Alanine Research Articles

Clinical study of combined blood purification therapy for patients with multiple organ dysfunction syndrome complicated with liver failure

Objective To explore the clinical efficacy of artificial liver technique - double plasma molecular adsorption(DPMAS) combined with continuous renal replacement therapy(CRRT) in the treatment of multiple organ dysfunction syndrome(MODS) patients with liver failure. Methods From April 2014 to October 2016, in the Qinghai Provincial People's Hospital emergency ICU hospitalized MODS combined with liver failure patients were enrolled in this study. On the basis of comprehensive medical treatment, these patients were randomly(random number) divided into CRRT control group(23 cases) and DPMAS + CRRT treatment group(22 cases). Blood biochemical, coagulation index, inflammatory factor and severity score of two groups were comparied before and 72 h after treatment. Results The levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), blood amine(NH3), creatinine(CREA), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), heart rate(HR), APACHEⅡ score and SOFA score in CRRT control group were statistically different before and after treatment (P 0.05); In the DPMAS + CRRT treatment group, the levels of ALT, AST, NH3, CREA, IL-6, TNF-α, HR, APACHEⅡand SOFA scores were significantly different before and after treatment (P 0.05). Conclusions Because of the combination of double plasma adsorption, besides the advantages of CRRT, DPMAS+CRRT can remove bilirubin and bile acid which can not be removed by CRRT, also improve coagulation function. The clearance efficiency of inflammatory factors is also higher, and the severity score is reduced more significantly. Key words: Double plasma molecular adsorption; Continuous renal replacement; Combined blood purification; Multiple organ dysfunction syndrome; Liver failure

Establishment of a new rat model of reversible obstructive jaundice

Objective To establish a rat model of reversible obstructive jaundice and to evaluate its clinical practical value. Methods Sixty SD rats were randomly divided into experimental group, control group and sham group. Each rat was drawn blood for liver function at days 0, 3, 7, 8, 10 and 14. Cholangiography was performed on experimental group 1 months after reliefof obstruction. Results Serum total bilirubin increased significantly at day 3 compared to day 0, and reached the highest level of (189.1±26.9) μmol/L at day 7. When the obstruction was relieved, serum total bilirubin slowly recovered to normal level at day 7; while the serum total bilirubin was significantly higher in control group than that in experiment group [(23.5±3.6) μmol/L vs. (4.3±1.5) μmol/L, P=0.001]. Other serum markers included alanine aminotransferase and glutamyl-transpeptidase followed a similar pattern with serum total bilirubin. Biliary duct dilatation was observed after the obstructive model established. When the obstruction was relieved, the distal biliary duct gradually recovered to normal. Conclusion The rat model of reversible obstructive jaundice provided a new way for future study of obstructive jaundice. Key words: Obstructive jaundice; Rat; Model, animal

Enteral hydrolyzed formula enhances preoperative bowel preparation in children with hirschsprung’s disease: a prospective andrandomized study

Objective To determine the effect of enteral hydrolyzed formula for preoperative bowel preparation in children with hirschsprung disease (HD). Methods Between December 2014 and February 2018, a total of 187 rectal-sigmoid HD patients underwent lapraroscopic Soave’s pull-through surgery in our institution were enrolled into three groups: Group A (n=68) received an enteral nutrition which is a kind of enteral hydrolyzed formula, group B (n=62) received routine diet for preoperative bowel preparation and gourp C (n=57) received total parenteral nutrition, during bowel preparation which began at least 10 days before surgery. The time of preoperative bowel preparation and intestinal cleanliness during surgery and various physiological indications before and after surgery were measured. Results The mean time of preoperative bowel preparation is (4.52±1.22), (7.42±1.85) and (2.85±0.70) days, respectively, in group A, B and C. No significant difference in the quality of colon cleansing during surgery between group A and C, and both higher than group B (P=0.001, respectively). Thirteen patients in group B had a slight decrease in serum prealbumin levels. In group C, 9 patients showed the increased level of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST). The mean time to first flatus postoperatively in group C was significantly longer than group A and B (3.21 d versus 0.93, 2.42 d, respectively, P=0.001). No significant difference in the occurrence of incision infection and anastomotic leakage postoperatively between three groups. The follow-up period was 1 month. The incidence of hirschsprung associated enterocolitis (HAEC) in group C was higher than group A and B, respectively (19.30% versus 8.82%, 9.68%, respectively, P=0.001). The length of hospital stay in group C was longer than group A and B, respectively (10.12 d versus 7.61, 8.33 d, respectively, P=0.013). Conclusion Enteral hydrolyzed formula as a nutrition support could facilitate the process of preoperative bowel preparation in HD patients; it can significantly reduce the time of preoperative bowel preparation and enhance recovery after surgery, with a significant reduction in length of hospital stay and incidence of HAEC. Key words: Hirschsprung disease; Enteral hydrolyzed formula; Preoperative bowel preparation; Laparoscopy; Pull-through

Ameliorating effect of green tea, sage, and their mixture against methomyl-induced physiological, biochemical, and histopathological alterations in male rats

Background and objectives Methomyl (MET) [S-methyl N-(methylcarbamoyloxy) thioacetimidate; C5H10N2O2S] is one of the most important carbamate (oximes) insecticides that is extensively used around the world. Carbamate compounds are known to cause an alteration in biochemical parameters and affect the oxidative status of the body through producing free radicals. Many antioxidants have been used to ameliorate the toxic effect of pesticides, but the search for such compounds will always be an urgent need to achieve the optimum degree of amelioration. For this purpose, the present study was designed to evaluate the ameliorating effect of green tea extract (GTE) (Camellia sinensis), sage extract (SE) (Salvia officinalis) and their mixture (GTE+SE) against MET-induced toxicity in male rats. Materials and methods A total of 60 rats (Rattus norvegicus) were divided into 12 groups: one negative control group (water); three positive control groups (GTE, SE, and GTE+SE) as the sole drinking source throughout the experimental duration (28 days); two groups administered MET orally at a dose equivalent to the acceptable daily intake and 10× acceptable daily intake; two groups were specified for GTE with MET two doses; two groups for SE with MET two doses; and two groups for GTE+SE with MET two doses. At the end of the experiment, blood samples were collected for measuring biochemical parameters for liver and kidney, as well as antioxidant enzymes. Results and conclusion The insecticide caused high elevation in aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, urea, creatinine and malondialdehyde levels, and high decline in the levels of butyrylcholinesterase, superoxide dismutase, and total antioxidant capacity. Alterations in these biochemical markers occurred in a dose-dependent manner and were referred to the oxidative stress induced by MET. Co-administration of GTE or SE in conjunction with MET brought most of the tested biochemical parameters to their normal levels, but the mixture (GTE+SE) resulted in superior ameliorating effects as compared with each of the individual extracts. The study introduced novel findings regarding to the protective effect of GTE, SE, and their mixture against MET-induced toxicity in rats.

Correlation analysis on liver function and serum markers of liver fibrosis in patients with fatty liver

Objective To analyze the changes of serum markers of liver function and liver fibrosis in patients with fatty liver, and to explore the relationship between them, so as to provide scientific basis for the prevention and treatment of fatty liver into hepatic fibrosis. Methods From January 1st, 2015 to December 31st, 2015, one thousand three hundred and forty-six healthy cases were selected, and 361 cases of fatty liver were diagnosed by ultrasound.Liver function index of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) was detected by automatic biochemical analyzer.Hyaluronic acid (HA), laminin (LN), serum type Ⅲ procollagen peptide (PC Ⅲ) and type Ⅳ collagen (C-Ⅳ) were detected by enzyme-linked immunosorbent assay.The correlation between liver function and serum liver fibrosis indexes was analyzed by Pearson parameter analysis. Results The liver function index ALT, AST((69.04±18.72) U/L, (59.78±15.65)U/L) in fatty liver group were higher than those in the non-fatty liver group((25.71±10.25) U/L, (23.68±8.23) U/L), the differences were statistically significant ( t=279.283, 388.461, P 0.05). Conclusion Liver function and serum liver fibrosis index can be used as the important basis for monitoring and diagnosis on the progression of fatty liver disease. Key words: Fatty liver; liver function; hepatic fibrosis; serum markers

Effect of radical resection combined with antiviral therapy on hepatitis B virus infection

Objective To study the effect of radical resection combined with antiviral therapy on hepatitis B virus infection. Methods From January 2012 to January 2016, 46 patients with hepatocellular carcinoma complicated with hepatitis B virus infection in the First People's Hospital of Jiashan County were enrolled in this study.All the subjects included in this study had complete clinical data and were willing to cooperate with this study.According to the random number table method, the patients were divided into two groups, with 23 cases in each group.The two groups were all treated by radical resection, the control group was not given anti-viral treatment after operation, the study group was given anti-virus combination therapy after surgery.The patients were followed up for more than 1 year.The levels of liver function[alanine aminotransferase (ALT), serum albumin (ALB), prealbumin (PA)]and hepatitis B virus (HBV-DNA) were measured before and after operation in both two groups.The incidence rate of postoperative complications, length of hospital stay, medical expenses and recurrence rate were analyzed. Results There were no statistically significant differences in ALT, ALB, PA and HBV DNA between the two groups before operation (all P>0.05). There were statistically significant differences between the two groups after operation[ALT: (97.74±33.27)U/L vs.(142.98±53.41)U/L, t=3.447; ALB: (34.57±5.01)g/L vs.(38.44±4.32)g/L, t=2.805; PA: (192.14±53.24)mg/L vs.(159.85±53.96)mg/L, t=2.042; HBV-DNA: (4.25±1.04)logcopes/mL vs.(6.22±1.18)logcopes/mL, t=6.006, all P 0.05). Conclusion Hepatocellular carcinoma with hepatitis B virus infection in patients with radical resection and anti-virus combination therapy, can better improve the patients' liver function and viral indicators, shorten the hospital stay, reduce medical costs, and can reduce the incidence of complications, with high safety. Key words: Liver neoplasms; Hhepatitis B virus; Hepatectomy; Antiviral agents

Value of endoscopic ultrasonography-guided biliary drainage for malignant obstructive jaundice(with video)

Objective To analyze the efficacy of endoscopic ultrasonography-guided biliary drainage (EUS-BD) for malignant obstructive jaundice and the management of adverse events. Methods Clinical data of 12 patients with malignant obstructive jaundice, who underwent EUS-BD between April 2016 and January 2017, were retrospectively analyzed. All patients received EUS-BD after unsuccessful ERCP, including EUS-guided hepaticogastrostomy (EUS-HGS), EUS-guided antegrade stenting (EUS-AS), and EUS-guided choledochoduodenostomy(EUS-CDS). Procedure outcomes, serum bilirubin and liver enzyme levels before the procedure and 1 week after, complications, treatment results, hospitalization time and follow-up were recorded. Results Two patients underwent EUS-HGS, 3 underwent EUS-AS, and 7 underwent EUS-CDS. Total bilirubin (t=3.462, P=0.005), direct bilirubin (t=3.351, P=0.006), alanine transaminase (t=2.399, P=0.037), γ-glutamate transpeptidase (t=3.256, P=0.031) reduced significantly after the procedure. Two patients (16.67%) developed complications. A patient undergoing EUS-HGS developed bile leakage, biliary peritonitis, and pneumoperitoneum. A patient undergoing EUS-CDS developed upper gastrointestinal bleeding. Both patients were successfully treated. There were no other adverse events, such as acute pancreatitis, subcutaneous emphysema, pneumothorax and emphysema. No procedure-related death occurred. The mean hospital stay was 13.75 ±6.92 days (range 5-26 days). Conclusion EUS-BD is a safe substitute after unsuccessful ERCP when performed by experienced biliary endoscopists. However, intensive care is necessary after the procedure for early detection and management of complications. Key words: Endosonography; Biliary drainage; Hepaticogastrostomy; Choledochoduodenostomy; Complication

Protective effect of Lidan Xiaohuang decoction on hepatic ischemia reperfusion oxidative stress in rats

Objective To observe the protective effect of Lidan Xiaohuang decoction on hepatic ischemia reperfusion injury in rats. Methods 225 SD rats were randomly divided into sham-operated group (Sham group), ischemia reperfusion injury (HIRI) control group (control group) and HIRI traditional Chinese medicine group (TCM group). Each group was divided into three subgroups at 60, 180 and 360 min after reperfusion. Rats in TCM group were given Chinese medicine gavage before operation. Control group and Sham group were given the same volume of normal saline. In Sham group, only open abdominal operation was performed, and TCM group and control group were treated with HIRI. A rat HIRI model was established and blood was collected from the inferior vena cava at 60, 180 and 360 min after ischemia and reperfusion in the liver. Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) levels were measured, and fresh liver specimens were taken at the same time for measuring MDA content and GSH-PX activity, and histopathological observations were performed. Results After 60, 180 and 360 min of HIR in rats, the ALT, AST and LDH in TCM group were (74.52±8.95), (89.48±16.87), (118.95±18.47), (225.94±49.76), (276.36±78.95), (329.85±79.59), (1 467.44±295.46), (2 860.59±347.32), (3 020.22±357.83) U/L respectively. The MDA content and the activities of GSH-PX were respectively (3.94±0.86), (7.33±3.12), (12.89±6.48) nmol/mgprot and (1 866.34±364.49), (1 299.05±269.49), (780.77±185.03) U/mgprot; The ALT, AST and LDH levels in the control group were respectively (99.24±12.71), (182.37±21.62), (298.13±36.26), (356.87±57.36), (529.31±79.39), (875.69±83.61), (1 937.59±279.55), (4 207.43±654.87), (4 672.66±539.11) U/L. And the MDA content and the activity of GSH-PX were (6.76±1.56), (14.20±4.87), (25.82±9.86) nmol/mgprot and (1 689.33±339.73), (792.19±241.66), (429.80±126.07) U/mgprotrespectively. As compared with the control group, the levels of ALT, AST, LDH and MDA contents in the TCM group were significantly reduced, and the GSH-PX activity was slightly decreased (P=0.000); The changes of ALT, AST and LDH levels, MDA content and GSH-PX activity in the Sham group were smaller (P=0.000). Pathological observation showed that TCM group and Control group also had a significant difference. Conclusion Lidan Xiaohuang decoction can protect against HIRI in rats, and the protective mechanism is related to its antioxidant mechanism. Key words: Lidan Xiaohuang Decoction; Hepatic ischemia; Reperfusion injury; Oxidative stress

Clinical features and treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children

To study the clinical features of macrolide-resistant Mycoplasma pneumoniae pneumonia and its treatment regimens in children. The samples of throat swab or bronchoalveolar lavage fluid were collected from 136 children with Mycoplasma pneumoniae pneumonia. Quantitative real-time PCR was used to detect 2063/2064 A:G mutation in 23S rRNA, and according to such results, the children were divided into drug-resistance group with 81 children and sensitive group with 55 children. The two groups were compared in terms of age composition, respiratory symptoms, extrapulmonary complications, laboratory markers, imaging changes, treatment regimens, and length of hospital stay. Compared with the sensitive group, the drug-resistance group had significantly longer duration of pyrexia and severe fever, a significantly higher percentage of children with reduced blood oxygen saturation, and significantly higher levels of alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) (P<0.05). The conventional azithromycin treatment had a good clinical effect in the sensitive group, while corticosteroid therapy was usually needed in the drug-resistance group. Macrolide-resistant Mycoplasma pneumoniae infection cannot be identified based on a single clinical feature, but prolonged duration of pyrexia and severe fever, reduced blood oxygen saturation, and increased ALT and LDH can suggest the presence of this disease. Azithromycin combined with glucocorticoids may be a good treatment regimen for children with macrolide-resistant Mycoplasma pneumoniae pneumonia.

Effects of associating liver partition with portal vein ligation for staged hepatectomy on liver regeneration of rat with liver cirrhosis

Objective To observe the effects of associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) on liver regeneration of the unligated lobe with cirrhosis. Methods 60 liver cirrhosis SD rats were randomly divided into three groups: C-ALPPS group (n=20, liver cirrhosis+ ALPPS), C-PVL group (n=20, liver cirrhosis+ PVL) and C-Sham group (n=20, liver cirrhosis+ sham operation). 60 normal SD rats were randomly divided into three groups: N-ALPPS group (n=20, normal liver+ PVL), N-PVL group (n=20, normal liver+ PVL) and N-Sham group (n=20, normal liver+ sham operation). The weight ratio of unligated lobes/total liver, proliferating cell nuclear antigen (Ki-67) and liver function were compared before operation and 2, 4 and 7 days after operation. Results Except for sham operation group, liver weight ratios of unligated livers on the 4th and 7th days after operation were lower than those in the normal group (P<0.05). The weight ratios of unligated lobes/total liver in C-ALPSS group and N-ALPPS group on 4th and 7th day postoperation were (54.3±3.1)% vs. (61.2±2.1)%, (65.0±4.1)% vs. (79.2±1.1)%. The weight ratio unligated lobes/total liver in group C-PVL and group N-PVL at 4th and 7th day postoperation were (52.4±1.8)% vs. (56.6±2.0)%, (63.8±3.1)% vs. (70.0±2.5)%. There was no significant difference on weight ratio of unligated lobes/total liver between C-ALPPS group and C-PVL group at each time point (P<0.05). There was significant difference on the alanine transaminase (ALT), aspartate aminotransferase (AST) and albumin (ALB) levels between cirrhosis group and normal group at 4 and 7 days after operation (P<0.05). The expression level of Ki-67 in cirrhosis group was significantly lower than that in normal group at each time point (P<0.05). The expression level of Ki-67 in group C-ALPSS and group N-ALPPS at 2nd, 4th and 7th day after operation were (19.4±4.8)% vs. (84.1±8.9)%, (33.6±3.5)% vs. (70.2±7.2)%, (20.2±2.5)% vs. (50.7±4.4)%, and the expression level of Ki-67 in group C-PVL and group N-PVL at 2nd, 4th and 7th day postoperation were (21.1±4.0)% vs. (52.1±7.3)%, (32.4±5.9)% vs. (35.6±5.3)%, (15.5±4.6)% vs. (12.2±4.9)%. There was no significant difference of Ki-67 levels between C-PVL group and C-ALPPS group at 2 and 4 days after operation (P<0.05). Conclusions In normal rats, the liver regeneration rate after ALPPS was significantly higher than that after PVL. The liver regeneration rate after ALPPS in cirrhotic rats was significantly lower than that in normal rats after ALPPS. There was no significant difference of the liver regeneration rate between ALPPS and PVL in cirrhotic rats. Key words: Cirrhosis; Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS); Liver regeneration

Protective Effect of remote ischemic preconditioning on liver warm ischemia-reperfusion injury in aged rats

Objective To investigate the effect of remote ischemic preconditioning on nuclear factor erythroid-2 related factor 2 (Nrf2) signaling in the liver of aged rats after warm ischemia reperfusion injury. Methods A 70% hepatic warm ischemia-reperfusion model was established in aged rats (15-16 months old) (1 hour after ischemia and 2 hours after reperfusion). 12 male Sprague-Dawley rats were divided into two groups: pretreatment group and control group. The level of serum alanine aminotransferase (ALT) was detected after operation and the liver tissues were harvested for the determination of malondialdehyde (MDA) content and the activity of antioxidant enzyme-superoxide dismutase (SOD). The pathological changes of liver were observed. The change of Nrf2 protein expression in liver tissue was examined by Western blot . Results Serum ALT and MDA in the pretreatment group were significantly lower than those in the control group. The liver pathological damage of pretreatment group rats were lighter than the control group (P<0.05). Compared with the control group, the Nrf2 protein expression and the activity of SOD increased in the liver of pretreatment group (P<0.05). Conclusions Remote ischemic preconditioning can reduce 70% hepatic ischemia-reperfusion injury in aged rats, and its mechanism may be related to its activation of Nrf2 signaling pathway. Key words: Ischemic preconditioning/MT; Warm ischemia/AE; Reperfusion injury/ET/PC; Liver; Rats

Clinical observation on the efficacy of liraglutide combined with metformin in the treatment of type2 diabetes mellitus with non-alcoholic fatty liver

Objective To observe the clinical efficacy of liraglutide combined with metformin in the treatment of newly diagnosed type2 diabetes mellitus (T2DM) accompanying non-alcoholic fatty liver disease (NAFLD). Methods 40 newly diagnosed patients with type 2 diabetes combined with fatty liver were randomly divided into observation group and control group. On the basis of lifestyle intervention, the observation group was given metformin 500 mg, oral, 3 times/d, Liraglutide Injection 1.8 mg, subcutaneous injection, 1 times/d, and the control group was given metformin 500 mg, orally, 3 times/d. The treatment process lasted for 12 weeks. Waist circumference, body mass index (BMI), fasting plasma glucose (FPG), 2 hour postprandial glucose (2 h PG), glycosylated hemoglobin A1c (HbA1c), alanine aminotransferase (ALT), aspartate transaminase (AST), glutamyl transpeptidase (GGT), total cholesterol (TC), triglyceride (TG), Transforming growth factor beta (TGF-β) and the degree of fatty liver were compared before and after treatment, and the adverse events were recorded. Results Compared with the control group, the degree of WC, BMI, FPG, 2 h PG, HbA1c, TG, TGF-beta and fatty liver were significantly improved in the observation group (P 0.05). Conclusions Liraglutide combined with metformin is a new kind of safe and effective treatment for T2DM accompanying NAFLD. Key words: Liraglutide/TU; Metformin/TU; Diabetes mellitus, type 2/CO/DT; Non-alcoholic fatty liver disease/CO/DT

Acute generalized exanthematous pustulosis caused by lincomycin: a case report

A 28-year-old male patient with coughing was treated with intramuscular injection of lincomycin, oral Kesouting granules and erythromycin in a local clinic. One day later, erythema occurred on the head and face, and rapidly spread to the trunk and limbs. Three days later, a large number of densely distributed needle tip- to millet-sized pustules occurred on the generalized erythema all over the body with fever and burning pain sensation of the skin. Skin examination revealed diffuse edematous erythema with obvious hyperemia on more than 90% of the body, a large number of needle tip- to millet-sized white-yellowish pustules on the erythema on the hair line, face, flexor aspect of the extremities and flexural site of the trunk (axillary and inguinal regions) , and bilateral lower-extremity swelling. No erythema or erosion was observed on the oral mucosa or genital mucosa. Histopathological examination of skin lesions on the right elbow showed local intraepidermal and subcorneal pustules, necrotic keratinocytes and neutrophil aggregation in the pustules, and infiltration of lymphocytes and eosinophils in the superficial dermis. Laboratory examination showed elevated white blood cell counts (26.9 × 109/L) , neutrophils proportion (Segment, 0.88) , C-reactive protein level (127.89 mg/L) , aspartate aminotransferase level (44.2 U/L) and alanine transarninase level (77.3 U/L) , but decreased proportion of lymphocytes (0.08) . The patient was diagnosed with acute generalized exanthematous pustulosis. After admission, the patient was treated with intravenous drips of methylprednisolone at a dose of 60 mg/d. Then, the condition was rapidly relieved, and the dosage was rapidly reduced. The patient was discharged on day 7. Key words: Acute generalized exanthematous pustulosis; Lincomycin; Drug eruptions; Drug-induced liver injury

Effects of Glutamine and Alanine Supplementation on Adiposity, Plasma Lipid Profile, and Adipokines of Rats Submitted to Resistance Training

ABSTRACTGlutamine and alanine are lipogenic and could prevent the effects of resistance training (RT) in reducing adiposity and modulating lipid profile. Thus, we aimed to investigate the effects of RT and glutamine and alanine supplementation, in their free or conjugated form, on relative epididymal adipose tissue (EAT) and brown adipose tissue (BAT) weight, plasma lipid profile, and adipokines in EAT. Thirty Wistar rats, aged two months, were distributed into five groups: control (CTRL), trained (TRN), trained and supplemented with alanine (ALA), glutamine and alanine in their free form (GLN+ALA), or L-alanyl-L-glutamine (DIP). Trained groups underwent a ladder-climbing exercise for eight weeks, with progressive load increase. Supplementations were offered in a solution with a concentration of 4% in the last 21 days of training. Food consumption and body weight gain were decreased in the TRN group compared with CTRL. RT also reduced relative EAT and BAT weight, while supplementations, especially with ALA, increased adipose tissue mass. RT reduced total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-c) (TRN vs. CTRL), whereas glutamine and alanine supplementation increased TC and LDL-c, impairing lipid profile modulation by physical exercise. RT did not affect the concentrations of adipokines in EAT, but DIP supplementation increased interleukin- (IL-) 6 and IL-10. In conclusion, RT reduced adiposity and modulated lipid profile, whereas glutamine and alanine supplementation increased adiposity and impaired lipid profile but increased the concentration of the anti-inflammatory cytokines IL-6 and IL-10 in EAT.

The hepatoprotective effect of lycopene on Con A-induced liver injury in mice.

Lycopene, the main fat-soluble pigment responsible for the red color of ripe tomatoes, is a symmetrical tetraterpene comprising eight isoprene units. In vitro and in vivo studies have shown that lycopene acts as a potent antioxidant; it is 100 times more effective than vitamin E and 125 times more effective than glutathione as an antioxidant. Here, we divided BALB/c male mice into three equal groups: control, Concanavalin A (Con A), and Con A and lycopene. The control group mice received only vehicle by intraperitoneal injection, the Con A group mice were given Con A, and the Con A and lycopene group mice received Con A and lycopene. The results showed that Con A administration increased histopathological damage, and the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), interleukin (IL)-6, interferon (IFN)-γ and tumor necrosis factor (TNF)-α were increased in serum samples whereas the levels of these compounds were significantly decreased in the Con A and lycopene group compared to the Con A group. Furthermore, we observed that lycopene led to an increase in cell viability and cell growth. The results of this study revealed that lycopene might be a useful hepatoprotective agent for reducing increased proinflammatory cytokine levels, and for increasing cell viability and cell growth.

Safety of hydrophilic fiber containing silver dressings for the treatment of pressure sore in elderly patients

Objective To explore the safety of hydrophilic fiber containing silver dressings used on the wound of the patient with pressure sore. Methods From January 2014 to January 2017, 60 elderly patients with pressure sore from inpatient and outpatient of Geriatrics Department of Shenzhen People's Hospital were selected as the research object. They were divided randomly into control group and experimental group, 30 patients for each group. Patients in the experimental group used hydrophilic fiber containing silver dressings on half of the area of the wound. Patients in the control group used hydrophilic fiber containing silver dressings on the whole area of the wound. All the treatment lasted for 4 weeks. Silver concentration of serum, serum creatinine and alanine aminotransferase value were detected in two groups of patients. Data were analyzed by SPSS 17.0 statistical software. Results After the use of hydrophilic fibers containing silver dressing, the silver concentration of serum in the two groups increased, the value reached a peak in the third week and a downtrend in the fourth week; There were no significant differences in silver concentration of serum between the two groups in the first 3 weeks (P> 0.05) , but the difference was statistically significant only in the fourth week (P 0.05) . Conclusions The usage of hydrophilic fibers containing silver dressing cannot directly affect serum creatinine and alanine transaminase within four weeks. Key words: Nursing care; Pressure injury; Aged; Hydrophilic fiber containing silver dressing

Association of hemoglobin level with thyroid-stimulating hormone in different trimester pregnant women with subclinical hypothyroidism

To investigate the association between hemoglobin (Hb) and thyroid-stimulating hormone (TSH) levels in different trimester pregnant women with subclinical hypothyroidism (SCH). 62 pregnant women, who were diagnosed as SCH when they had their first antenatal care and eventually delivered in the Affiliated Quanzhou First Hospital of Fujian Medical University from March 2013 to December 2014, were enrolled in this study. These subjects were divided into three groups according to weeks of gestation when they had their first prenatal care: including first trimester (n=24), second trimester (n=17), and third trimester (n=21) groups. All SCH pregnant women were treated with levothyroxine (L-T4). The clinical and laboratory data in the first antenatal care and antepartum period were collected. Association of Hb level with other clinical and laboratory data were analyzed. Compared to baseline, the levels of TSH, γ-glutamyl transpeptidase, alanine aminotransferase, and total cholesterol were lower (all P<0.05), and the levels of Hb were higher (P<0.05), after treated with L-T4 in three groups. Pearson correlation analysis showed that the level of Hb was negativly correlated with TSH in all pregnancies or in third trimester groups (r=-0.394, -0.308, -0.537 and -0.453 respectivly, all P<0.05). Multivariate regression analysis indicated that the level of Hb was independently associated with TSH and body mass index in pregnant women with SCH. In pregnant women with SCH, the higher TSH and body mass index levels are correlated with increased risk of anemia. L-T4 treatment may ameliorate anemia during pregnancy. (Chin J Endocrinol Metab, 2018, 34: 505-508) Key words: Pregnancy; Subclinical hypothyroidism; Hemoglobin; Levothyroxine

Changes in FUNDC1/LC3II signaling pathway during sepsis-induced liver injury in mice

Objective To investigate the changes in FUNDC1/microtubule-associated protein 1 light chain 3Ⅱ (LC3Ⅱ) signaling pathway during sepsis-induced liver injury in mice. Methods Thirty-two clean-grade healthy male C57BL/6 mice, aged 6 weeks, weighing 20-25 g, were divided into sham operation group (n=8) and sepsis group (n=24) using a random number table method.Sepsis was induced by cecal ligation and puncture.Blood samples were obtained at 24 h after operation in sham operation group and at 6, 12 and 24 h after establishing the model in sepsis group for determination of concentrations of alanine aminotransferase and aspartate aminotransferase in serum.Mice were then sacrificed, and the right lobe of livers was removed for examination of the pathological changes and for determination of the expression of FUNDC1 and LC3Ⅱ by Western blot.The mitochondria in the right lobe of livers were isolated to measure the respiratory function, and respiratory control rate was calculated. Results Compared with sham operation group, the concentrations of alanine aminotransferase and aspartate aminotransferase in serum and pathological scores were significantly increased, the respiratory control rate of mitochondria was decreased, the expression of FUNDC1 was down-regulated, and the expression of LC3Ⅱ was up-regulated at each time point after establishing the model in sepsis group (P<0.05). Conclusion The mechanism by which sepsis induces liver injury may be related to inhibiting activation of FUNDC1/LC3Ⅱ signaling pathway in mice. Key words: Sepsis; Liver; Membrane proteins; Autophagy

Efficacy analysis of neoadjuvant chemotherapy for resectable locally advanced adenocarcinoma of the esophageal-gastric junction

Objective To investigate the clinical efficacy of neoadjuvant chemotherapy (oxaliplatin + capecitabine, XELOX) for the resectable locally advanced adenocarcinoma of esophageal-gastric junction (AEG). Methods The prospective study was conducted. The clinicopathological data of 106 locally advanced AEG patients who were admitted to the Cancer Hospital of Shantou University Medical College from January 2011 to December 2014 were collected. All the patients were divided into the treatment group and control group by single blind, randomized, controlled random number table. Patients underwent preoperative neoadjuvant chemotherapy (XELOX) + surgery + postoperative adjuvant chemotherapy (XELOX) in the treatment group and surgery + postoperative adjuvant chemotherapy (XELOX) in the control group. Total gastrectomy + Roux-en-Y esophagojejunostomy + D2 lymphadenectomy were applied to patients by the same team of doctors. Observation indicators: (1) treatment situations; (2) results of postoperative pathological examination; (3) follow-up and survival situations. Follow-up using outpatient examination was performed to detect the postoperative tumor recurrence or metastasis and patients′ survival up to February 2017. Measurement data with normal distribution were represented as ±s, and comparisons between groups were evaluated with the t test. Measurement data with skewed distribution were described as M (range) and analyzed by the nonparametric test. Comparisons of count data were analyzed using the chi-square test. The ordinal data were compared using the nonparametric test. Survival rate and curve were respectively calculated and drawn by the Kaplan-Meier method and survivals were compared using the Long-rank method. Results One hundred and six patients were screened for eligibility, including 54 in the treatment group and 52 in the control group. (1) Treatment situations: ① preoperative neoadjuvant chemotherapy: 54 in the treatment group received 2-4 cycle neoadjuvant chemotherapy. During the chemotherapy, gastrointestinal reaction, grade 1-2 granulocytopenia, elevated alanine transaminase (ALT) and grade 3 granulocytopenia were detected in 21, 17, 8, 1 patients, and 7 patients had no adverse reaction. The complete response(CR), partial response (PR), stable disease (SD) and progressive disease (PD) of neoadjuvant chemotherapy in the treatment group were detected in 4, 27, 20 and 3 patients, respectively. Of 54 patients in the treatment group, 4, 13, 25 and 12 were in grade 0, 1, 2 and 3 of response to preoperative chemotherapy, respectively. ② Surgical situations: preoperative carcinoembryonic antigen (CEA) in the treatment and control groups were respectively 4.71 μg/L (range, 0.20-36.19 μg/L) and 14.09 μg/L (range, 0.71-178.20 μg/L), with a statistically significant difference between groups (Z=-1.92, P 0.05). ③ Postoperative adjuvant chemotherapy: all the patients completed the postoperative adjuvant chemotherapy. The granulocytopenia, elevated ALT and gastrointestinal reaction occurred in 25, 5, 28 patients in the treatment group and 21, 7, 30 patients in the control group, respectively, with no statistically significant difference between groups (χ2=0.38, 0.47, 0.36, P>0.05). Some of the patients were merged with multiple adverse reactions. (2) Results of postoperative pathological examination: maximum tumor dimension, cases with lymphovascular invasion, perineural invasion, T0, T2, T3, T4 (T stage), stage 0, Ⅰ, Ⅱ and Ⅲ (TNM stage) were respectively (3.6±1.4)cm, 5, 10, 4, 10, 20, 20, 4, 7, 15, 28 in the treatment group and (4.5±1.7)cm, 24, 30, 0, 2, 13, 37, 0, 1, 12, 39 in the control group, with statistically significant differences between groups (t=-2.88, χ2=18.14, 17.30, Z=14.74, 8.13, P 0.05). There was a statistically significant difference in cases with local recurrence between groups (χ2=4.41, P<0.05) The tumor-free survival time and overall survival time in the treatment group were respectively 29 months (range, 8-72 months), 38 months (range, 10-72 months) in 31 patients with CR and PR and 11 months (range, 3-68 months), 18 months (range, 4-68 months) in 23 patients with SD and PD, showing statistically significant differences in tumor-free and overall survival times (χ2=5.27, 7.72, P<0.05). Conclusion Neoadjuvant chemotherapy with oxaliplatin and capecitabine is safe and effective for patients with the resectable locally advanced AEG, it can also decrease tumor stage and reduce local recurrence, but fail to demonstrate a survival benefit. Key words: Adenocarcinoma of esophagogastric junction; Locally advanced; Neoadjuvant chemotherapy

Application of timely regional vascular occlusion in primary liver cancer resection

Objective To study the application effects of timely regional vascular occlusion in primary liver cancer (PLC) surgery. Methods Eighty-eight patients with PLC who underwent surgery in the Department of General Surgery of Yan′an University Affiliated Hospital from January 2014 to December 2016 were selected for prospective study, and they were divided into the experimental group and the control group by the random number table method, 44 cases of each group. In the experimental group, the blood supply was blocked with timely regional vascular occlusion while in the control group, the blood supply was blocked with half hepatic vascular occlusion. The occurrence of postoperative complications, and surgical indexes (surgical time, intraoperative blood loss, the time of hepatic portal occlusion, blood transfusion volume, abdominal drainage volume and hospital stay), levels of alanine aminotransferase, albumin and total bilirubin, levels of CD3+ , CD4+ , CD8+ and CD4+ /CD8+ , effective rate, control rate, and clinical efficacy were compared between the two groups. Measurement data with normal distribution were represented as ±s and analyzed using the independent-sample t test between the two groups; within the groups, paired t-tests were used. Comparison of count data were represented as n(%), and analyzed using the chi-square test. Results The intraoperative blood loss, time of hepatic portal occlusion, blood transfusion volume and hospital stay of the experimental group were (331.48±30.65) ml, (14.78±2.27) min, (132.61±13.87) ml, (9.29±1.19) d, and the control group were (500.61±50.62) ml, (23.96±2.89) min, (305.76±30.64) ml, (12.10±1.22) d, with statistically significant differences in above indexes between the two groups (all P 0.05). After surgery, the levels of alanine aminotransferase, total bilirubin and albumin of the experimental group were (54.86±5.61) U/L, (20.65±2.32) U/L, (41.95±4.32) ng/ml, and the control group were (120.75±13.03) U/L, (35.42±3.21) U/L, (70.25±7.45) ng/ml, with statistically significant differences in above indexes between the two groups (all P 0.05). Conclusions The application of timely regional vascular occlusion in PLC surgery can reduce the intraoperative blood loss, the time of hepatic portal occlusion, blood transfusion volume and hospital stay, improve the immune level and liver function. And there is no difference in response rate and control rate compared with half hepatic vascular occlusion, therefore it is worthy of clinical application. Key words: Liver neoplasms; Liver function tests; Timely regional vascular occlusion; Primary liver cancer