapy or as secondary prophylaxis of VRB in patients with HBV-related cirrhosis combined with portal hypertension. There is no significant between-group difference in VRB rates.

Clinical presentations and outcomes of pancreaticobiliary maljunction in different pediatric age groups

BackgroundPancreaticobiliary maljunction (PBM) is a congenital defect, with risk of developing various pancreaticobiliary and hepatic complications. The presentations of PBM in children and adults are believed to be different, but studies on PBM children of different age groups are limited. This study was to evaluate clinicopathologic characteristics and outcomes in PBM children of different ages.MethodsA total of 166 pediatric patients with PBM were reviewed retrospectively. Clinicopathological, imaging, laboratory, surgical, and follow-up data were collected and analyzed. The patients were divided into three age groups, namely, group A (< 1 year, n = 31), group B (1–3 years, n = 63), and group C (> 3 years, n = 72).ResultsThe major clinical manifestation was jaundice in group A and abdominal pain and vomiting in groups B and C. Acute pancreatitis was more often seen in group C than group A. The length of common channel was significantly longer in group C than group A, while the maximum diameter of common bile duct in group C was smaller than that in group A. Cholangitis and cholecystitis were more commonly performed in groups B and C, while hepatic fibrosis in group A. Whether preoperatively or postoperatively, group C was more likely to have elevated serum amylase, while groups A and B were more likely to present with abnormal liver function indicators, including the increase of aspartate transaminase, alanine transaminase, and gamma-glutamyl transpeptidase.ConclusionPresentation of PBM varies among different pediatric age groups, thus suggesting that targeted management should be carried out according to these differences.

Prevelance and Outcome of Liver Function Abnormalities among Egyptian Patients with COVID-19

Background In December 2019, a novel corona virus was identified as the pathogen to cause pneumonia in Wuhan, China, which was temporarily named as 2019-nCoV by the World Health Organization, SARS-CoV-2 can be transmitted from person to person through respiratory droplets and close contact, The main manifestations of SARS-CoV-2 infection include fever, dry cough, weakness, and breathing difficulty. Abnormality in liver function tests has been reported; almost one-half of patients experience different degrees of liver test abnormalities, According to a recent study using single-cell RNA sequencing, angiotensin-converting enzyme 2 was highly expressed not only in type II alveolar epithelial cells, but also in bile duct cells. Importantly, recent studies confirmed that angiotensin-converting enzyme 2 receptor is the cell entry receptor of SARS-CoV-2 Objectives To measure the prevelance of liver function abnormalities among Egyptian patients with COVID -19 and To measure relation between liver function abnormalities and outcome among Egyptian patients with COVID -19. Patients and Methods The present study was conducted on 299 patients with covid -19, patients attended to Ain Shams Isolation Hospitals, (retrospective cohort study). Total number of cases during the study period was 299 patients. patients diagnosed with acute hepatitis were excluded from the study, Eventually, 299 patients were enrolled in the study fulfilling the inclusion criteria. Results The mean age of our patients is 59.4 years with Male predominance (159 males and 104 females). AST baseline was (55.50%) normal and (5.70%) more than 3 fold, AST after 1 week was (52.5%) normal and (6%) More than 3 fold, AST after 10 days was (54.2%) normal and (6%) More than 3 fold., ALT baseline was (71.2%) normal and (3%) more than 3 fold, ALT after 1 week was (71.9%) normal and (3.3%) More than 3 fold, ALT after 10 days was (74.6%) normal and (3.3%) More than 3 fold. Conclusion Elevated liver function is very common in patients with COVID-19 infection and a significant difference was found between liver function abnormalities and outcome .

Risk Factors and Predictors of Occlusion of Stent of Trans Jugular Intrahepatic Porto-Systemic Shunt (TIPSS) in Egyptian Patients with Primary Budd Chiari Syndrome: A Single Center Experience

Background Budd–Chiari syndrome is a heterogeneous group of disorders characterized by hepatic venous outflow obstruction at the level of the hepatic venules, the large hepatic veins, the inferior vena cava till its junction with the right atrium. The classic triad of abdominal pain, ascites, and hepatomegaly is observed in the vast majority of patients with Budd-Chiari syndrome. The diagnosis of BCS is made by clinical presentation and confirmatory investigations. Standard laboratory investigations are rarely helpful in establishing the diagnosis, because abnormal liver function tests are not specific for BCS, real time Gray-scale sonography combined with colour flow is considered by some to be the initial imaging technique. The recommended stepwise therapeutic algorithm of BCS is mainly by medical treatment with anticoagulation, angioplasty with or without stenting, TIPS of surgical shunting and liver transplantation if indicated. TIPS is a common teqnique used in BCS and TIPS stent occlusion is major complication. Objectives To identify the possible risk factors and predictors of stent occlusion in primary BCS patients who underwent TIPSS. Patients and Methods The studied patients were selected from patients presented to Budd Chiari outpatient clinic. Tropical medicine department in Ain Shams University hospitals. total number of cases during the study period was 76 cases fulfilling the inclusion criteria, they were divided in 2 groups according to patency of TIPS stent and comparing both groups regarding their pre and post TIPS data. Results The mean age of the patients was (29.29 ± 7.92) with female predominance. FVLM (69.7%) &amp; MTHFRD (67.1%) were the most common causes of BCS in the studied patients. positive and higher CRP results were found in the occluded stent patients than patent groups. also, higher TLC levels were found in the occluded TIPS stent patients. Conclusion Identifying these risk factors may help predict the outcome of TIPS stent patency.

Prevalence of Abnormal Liver Functions in Covid-19 Patients

Abstract Background Coronaviruses are a family of viruses that are known to cause both respiratory and intestinal diseases in various animal species and humans. These viruses tend to target the upper respiratory tract, causing anywhere from moderate to severe illnesses, such as the cold or in more extreme cases, pneumonia. To date, 7 human coronaviruses have been identified, including the 3 epidemic viruses of severe acute respiratory syndrome (SARS)-CoV, middle east respiratory syndrome (MERS)-CoV and the newest, severe acute respiratory syndrome coronavirus 2 (SARSCoV-2). Aim of the Work To evaluate the incidence of concurrent elevation of liver function tests (AST, ALT, Bilirubin), examine dynamic changes of it and its relationship with disease throughout the course of COVID-19 patients. Patients and Methods We retrospectively evaluated and analyzed the liver enzymes and total bilirubin results (Ast, Alt, bilirubin) along with the medical history obtained from 105 adult patients of both genders with confirmed COVID-19, moderate group (62) patients, severe group (43) patients from 15 March 2020 to 15 June 2020 admitted at Ain Shams University isolation hospitals. Results AST was significantly higher in patients with severe disease on admission compared to moderate cases, however it's median level did not show marked elevation from normal values (median AST level 45 u/l, range 12-2228), normal value of AST less than 40 U/L. During hospital stay AST also was significantly higher in severe group compared to moderate group with p value 0.022. ON discharge patients had almost normal AST level as patients were improved (2 COVID PCR were negative). Conclusion Liver injury not a frequent finding in patients with COVID-19. Any rise in liver function may indicate severe COVID disease. Monitoring liver functions during course of severe disease till recovery.

Role of MRCP in Patients with Jaundice When Biliary Tree Is Normal on Previous Imaging

Background Obstructive jaundice is one of the most frequent and grave form of hepatobiliary disease. It is important for treatment planning to detect level and cause of obstruction. Aim of the Work To assess the role of MRCP in patients presented with jaundice, right hypochondrial pain with the absence of dilated biliary system by ultrasound. Patients and Methods This was cross sectional study that included 38 patients who presented with obstructive jaundice or right hypochondrial pain with normal biliary system by ultrasound referred to the Radio diagnosis Department for MRCP. Results MRCP has high sensitivity reaching 100% and high specificity reaching 93.33% in gall bladder pathology and high specificity 100% in biliary and pancreatic pathology in comparison to ultrasound. Conclusion if there is high clinical suspicion of ductal pathology when patient presented by jaundice or right hypochondrial pain with abnormal liver function tests despite normal biliary tree by ultrasound, an MRCP examination should be strongly considered as next imaging modality of choice

Development and validation of a nomogram model for central venous access device-related thrombosis in hospitalized children.

The nomogram model can be used as a risk assessment tool to reduce the missed diagnosis rate and the incidence of CRT in hospitalized children. • Central venous access device-related thrombosis is generally asymptomatic for hospitalized children, causing the missed diagnosis of central venous access device-related thrombosis easily. • No risk prediction nomogram model for central venous access device-related thrombosis in hospitalized children has been established. • A visual and personalized nomogram model was built by seven accessible variables (blind catheterization, abnormal liver function, central line-associated bloodstreaminfection, infection, number of catheter lines, leukemia, and bed rest > 72h). • The model can effectively predict the risk of central venous access device-related thrombosis for hospitalized children.

Study of Inter-relatedness between Hepato-renal Indices and Essential Minerals during the Last Trimester of Pregnancy

Purpose: Earlier on, it was reported that altered hepato-renal parameters and depletions of some nutrients co-existed at third trimester among the study participants. Yet the role low levels of nutrients played in altered hepato-renal axis (i.e. a possible association between the two) was not investigated. Even though liver is known for its physiologic importance in the metabolism of various metals and abnormal levels of certain elements also induce alterations in physiologic processes in specific organs. The study is aimed at investigating correlation between nutritional parameters (total protein, albumin, calcium, magnesium) and hepato-renal indices (alanine aminotransferase, aspartate aminotransferase, bilirubin, alkaline phosphatase, urea and creatinine) at the last trimester of pregnancy.&#x0D; Study Design: This is a cross-sectional study.&#x0D; Methods/Participants: Forty pregnant women in the third trimester (29 weeks to term) were recruited as test group while another group of 40 women (age-matched, non-pregnant) served as control. 5 mL of blood was collected and used for estimation of nutritional indices and hepato-renal markers. Information on birth weight was obtained. Data were analyzed using Pearson’s correlation coefficient. P≤ 0.05 was considered significant.&#x0D; Results: Data obtained from the study revealed that there were no correlations between any nutritional marker and hepato-renal indices. Similarly, nutritional markers were not correlated with birth weight.&#x0D; Conclusion: There is no indication that there is a relationship between abnormal nutritional markers and indices of nephro-hepatic activities in third trimester women that had earlier being reported to feature abnormal liver and kidney function.

WTP3.4 Improvement of biliary service in hospital by altering the management of suspected or confirmed bile duct stones. Confirmed bile duct stones can be managed by single-stage procedure of laparoscopic cholecystectomy (LC) plus common bile duct exploration (CBDE). Intra-operative cholangiogram (IOC) can be used to avoid delays waiting for MRCP

Abstract Background Significant delays can follow the process of emergency admissions with biliary problems in hospitals. Routine pathway for gallstones and abnormal liver functions tests (LFTs) is ultrasound (US) followed by MRCP. Pathway for confirmed common bile duct (CBD) stones has been routinely an ERCP followed by LC either as inpatient or outpatient. Significant delays take place awaiting MRCP considering that there is no out-of-hours or weekend service, while ERCP lists only occur twice weekly for both emergency and elective which can lead to unnecessary delays. Methods An audit was performed for 2 months period from 1st October 2022 to 30th November 2022 to assess how patients were managed in the department. Results A total of 16 emergency LCs were done in this period. 3 of them had ERCP prior to operation while 5 had MRCP prior to exclude CBD stones. Average length of stay (LOS) for these 8 patients was 7 days. It was estimated that LOS for these patient would have been reduced to 4 days if IOC +/- CBDE were done. A total of 37 ERCPs were done in the same period. 22 of them were done as emergency of which 12 were for CBD stones, 7 for cancers and 3 for bile leak. 7 of the 12 emergency ERCPs for CBD stones would have benefited from one stage procedure of LC + CBDE reducing their LOS and leaving space for other cases in ERCP lists. Conclusion A dedicated weekly IOC/CBDE list was proposed to overcome this problem.

Protective effect of water extracts of Veronicastrum latifolium (Hemsl.) Yamazaki on carbon tetrachloride-induced liver fibrosis in mice and its effect on intestinal flora

Liver fibrosis refers to a reversible event of repair and reconstruction following injury due to various etiologies, and its continuous development will lead to cirrhosis and liver cancer. Abnormal alterations in intestinal microbiota can hasten the development of hepatic fibrosis and damage. Veronicastrum latifolium (Hemsl.) Yamazaki (VLY) is a classic drug applied extensively for managing acute and chronic hepatitis, liver cirrhosis and ascites in ethnic minority areas of Guizhou Province, China, which possesses broad-spectrum pharmacological activities. In view of the crucial role of intestinal microbiota in the development of liver fibrosis, the present study attempted to investigate the effects of VLY aqueous extract on ameliorating CCl4-elicited liver fibrosis in mice and on intestinal microbiota and to explore its possible mechanism. Phytochemical analysis showed that VLY water extract contained a variety of components, particularly rich in organic acids and their derivatives, flavonoids, phenolic acids, nucleotides and their derivatives, carbohydrates and other compounds. VLY water extract remarkably alleviated CCl4-induced liver damage and fibrosis in mice, improved liver histology, and improved liver function abnormalities. VLY water extract also inhibited the activation of hepatic stellate cells and invasion of intrahepatic inflammatory cells. Additionally, sequencing the 16 s rDNA gene revealed that VLY water extract changed the intestinal microbiota composition in liver fibrotic mice. It elevated the Firmicutes/Bacteroidota ratio and enriched the relative Lactobacillus richness, which is capable of mitigating fibrosis and inflammation in impaired liver. In summary, through modulation of inflammation and intestinal microbiota, VLY water extract can reduce the CCl4-elicited liver fibrosis.

E39 Hepatocellular insufficiency and systemic lupus; what is the relationship?!!

Abstract Introduction Systemic lupus erythematosus (SLE) can be associated with several nonspecific hepatic manifestations, but acute lupus hepatitis remains uncommon and rarely constitutes a revelation mode. Objectives To report a case of systemic lupus presented by hepatocellular insufficiency. Materials and methods The patient was eleven years old when admitted in 2017 for investigation of hepatocellular failure. Physical examination: mucocutaneous jaundice with dark urine without other abnormalities. The biological assessment revealed significant hepatic cytolysis, cholestasis, as well as a biological inflammatory syndrome, polyclonal hypergammaglobulinemia predominant on gamma globulins. Urinary sediment and blood count were normal. Ultrasound and hepatosplenic Doppler showed signs of chronic liver disease: portal hypertension and moderate ascites. Cardiac ultrasound showed pericardial effusion. We carried out an etiological assessment comprising: an exhaustive questioning having eliminated any drug or toxic intake. The serologies for viral hepatitis A, B and C were negative. The search for non-organ-specific anti-tissue antibodies (anti-smooth muscle, anti-mitochondria and anti-LKM1) were negative, as well as a cupric balance. Antinuclear antibody was positive with a titre of 1/1000, anti-DNA was positive (&amp;gt; 866 IU/ml), C3, C4 and CH50 were low, and antiphospholipid antibodies were positive. The diagnosis of systemic lupus erythematosus was made. The patient was on corticosteroid therapy and immunosuppressant. The evolution was marked by the progressive improvement of the hepatic balance sheet. Discussion Although hepatic involvement during SLE is not part of the diagnostic criteria, abnormal liver function tests are frequent, ranging from 23% to 60% depending on the series in the literature. However, SLE-specific liver disease or lupus hepatitis is rare, observed in 1% to3% according to the literature. Our patient was symptomatic with hepatocellular insufficiency. Conclusion Lupus hepatitis is a rare manifestation of SLE and constitutes a rare presenting mode that should not be overlooked. Ethics Associate Professor of pediatrics, department of medicine University Setif-Algeria (pediatric center –Setif-Algeria).

Apatinib induces zebrafish hepatotoxicity by inhibiting Wnt signaling and accumulation of oxidative stress.

Apatinib, a small-molecule VEGFR2-tyrosine kinase inhibitor, has shown potent anticancer activity in various clinical cancer treatments, but also different adverse reactions. Therefore, it is necessary to study its potential toxicity and working mechanism. We used zebrafish to investigate the effects of apatinib on the development of embryos. Zebrafish exposed to 2.5, 5, and 10 μM apatinib showed adverse effects such as decreased liver area, pericardial oedema, slow yolk absorption, bladder atrophy, and body length shortening. At the same time, it leads to abnormal liver tissue structure, liver function and related gene expression. Furthermore, after exposure to apatinib, oxidative stress levels were significantly elevated but liver developmental toxicity was effectively ameliorated with oxidative stress inhibitor treatment. Apatinib induces down-regulation of key target genes of Wnt signaling pathway in zebrafish, and it is found that Wnt activator can significantly rescue liver developmental defects. These results suggest that apatinib may induce zebrafish hepatotoxicity by inhibiting the Wnt signaling pathway and up-regulating oxidative stress, helping to strengthen our understanding of rational clinical application of apatinib.

Characteristics of peripheral lymphocyte subsets in patients with different stages of schistosomiasis japonica.

Immune cells are important for the development of schistosomiasis japonica and are also critical for the treatment of schistosomiasis. The immune cells in the peripheral blood help assess the immune state. The peripheral lymphocytes in schistosomiasis mansoni were well studied; however, immune cells in patients with different stages of schistosomiasis japonica are not well analysed. Here, we performed a preliminary study to explore characteristics of peripheral lymphocyte subsets in patients with different stages of schistosomiasis japonica. 135 patients with Schistosoma japonicum infection and 25 healthy volunteers were included in this study, including 84 patients with chronic S. japonicum infection and 51 patients with advanced S. japonicum infection. Flow cytometry analysis was performed to evaluate peripheral lymphocytes including T cells, B cells, and natural killer (NK) cells. Blood routine and liver function test data were analysed. Ultrasound examination was used to access liver fibrosis according to the World Health Organization standard about ultrasound in schistosomiasis. Demographic data analysis suggested there was no difference in age and gender in patients with S. japonicum infection and health control group. Liver function tests showed that patients with advanced schistosomiasis had a higher incidence of liver function abnormality and blood lipid than those with chronic schistosomiasis. Blood routine results reflected that haemoglobin, red blood cells, platelets, as well as lymphocytes in the advanced group were significantly less than that in the chronic group. Furthermore, flow cytometry analysis indicated that the percentage of CD4+ T cells was lower in the advanced group, but the percentage of CD19+ B cells was higher in the advanced group. In addition, the number of CD3+ T cells, CD3+ CD4+ T cells, CD3+ CD8+ T cells, and NK cells was less in the advanced group when compared with those in the chronic group. In addition, there was a correlation between the decrease in CD4+ T cells and more severe fibrosis on ultrasound images. Our results indicated that the immune state in the peripheral is different in different stages of S. japonicum infection. Lymphocyte subset analysis has potential to facilitate differential diagnosis of different stages of schistosomiasis japonica and even to be a prognostic factor.

The role of miRNA-26a-5p and target gene socs1a in flutolanil induced hepatotoxicity of zebrafish at environmental relevant levels

Flutolanil has been detected worldwide in aquatic environment and fish, which has become an undeniable stressor on ecosystem and human health. Flutolanil has been reported to be toxic to aquatic organisms. However, the pathophysiological and molecular mechanism behind the detrimental effects remains obscure. Here we reported hepatotoxicity induced by flutolanil in HepG2 cells and zebrafish, as revealed by toxicokinetic, HE staining, miRNAs-mRNAs sequencing, molecular dynamic simulations and dual luciferase reporter assays. Collectively, our results indicated that flutolanil could be absorbed by and accumulated in the liver of zebrafish, causing hepatic vacuolar degeneration, steatosis and nuclear condensation and abnormal liver function, where its exposure at environmental levels disrupted the expressions of miRNA-26a-5p and its target gene socs1a by mediating JAK-STAT signaling pathway, which was partially responsible for hepatotoxicity, correlated with oxidative stress, cell apoptosis, inflammation, cell cycle disorder and mitochondrial dysfunction. These findings suggest that miRNA-26a-5p/socs1a can serve as potential biomarkers of hepatotoxicity in zebrafish following exposure to flutolanil. This uncovered route will provide a new tool for the risk assessment of flutolanil and a guide to proper use of flutolanil and environmental remedy, and open up a new horizon for liver disease assessment.

Abnormal liver function in children hospitalized with acute respiratory infection of adenoviruses: a retrospective study.

Human adenoviruses (HAdVs) can cause acute hepatitis in immunocompromised patients. However, it is unclear whether HAdVs are contributors to hepatitis in immunocompetent children. In this study, the liver function test (LFT) results were retrospectively analyzed among children hospitalized (age < 14 years) between January 2016 and October 2019 for acute respiratory infection caused by adenoviruses. Alanine transaminase (ALT) and aspartate aminotransferase (AST) levels were elevated in 7.74% and 46.89% of patients, respectively. All patients with > 2 folds of the upper limit of ALT or AST levels were infected with HAdV-7 or HAdV-55. Significantly higher levels of ALT, AST, γ-glutamyl transpeptidase (γ-GT), and lower albumin levels were observed in the HAdV-7 infection group than in the HAdV-3 infection group. HAdV-55 infection led to significantly higher γ-GT, total bilirubin, and direct bilirubin levels than the other infection types. The records of four patients with serial monitoring of the LFT results were further analyzed. Multiple indicators remained abnormal during the entirehospitalization in these patients. These results indicate that HAdV infection is often accompanied by abnormal liver function, and HAdV-7 and HAdV-55 might be under-recognized contributors to hepatitis among children.

Abnormal liver function in children hospitalized with acute respiratory infection of adenoviruses: a retrospective study

Human adenoviruses (HAdVs) can cause acute hepatitis in immunocompromised patients. However, it is unclear whether HAdVs are contributors to hepatitis in immunocompetent children. In this study, the liver function test (LFT) results were retrospectively analyzed among children hospitalized (age <14 years) between January 2016 and October 2019 for acute respiratory infection caused by adenoviruses. Alanine transaminase (ALT) and aspartate aminotransferase (AST) levels were elevated in 7.74% and 46.89% of patients, respectively. All patients with >2 folds of the upper limit of ALT or AST levels were infected with HAdV-7 or HAdV-55. Significantly higher levels of ALT, AST, γ-glutamyl transpeptidase (γ-GT), and lower albumin levels were observed in the HAdV-7 infection group than in the HAdV-3 infection group. HAdV-55 infection led to significantly higher γ-GT, total bilirubin, and direct bilirubin levels than the other infection types. The records of four patients with serial monitoring of the LFT results were further analyzed. Multiple indicators remained abnormal during the entire hospitalization in these patients. These results indicate that HAdV infection is often accompanied by abnormal liver function, and HAdV-7 and HAdV-55 might be under-recognized contributors to hepatitis among children.

Depletion of S-adenosylmethionine induced by arsenic exposure is involved in liver injury of rat through perturbing histone H3K36 trimethylation dependent bile acid metabolism

Long-term exposure to arsenic, a common environmental pollutant, can induce various types of liver injury, but the mechanism and treatment measures remain unclear. This study constructed a rat model of arsenic-induced liver injury, with methyl group donor S-adenosylmethionine (SAM) supplementation and Rosa roxburghii Tratt juice intervention, to explore the epigenetic mechanism and intervention method of arsenic-induced liver injury from the perspective of hepatic bile acid metabolism. The results showed that arsenic exposure induced the accumulation of total bile acids (TBA) in the liver and serum of rats, and the abnormalities in liver function and liver histopathology. Arsenic reduced histone H3K36 trimethylation (H3K36me3) in the liver via consuming methyl group donor SAM. The reduction of H3K36me3 was involved in arsenic-induced bile acid accumulation by inhibiting the transcription of negative feedback regulators Fxr and Fgfr4 for hepatic bile acid synthesis. SAM supplementation reversed arsenic-induced bile acid accumulation and liver injury by reactivating H3k36me3-dependent transcription of Fxr and Fgfr4. Moreover, this study found that Rosa roxburghii Tratt juice could rescue arsenic-induced SAM consumption, recover H3K36me3-dependent negative feedback regulation of hepatic bile acid synthesis, and alleviate arsenic-induced bile acid accumulation and liver injury. In conclusion, arsenic exposure perturbed H3K36me3-dependent hepatic bile acid metabolism via depleting SAM, thereby inducing hepatic bile acid accumulation and liver injury, which was ameliorated by the supporting effect of Rosa roxburghii Tratt juice on SAM. This study contributes to understanding the mechanism of arsenic-induced liver injury from the perspective of SAM-dependent epigenetics, providing new insight into its prevention and treatment.

Rare causes of abnormal liver function in a case of renal cysts and diabetes syndrome

Rare causes of abnormal liver function in a case of renal cysts and diabetes syndrome

Experimental observation on a new chimney-shaped mechanical valve completely implanted above the mitral annulus in animals.

Current commercially available prosthetic valves suffer from limited size, high requirements for implantation technique, subvalvular structural destruction, and valve dysfunction due to proliferation of fibrous endothelial tissue. This study aims to perform the preclinical large animal experiments for surgically implanting a chimney-shaped artificial mechanical heart valve with zero left ventricular occupancy, which fully accommodates the movement of the valve leaflets in the valve frame and realizes completely supra-annular surgical implantation. A total of 7 sheep underwent the replacement of artificial valve, and 5 sheep survived normally until anatomical examination. The mechanical properties of these artificial mitral valves remain functionally normal. There was no obvious thromboembolism around the artificial valve and in the important organs. The tissue layer of suture ring was completely organized and endothelialized, and the thickness of tissue layer was about 0.6-1.0mm. The follow-up of echocardiography showed that the left ventricular ejection fraction was normal (60-70%) before and 6months after operation. The results of transvalvular pressure gradient and blood flow velocity of artificial valve were normal. Left ventricular retrograde angiography showed that the artificial valve was completely located in the left atrium with good position and normal opening and closing. There was no obvious perivalvular leakage and other abnormalities. At 3 and 6months, there were no obvious abnormalities in blood routine test, liver and kidney function, and other indexes. The new chimney-shaped artificial mechanical valve implanted completely above the mitral annulus had good wear resistance, histocompatibility, and antithrombotic and hemodynamic performance.