Liver Function Disorders Research Articles

Metabolic and genetic basis of liver damage in mechanical jaundice of non-tumor genesis in obstractive cholangitis or biliary pancreatitis

Aim. Establishment of versatile mechanisms behind liver damage in mechanical jaundice of non-tumor genesis combined with acute obstructive cholangitis or acute biliary pancreatitis.Materials and methods. In total, 64 cases of mechanical jaundice developed against the background of cholelithiasis were studied. Group 1 included 30 patients with mechanical jaundice combined with cholangitis; group 2 included 34 patients with acute biliary pancreatitis. Bile duct reconstruction was performed by an open method followed by standardized treatment. The intensity of membrane lipid peroxidation was determined by the level of diene conjugates, malonic dialdehyde, superoxide dismutase activity, and the activity of phospholipase A2. The severity of endotoxemia was estimated; a molecular-genetic test of the polymorphism of antioxidant system genes was performed.Results. The significance of the gene polymorphism of antioxidant enzymes in the formation of systemic alterative phenomena and severity of liver damage in mechanical jaundice complicated by cholangitis or acute pancreatitis was determined by allocation of patient subgroups depending on the presence of mutant allele T in the gene of superoxide dismutase SOD2 (C1147T). The groups of patients with the presence of such polymorphism, regardless of the combined diseases, demonstrated more pronounced and prolonged liver functional disorders and homeostasis disorders after restoration of biliary tract patency.Conclusion. The presence of mutant alleles of the SOD2 gene (C47T) in patients with non-tumor mechanical jaundice combined with acute cholangitis or pancreatitis is associated with an increase in the intensity of damage mechanisms at the systemic level, primarily with membrane lipid peroxidation, which correlates with the severity of liver damage (r = 0.834–0.967; p < 0.05).

Intestinal microbiota and metabolically associated steatotic liver disease: current understanding of the problem. Review

Cross‑interaction of microbes, microbial products, and the intestinal barrier are components of the so‑called «intestine‑liver axis», as the liver and intestines have a close two‑way relationship. In patients with metabolically associated steatotic liver disease (MASLD), significant characteristic changes in the intestinal microbiome are observed, in particular, the growth of gram‑negative bacteria, which contributes to the formation of a pro‑inflammatory status (primarily due to endotocins) and disruption of metabolic processes, while an increase in Bacteroides and Ruminococcus and a decrease in Prevotella are associated with severe stages of liver fibrosis. Intestinal microbiota modulates the pool of bile acids thereby affecting metabolic homeostasis and pro‑inflammatory processes. Dysbiosis associated with MASLD is characterized by an excess of bacteria — producers of secondary bile acids, which are one of the factors in the progression of metabolically associated steatohepatitis. In addition, dysbiosis leads to increased production of short‑chain fatty acids, which promotes gluconeogenesis, synthesis and accumulation of toxic lipids in the liver and, accordingly, the development and progression of MASLD. But liver function disorders connected with dysbiosis are associated not only with intestinal bacteria, but also with fungi and viruses. According to the results of recent studies, MASLD is associated with a significant diversity of the mycobiome and has certain differences in the progression of the disease depending on the degree of liver inflammation and the stage of fibrosis. Chronic hyperproduction of endogenous ethanol (Klebsiella pneumoniae, Escherichia, Candida, etc.) is an important factor in the pathogenesis of MASLD, as it disrupts glucose and lipid metabolism, contributing to the formation of liver steatosis and steatohepatitis. Ultrastructural and functional changes of mitochondria are recognized determinants in the pathogenesis of MASLD. Mitochondria and intestinal microbiota have a bidirectional relationship: microbiota supplies metabolites for mitochondrial metabolism and redox homeostasis, and the development of dysbiosis contributes to oxidative stress and proinflammatory status — key factors in the development of metabolically associated steatohepatitis. Mitochondria can also modulate intestinal microflora by affecting the permeability of the intestinal barrier. The data presented in the article expand our knowledge about the interaction of the liver and the intestine and inspire the development of new promising therapeutic approaches to the treatment of MASLD, which involve a synergistic effect on the intestinal microbiota, microbiome, virome, and mitochondrial function.

Digital subtraction angiography-guided pancreatic arterial infusion of GEMOX chemotherapy in advanced pancreatic adenocarcinoma: a phase II, open-label, randomized controlled trial comparing with intravenous chemotherapy

BackgroundAdvanced pancreatic adenocarcinoma lacks effective treatment options, and systemic gemcitabine-based chemotherapy offers only marginal survival benefits at the cost of significant toxicities and adverse events. New therapeutic options with better drug availability are warranted. This study aims to evaluate the safety and efficacy of digital subtraction angiography (DSA)-guided pancreatic arterial infusion (PAI) versus intravenous chemotherapy (IVC) using the gemcitabine and oxaliplatin (GEMOX) regimen in unresectable locally advanced or metastatic pancreatic cancer (PC) patients.Materials and methodsThis study prospectively enrolled 51 eligible treatment-naive patients with unresectable PC to receive GEMOX treatment via PAI or IVC (1:1 ratio randomization) from December 2015 to December 2019. Cycles were repeated monthly, and each process consisted of two treatments administered bi-weekly. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), 1-year survival, 6-month survival, tumor-site subgroup survival, and incidences of adverse events were compared.ResultsThe median OS of the PAI and IVC groups were 9.93 months and 10.07 months, respectively (p = 0.3049). The median PFS of the PAI and IVC groups were 5.07 months and 4.23 months (p = 0.1088). No significant differences were found in the ORR (11.54% vs. 4%, p = 0.6312), DCR (53.85% vs. 44%, p = 0.482), and 1-year OS rate (44% vs. 20.92%, p = 0.27) in PAI and IVC groups. The 6-month OS rate was significantly higher in the PAI group (100%) than in the IVC group (83.67%) (p = 0.0173). The median OS of patients in PAI group with pancreatic head and neck tumors were significantly higher than those of body and tail tumors (12.867 months vs. 9 months, p = 0.0214). The incidences of hematologic disorders, liver function disorders, and digestive disorders in the IVC group were higher than in the PAI group (p < 0.05).ConclusionGEMOX PAI therapy presented a higher 6-month OS rate and fewer adverse events than IVC in advanced pancreatic adenocarcinoma patients. Those with pancreatic head and neck tumors may yield a superior treatment outcome from PAI treatment.Trial registration numberNCT02635971.Date of registration21/12/2015.

Hepatosis in broiler chickens: The role and efficacy of therapeutic and prophylactic agents containing hepatoprotectors

The preservation of poultry stock can be improved by incorporating therapeutic and preventive agents, including hepatoprotectors, into the diet. This study aimed to evaluate the effect of an experimental drug containing hepatoprotectors on the health of broiler chickens. The research sought to identify the potential of the preparation to enhance liver function and overall poultry stock survival. The study was conducted from 2023 to 2024 at Odesa State Agrarian University. Investigations were carried out to assess the effects of the experimental preparation in the following doses: 1.0 g/kg body weight (therapeutic dose), 2.0 g/kg body weight (double therapeutic dose), and 5.0 g/kg body weight (fivefold therapeutic dose) over 30 days. The experiment was conducted on 500 Cobb 500 broiler chickens aged 1 to 40 days. Additionally, biochemical blood parameters were measured and analysed using a Polish biochemical selective automatic analyser, the Hitachi 902. Studies have established that the optimal dose of the experimental drug for hepatosis in broiler chickens is 1.0 g/kg body weight. After administration of the drug, the serum bilirubin content decreased by 27.3%, lactate dehydrogenase activity decreased by 17.1%, aspartate aminotransferase activity decreased by 16.4%, alanine aminotransferase activity decreased by 19.3%, and vitamin A content increased by 25.6%, while the phagocytic activity of pseudoeosinophils increased by 23.1%. The results of the studies have proven that the experimental drug normalises liver function, positively affects the biochemical composition of blood, promotes growth, provides protection and natural resistance of the broiler organism, and even improves the quality of poultry products. Based on the above, it is necessary to improve methods for early diagnosis of liver function disorders in poultry and apply effective methods for correcting metabolic processes

Nicotinate-curcumin improves NASH by inhibiting the AKR1B10/ACCα-mediated triglyceride synthesis

BackgroundNonalcoholic steatohepatitis (NASH) is a prevalent chronic liver condition. However, the potential therapeutic benefits and underlying mechanism of nicotinate-curcumin (NC) in the treatment of NASH remain uncertain.MethodsA rat model of NASH induced by a high-fat and high-fructose diet was treated with nicotinate-curcumin (NC, 20, 40 mg·kg− 1), curcumin (Cur, 40 mg·kg− 1) and metformin (Met, 50 mg·kg− 1) for a duration of 4 weeks. The interaction between NASH, Cur and Aldo-Keto reductase family 1 member B10 (AKR1B10) was filter and analyzed using network pharmacology. The interaction of Cur, NC and AKR1B10 was analyzed using molecular docking techniques, and the binding energy of Cur and NC with AKR1B10 was compared. HepG2 cells were induced by Ox-LDL (25 µg·ml− 1, 24 h) in high glucose medium. NC (20µM, 40µM), Cur (40µM) Met (150µM) and epalrestat (Epa, 75µM) were administered individually. The activities of ALT, AST, ALP and the levels of LDL, HDL, TG, TC and FFA in serum were quantified using a chemiluminescence assay. Based on the changes in the above indicators, score according to NAS standards. The activities of Acetyl-CoA and Malonyl-CoA were measured using an ELISA assay. And the expression and cellular localization of AKR1B10 and Acetyl-CoA carboxylase (ACCα) in HepG2 cells were detected by Western blotting and immunofluorescence.ResultsThe results of the animal experiments demonstrated that NASH rat model induced by a high-fat and high-fructose diet exhibited pronounced dysfunction in liver function and lipid metabolism. Additionally, there was a significant increase in serum levels of FFA and TG, as well as elevated expression of AKR1B10 and ACCα, and heightened activity of Acetyl-CoA and Malonyl-CoA in liver tissue. The administration of NC showed to enhance liver function in rats with NASH, leading to reductions in ALT, AST and ALP levels, and decrease in blood lipid and significant inhibition of FFA and TG synthesis in the liver. Network pharmacological analysis identified AKR1B10 and ACCα as potential targets for NASH treatment. Molecular docking studies revealed that both Cur and NC are capable of binding to AKR1B10, with NC exhibiting a stronger binding energy to AKR1B10. Western blot analysis demonstrated an upregulation in the expression of AKR1B10 and ACCα in the liver tissue of NASH rats, accompanied by elevated Acetyl-CoA and Malonyl-CoA activity, and increased levels of FFA and TG. The results of the HepG2 cell experiments induced by Ox-LDL suggest that NC significantly inhibited the expression and co-localization of AKR1B10 and ACCα, while also reduced levels of TC and LDL-C and increased level of HDL-C. These effects are accompanied by a decrease in the activities of ACCα and Malonyl-CoA, and levels of FFA and TG. Furthermore, the impact of NC appears to be more pronounced compared to Cur.ConclusionNC could effectively treat NASH and improve liver function and lipid metabolism disorder. The mechanism of NC is related to the inhibition of AKR1B10/ACCα pathway and FFA/TG synthesis of liver.

Enhancing Disease Diagnosis: Statistical Analysis of Haematological Parameters in Sickle Cell Patients, Integrating Predictive Analytics

Sickle cell disease (SCD) affects 30 million people worldwide, causing a range of symptoms from mild to severe, including Vaso occlusive crises (VOC). SCD leads to damaging cycles of sickling and desickling of red blood cells due to HbS polymer formation, resulting in chronic haemolytic anaemia and tissue hypoxia. We propose using machine learning to categorize SCD patients based on haemoglobin, reticulocyte count, and LDH levels, crucial markers of hemolysis. Statistical analysis, particularly Linear Regression, demonstrates how haemoglobin depletion occurs using LDH and reticulocyte parameters.&#x0D; Bilirubin and haemoglobin, two integral biomarkers in clinical biochemistry and haematology, serve distinct yet interconnected roles in human physiology. Bilirubin, a product of heme degradation, is a critical indicator of liver function and various hepatic disorders, while haemoglobin, found in red blood cells, is responsible for oxygen transport throughout the body. Understanding the statistical relationship between these biomarkers has far-reaching clinical implications, enabling improved diagnosis, prognosis, and patient care. This research paper conducts a comprehensive statistical analysis of bilirubin and haemoglobin using various regression techniques to elucidate their intricate association. The primary objective of this study is to characterize the relationship between bilirubin and haemoglobin. Through meticulous data analysis, we explore whether these biomarkers exhibit positive, negative, or no correlation. Additionally, this research develops predictive models for estimating haemoglobin levels based on bilirubin data, offering valuable tools for healthcare professionals in clinical practice.

Tomatidine ameliorates high-fat-diet/streptozocin (HFD/STZ)-induced type 2 diabetes mellitus in mice

Objective To investigate the effects of tomatidine (Td) on the progression of type 2 diabetes mellitus (T2DM) in mice and uncover the mechanism. Methods T2DM mice model was induced by high-fat diet (HFD) and intrabitoneal injection of streptozotocin (STZ). The mice were grouped as follows: 1, control; 2, T2D; 3, T2D + tomatidine (5 mg/kg); 4, T2D + tomatidine (10 mg/kg); 5, T2D + tomatidine (20 mg/kg). Fasting blood glucose was detected by glucose metre and fasting insulin was detected by the kit to determine the effect of Td on T2DM mice. ELISA, qPCR, and Immunoblot assays were performed to detect the effects of Td on the hepatic glucose homeostasis and inflammation of mice. Immunoblot assays further confirmed the mechanism. Results Td improved blood glucose and insulin resistance in T2DM mice. In addition, Td improved liver function and lipid metabolism disorder in T2DM mice. Td also affected the liver glucose homeostasis related genes in T2DM mice. Td alleviated serum inflammation in T2DM mice. We further found that Td activated AMPK pathway, therefore ameliorating T2DM. Conclusion Td ameliorated HFD/STZ-induced T2DM in mice, suggesting that it could serve as a drug of T2DM.

Quercetin prevents rats from type 1 diabetic liver damage by inhibiting TGF-ꞵ/apelin gene expression

BackgroundHyperglycemia-induced oxidative stress is a significant contributor to diabetic complications, including hepatopathy. The current survey aimed to evaluate the ameliorative effect of quercetin (Q) on liver functional disorders and tissue damage developed by diabetes mellitus in rats. MethodsGrouping of 35 male Wistar rats was performed as follows: sham; sham + quercetin (sham + Q: quercetin, 50 mg/kg/day in 1 ml 1% DMSO for 6 weeks, by gavage); diabetic control (Diabetes: streptozotocin (STZ), 65 mg/kg, i.p.); diabetic + quercetin 1 (D + Q1: quercetin, 25 mg/kg/day in 1 ml 1% DMSO for 6 weeks, by gavage after STZ injection); and diabetic + quercetin 2 (D + Q2: quercetin, 50 mg/kg/day in 1 ml 1% DMSO for 6 weeks, by gavage after STZ injection). Body weight, food intake, and water intake were measured. Ultimately, the samples of plasma and urine, as well as tissue samples of the liver and pancreas were gathered for later assays. ResultsSTZ injection ended in elevated plasma blood glucose levels, decreased plasma insulin levels, liver dysfunction (increased activity levels of AST, ALT, and ALP, increased plasma levels of total bilirubin, cholesterol, LDL, triglyceride, decreased plasma levels of total protein, albumin and HDL), enhanced levels of malondialdehyde, diminished activities of antioxidant enzymes (superoxide dismutase, and catalase), reduced level of glutathione (GSH) increased gene expression levels of apelin and TGF-ꞵ, plus liver histological destruction. All these changes were diminished by quercetin. However, the measure of improvement in the D + Q2 group was higher than that of the D + Q1 group. ConclusionsQuercetin improved liver function after diabetes mellitus type 1, possibly due to reduced lipid peroxidation, increased antioxidant systems, and inhibiting the apelin/TGF-ꞵ signaling pathway.

Comparison of Serum Glutamic Pyruvic Transaminase and Serum Glutamic Oxaloacetic Transaminase Enzyme Levels between Light and Heavy Drinkers in Renon Village, Denpasar City

Arak is a non-electrolyte liquid that easily circulates in the blood circulation and is absorbed in the digestive tract. One disease that can be caused by alcohol consumption is liver function disorders, such as alcoholic hepatitis. So it can increase the serum enzymes glutamate pyruvate transaminase (SGPT) and serum glutamic oxaloacetic transaminase (SGOT). This research was conducted on light and heavy drinkers in Renon Village, Denpasar City. This research uses a longitudinal quantitative design. The results obtained were that the average SGPT level of light drinkers was 46.21 ± 0.155 IU/L, while the respondents who were heavy drinkers had SGPT levels with an average of 64.02 ± 0.430 IU/L. for SGOT from light drinkers is 50.20 ± 0.101 IU/L. Respondents who drank heavily had SGPT levels with an average of 74.40 ± 0.048 IU/L. All wine drinkers, both light drinkers and heavy drinkers, had SGPT-SGOT levels that exceeded the reference value.

Effect of milk thistle and silimevit on the functional state and protein synthesizing-function of the liver of laying hens under conditions of cadmium load

The purpose of the work was to study the effect of Cadmium on liver function disorders and to develop practical recommendations for using silimevit and milk thistle to reduce the toxic effect of Cadmium on chickens. To achieve the set goal in experiments on chickens under cadmium load, it was necessary to solve the following tasks: to study the effect of Cadmium on the protein synthesis function of the liver of laying hens; to study the effect of Cadmium on the functional state of the liver of laying hens; to investigate the effect of silimevit and the fruits of milk thistle on the functional state of the liver of laying hens under cadmium load; to investigate the effect of silimevit and milk thistle fruits on the protein synthesis function of the liver of laying hens under cadmium load and to justify the use of silimevit and milk thistle to prevent cadmium toxicosis in chickens. Drinking cadmium sulfate to laying hens violates the liver's functional state and protein-synthesizing function. A decrease in total protein and albumin content in their blood was established (Р &lt; 0.001). An increase in alanine and aspartate aminotransferase activity was detected (Р &lt; 0.001). Silimevit and milk thistle positively affect the functional state of the liver of laying hens under cadmium load, as evidenced by a decrease in the activity of aminotransferases in their blood serum. Silimevit and spotted thistle, under the cadmium load of laying hens, positively affect the liver's protein-synthesizing function, evidenced by an increase in total protein and albumin fraction. Feeding laying hens under cadmium load with slime feed contributed to a better-normalizing effect on the activity of aminotransferases and protein-synthesizing function of the chickens' liver than milk thistle.

Outcome of Proton Beam Therapy for Primary Hepatocellular Carcinoma with “Unfavorable” Macroscopic Classification

Transcatheter arterial chemoembolization (TACE) is the standard treatment for early to intermediate-stage hepatocellular carcinoma (HCC) unfit for hepatectomy or radiofrequency/microwave ablation (RFA/MWA). Putting aside its hepatic toxicity, local control of TACE is far from satisfactory, especially with non- "simple nodular type" appearances, to an extent where systemic therapy is suggested to be more beneficial. We here analyzed the outcome of proton beam therapy (PBT) for primary HCC by macroscopic classification. Primary HCC treated with PBT between 2010 and 2018 were extracted from an all-in treatment database. The macroscopic classification was defined by CT or MRI prior to PBT. Local recurrence was defined as tumor re-enlargement or the appearance of arterial phase hyperenhancement. Adverse events were evaluated by CTCAE v5.0. Overall survival, local control, intrahepatic recurrence-free survival, and extrahepatic recurrence-free survival were determined by the Kaplan-Meier method, and the association with treatment factors was analyzed by log-rank and cox regression model. A total of 202 primary HCC cases were extracted, all not a candidate for hepatectomy nor RFA/MWA. Out of them, 75 cases were simple nodular type, 79 were simple nodular type with extranodular growth, 38 were confluent multinodular type, and 10 were infiltrative type. 26 cases were HBV positive, and 84 cases were HCV positive. 35 cases had macroscopic vascular invasion (MVI). With a median follow-up period of 3.72 years (IQR: 1.79-5.85years), the 3-year overall survival rate was 68.1% (95% CI 61.0 - 74.3%), the 3-year local control rate was 89.6% (95% CI 83.4-93.5), the 3-year intrahepatic recurrence-free survival rate was 53.7% (95% CI 45.9-60.8%), and the 3-year extrahepatic recurrence-free survival rate was 87.4% (95% CI: 81.5-91.6%). Simple nodular type had better overall survival (73.2% vs 65.2% p = 0.012) and extrahepatic recurrence free survival (96.9% vs 81.9% p<0.01), but there was no statistically significant difference in local control (92.7% vs 87.6% p = 0.06) and intrahepatic recurrence-free survival (62.0% vs 48.5% p = 0.114). Multivariate analysis of risk factors against OS, including age, sex, AFP, MVI, and macroscopic classification, revealed age and macroscopic classification as independent risk factors. Adverse events of grade 3 included 2 cases of gastrointestinal bleeding, 7 cases of liver function disorder, 1 cases of biliary hemorrhage, and 1 case of pleural effusion. Other than one case of early death (2 weeks after treatment) with an unknown causal relationship, there were no adverse events of grade 4 or severe. PBT for non- "simple nodular type" primary HCC appears to be safe and effective, whilst suppression of out-of-field recurrence is needed for further survival prolongment.

Functional state and protein-synthesizing function of the liver of laying hens under conditions of cadmium loading

The toxicity of cadmium in the bird's body depends on the penetration method, the total dose, and the duration of poisoning. That is why the work aimed to study the effect of Cadmium on liver function disorders. To achieve the set goal in experiments on chickens under cadmium load, it was necessary to solve the following tasks: to study the effect of cadmium on the protein synthesis function of the liver of laying hens; to study the effect of cadmium on the functional state of the liver of laying hens. 24 laying hens aged 78 weeks were selected for research. These chickens were divided into three groups: control and two experimental, taking into account their age and weight. Chickens from the control group received compound feed and clean water without adding cadmium sulfate. In the chickens of the experimental groups, cadmium sulfate was added to the drinking water in different concentrations for 30 days: the first group (R1) – 2 mg per kilogram of body weight, the second group (R2) – 4 mg per kilogram of body weight. According to the conducted studies, it was found that in laying hens under conditions of cadmium load, the functional state of the liver is disturbed, as evidenced by the increased activity of aminotransferases in their blood serum. It is worth noting that the highest activity of alanine and aspartate aminotransferases was in the blood serum of laying hens of the second experimental group on the 21st day of the experiment. The results indicate an increase in destructive processes in the body of laying hens due to cadmium loading. In laying hens under cadmium load, the liver's protein synthesis function is suppressed, manifested by a decrease in the level of total protein and albumins, with a simultaneous increase in the level of globulins. Drinking cadmium sulfate with water in a larger dose (4 mg/kg of body weight) was accompanied by a more probable decrease in total protein and albumin level than drinking cadmium sulfate in a smaller dose (2 mg/kg of body weight). Under cadmium load, an albumin-globulin disproportion occurs, which is indicated by the value of the A/G ratio. In the chickens of the first experimental group, it was found that the value of the A/G ratio on the 21st day of the experiment was 0.42, while in the second experimental group, it was lower and was 0.39, respectively, against the control 0.52.

Predictors of COVID-19 Severity in Elderly Patients Infected by Omicron in China, 18 December 2022-5 February 2023.

To analyze the clinical characteristics and prognosis of patients hospitalized with non-severe, severe pneumonia and death in Omicron COVID-19. We collected clinical data from 118 patients with COVID-19 in China from 18 December, 2022 and 5 February, 2023. According to the outcome, the patients were divided into non-severe group, severe group and death group. Subsequently, we statistically analyzed the general condition, clinical manifestations, laboratory parameters, NLR, MLR, PLR and HALP of these groups. We also retrospectively analyzed the possible factors affecting the prognostic regression of patients with COVID-19. A total of 118 COVID-19 patients were enrolled in this study, including 64 non-severe patients, 38 severe patients and 16 death patients. Compared with the non-severe group, T lymphocytes, B lymphocytes, Th1, Th2, Th17, Treg cells, IgA, IgG, IgM in the severe and death groups decreased more significantly (P<0.05). The levels of myocardial markers, ALT, AST, BUN, Cr, D-dimer, fibrinogen, NLR, MLR and PLR in the severe and death groups were significantly higher than those in the non-severe group (P<0.05). The level of HALP was significantly lower than that of non-severe group (P<0.05). MLR is not only an independent risk factor for the transition from non-severe to severe disease, but also an independent risk factor for predicting the possibility of death in COVID-19 patients. The analysis of COVID-19 patients in China showed that severe patients were older, more likely to have related complications, lower lymphocyte count, liver and kidney function disorder, glucose and lipid metabolism disorders, myocardial injury, and abnormal coagulation function, suggesting the need for early anticoagulant therapy. In addition, NLR, MLR, PLR and HALP can be used as biomarkers to evaluate the severity and prognosis of COVID-19 patients.

Hiatal Hernia with Prolapse of the Pancreas Causing Bile Duct Stricture and Liver Function Disorders: A Case Report and Literature Review.

Hiatal hernia is a common condition in elderly patients, but the additional presence of prolapse of the pancreas is extremely rare. We herein report an 89-year-old woman who presented with liver function disorders and abdominal pain. Her laboratory tests revealed cholestasis, and imaging examinations showed stenosis of the common bile duct pulled toward the hernia sac. She was diagnosed with a common bile duct stricture due to pancreatic herniation and underwent laparoscopic surgery. Our review of the literature identified three types of pancreatic herniations: asymptomatic, bile duct complication, and acute pancreatitis. Pancreatic head herniation tends to induce bile duct complications.

Non-invasive detection of total bilirubin based on multi-wavelength PPG signal

Background and objectiveAbnormal bilirubin metabolism can result in various liver function disorders. Current clinical practice for bilirubin level detection involves invasive blood collection from patients, which is time-consuming, painful, and poses infection risks. Thus, there is a pressing need for non-invasive bilirubin detection methods. This study aims to develop a non-invasive total serum bilirubin(TSB) detection method in humans based on multi-wavelength photoplethysmography (PPG) signals. MethodsThe experimental instrument includes a light source and a spectrometer. PPG signals are collected from the subjects' fingers, and the samples are selected based on the PPG deviation degree screening method. The absorption spectrum of blood is extracted from the PPG signal using dynamic spectroscopy. Finally, locally developed software calculates the total bilirubin value. The instrument is modeled and validated according to the clinical-biochemical test values. ResultsThe results of the prediction set (correlation coefficient is 0.91, RSMEP is 2.32 umol/L, average absolute error percentage is 9.3%) show that our method has a strong correlation with the detection results of clinical-biochemical analysis instruments. The Bland-Altman test showed that the device deviated from the data detected by biochemical methods in the clinic with a mean deviation of about 0.12 umol/L and a 95% confidence interval between -2.95 umol/L and 2.7 umol/L. ConclusionsThis study's non-invasive bilirubin detection method has high accuracy, which can meet the needs of continuous non-invasive total bilirubin detection in clinical practice.

Efficacy and Safety of Drug-Eluting Bead TACE in the Treatment of Primary or Secondary Liver Cancer.

The drug-eluting beads transarterial chemoembolization (DEB-TACE) has already been used in hepatic malignancies. We aim to evaluate the efficacy and safety of DEB-TACE in treating primary or secondary liver cancer. We retrospectively evaluated 59 patients with hepatic malignancies, including 41 patients with primary liver cancer and 18 patients with secondary liver cancer, between September 2016 and February 2019. All patients were treated with DEB-TACE. Objective response rate (ORR) and disease control rate (DCR) were evaluated by mRECIST. The pain was assessed using a numerical rating scale (NRS) where 0 represented no pain, and a score of ten was unbearable. Adverse reactions were assessed according to Common Terminology Criteria for Adverse Events 4.0 (CTCAE4.0). In the subgroup of primary liver cancer, 3 patients (7.32%) got complete response, 13 patients (31.71%) got partial response, 21 patients (51.22%) experienced stable disease, and 4 patients (9.76%) suffered progressive disease; ORR was 39.02% and DCR was 90.24%. In the subgroup of secondary liver cancer, 0 patients (0%) got complete response, 6 patients (33.33%) got partial response, 11 patients (61.11%) experienced stable disease, and 1 patient (5.56%) suffered progressive disease; ORR was 33.33% and DCR was 94.44%. We did not find any difference when comparing the efficacy between primary and secondary liver cancer (P=0.612). The one-year survival rate was 70.73% for primary liver cancer and 61.11% for secondary liver cancer. There was no significant difference between the two groups (P=0.52). For the patients with CR or PR, no factor could predict the efficacy of DEB-TACE. The most common treatment-related adverse reactions were short-term liver function disorders. The symptoms included fever (20.34%), abdomen pain (16.95%), and vomiting (5.08%), all patients with adverse reactions got remission after treatment. DEB-TACE has a promising effect in the treatment of primary or secondary liver cancer. The treatment-related adverse reactions are tolerable.

Эклампсия. Современный портрет

Hypertensive disorders consistently occupy one of the leading causes of maternal mortality. An important role in the diagnosis of eclampsia is given to MRI (magnetic resonance imaging) of the brain, which allows to identify a pathognomonic symptom of eclampsia, posterior reversible encephalopathy syndrome (PRES). Patients and methods. Six clinical cases of patients with eclampsia were retrospectively analyzed. Results. The result of the first screening showed a low risk of pre-eclampsia in 83.3% of patients, and only 16.7% were at risk. All patients developed the eclamptic episode in the third trimester of pregnancy, and they all had elevated diastolic blood pressure (above 110 mm Hg). In 66.7% of patients, systolic blood pressure was within the range of 180–200 mm Hg. There were no disorders of liver function and coagulation system, and platelet levels were within the normal range. According to the brain MRI, all patients were diagnosed with PRES without signs of cerebral circulation disorders. Conclusion. This study demonstrates that the causes and pathogenesis of eclampsia are still unknown. Perhaps we are talking about a new manifestation of the disease, or maybe the causes lie in the pathogenesis, which is not fully understood. Key words: hypertensive disorders of pregnancy, pre-eclampsia, posterior reversible encephalopathy syndrome, eclampsia, PRES

The effective treatment of hepatic lipidosis and lipemia in an ornamental hen: a case report

This study discusses the significant role of lipids in liver functional disorders, emphasizing their impact on metabolic processes and the evaluation of organism and cell function. Hepatic lipidosis, observed across various species, including birds, results from an imbalance in fatty acid metabolism. The study focuses on a case presentation of a laying hen with severe respiratory symptoms and abdominal distension, diagnosed with hepatic lipidosis due to an inappropriate high-fat diet. Diagnostic methods include clinical examinations, blood tests, radiology, and ultrasonography. Treatment involves atorvastatin, furosemide, and dietary adjustments, resulting in a complete recovery. The discussion highlights the metabolic aspects of hepatic lipidosis in laying hens and the challenges in diagnosing pet birds, suggesting biochemical tests and ultrasonography. Additionally, the article explores the application of atorvastatin in treating hyperlipidemia in birds and emphasizes the importance of maintaining a healthy liver in actively egg-laying birds. Our study and experiences have shown that, alongside chemical compounds, herbal compounds can also be utilized for optimal liver health.

Enteric hepatitis

Viral hepatitis is an extensive group of human diseases caused by viruses with tropism to liver damage, which leads to a liver function disorder. There are various ways of viral hepatitis transmission, but the main ones are enteral and parenteral. Hepatitis with a predominantly enteral route of transmission includes hepatitis A and E. Methods for diagnosing and treating this pathology are presented in the article.

A clinical case of disorders of hepatic function and possibilities of their correction after COVID-19 based on foreign and domestic recommendations

Due to the complex epidemiological situation resulting from the infection of COVID‑19, doctors of various specialties have a number of questions regarding the tactics of patients’ management. Current data indicate that SARS‑CoV‑2 has the ability to affect all organs and systems of the body, including the gastrointestinal tract. Liver is one of the target organs, affected by COVID‑19 infection. The authors consider the latest foreign and domestic recommendations for the treatment of patients with hepatic lesions. A clinical case of hepatic dysfunction and possibilities of its correction after COVID‑19 have been outlined. The main pathogenetic mechanisms of changes in liver samples are highlighted, including immune activation and inflammation caused by cytokines with the initiation of cytokine storm, coagulopathy and multiple organ failure, cytotoxicity due to virus replication in cholangiocytes and hepatocytes with the participation of angiotensin‑converting enzyme‑2 and serine protease‑2 receptors, severe hypoxia caused by vascular endothelium damage, drug‑induced liver damage caused by hepatotoxicity and immune‑mediated damage, reactivation of previously existing liver diseases (hepatitis, non‑alcoholic fatty liver disease, as well as progression and decompensation of liver cirrhosis). The domestic algorithm for the management of patients with liver diseases, hospitalized with confirmed COVID‑19 infection, involves the control of liver samples once every 2 — 3 months, annual control of fibrosis degree, correction of diet and lifestyle, minimization of drug therapy, administration of drugs (hepatoprotectors) and correction of microcirculation processes and functions of other organs/systems.&#x0D; The presented clinical case demonstrates the importance of timely treatment of liver functional disorders and the need for dynamic monitoring of the condition of patients who have contracted COVID‑19.&#x0D;