Disturbed Liver Function Research Articles

Effect of rapamycin on hepatic metabolomics of non-alcoholic fatty liver rats based on non-targeted platform

Rapamycin (Rapa) is an inhibitor of mTOR complex, and its therapeutic effect on liver function was examined in non-alcoholic fatty liver disease (NAFLD) rats here. And the possible mechanism of Rapa in NAFLD was preliminarily elucidated based on the non-targeted metabolomics analysis. Adult male SD rats were fed with a high-fat and high-cholesterol diet (HFD) to establish NAFLD model. For Rapa group, 0.8 mg/(kg.d) Rapa was given to the HFD rats. Ultra-performance liquid chromatography and Q-Tof-mass spectrometry (UPLC and Q-TOF/MS) analysis were applied for the identification of metabolites in the serum of rats, which were annotated using Kyoto Encyclopedia of Genes and Genomes (KEGG). NAFLD rats presented with disturbed liver function, lipid metabolism and oxidative stress, but Rapa exerted a mitigating influence on the disorders. The metabolite profile data identified 579 metabolites that varied remarkably between the Rapa and HFD groups, with the main classes of amino acids and peptides, benzene, lipids and fatty acids. The differential metabolites were mainly involved in biosynthesis of cofactors, bile secretion, and glycerophospholipid metabolism were mainly enriched. In conclusion, Rapa has a potential protective effect against HFD-induced NAFLD, its hepatoprotective effect may achieved through mediating bile secretion and glycerophospholipid metabolism.

Unveiling the Interplay: Antioxidant Enzyme Polymorphisms and Oxidative Stress in Preterm Neonatal Renal and Hepatic Functions.

To explore the relationship between oxidative stress biomarkers and the occurrence of acute kidney injury (AKI) alongside notable liver function disturbances in preterm neonates. Given the immaturity of kidneys and incomplete liver development in preterm neonates, oxidative stress poses a considerable threat to their renal and hepatic health. To find out the association between various oxidative stress biomarkers and polymorphisms of antioxidant enzymes with renal and live functions. In this cross-sectional study, we gathered umbilical cord blood and peripheral blood samples for assessing oxidative stress biomarkers and identifying single nucleotide polymorphisms (SNPs) in antioxidant enzymes. Utilizing enzyme-linked immunosorbent assay kits, we quantified these oxidative stress biomarkers. Receiver-operating characteristics curve analysis was employed to ascertain the predictive capacity of these biomarkers, denoted by the area-under-the-curve (AUC). Our findings revealed that umbilical cord heat-shock proteins emerged as robust predictors of neonatal AKI (AUC: 0.92; 95% CI: 0.8-1) with a defined cut-off concentration of 1.8 ng/mL. Likewise, umbilical cord 8-hydroxy-2-deoxy guanosine demonstrated significant predictability for liver function alterations (AUC: 0.7; 95% CI: 0.6-0.9) at a cut-off concentration of 2487.6 pg/mL. We observed significant associations between SNPs in endothelial nitric oxide synthase and catalase with both AKI and impaired liver functions. Prospective studies are warranted to validate these findings, with a particular focus on exploring potential antioxidant interventions aimed at mitigating AKI and liver function abnormalities.

The role of lycopene in alleviating nanoplastic-induced liver inflammation and steatosis: Insights from gut microbiota remodeling

Nanoplastics (NPs) are emerging pollutants that are widespread in food and drinking water and present a serious danger to the health of animals and humans. Therefore, it is increasingly important to dissect their targeted toxicity mechanism and explore how to mitigate their damaging effects on the organism. Lycopene (LYC)possesses anti-inflammatory, antioxidant, and lipid metabolism– and intestinal microbiota–regulating properties. The research sought to assess the defensive properties of LYC in preventing liver lipid metabolism disorder in mice induced by chronic exposure to nanoparticles. The results indicated that LYC treatment significantly decreased the accumulation of tissue NPs, promoted the excretion of fecal NPs, remodeled intestinal flora, alleviated intestinal injury, decreased circulating lipopolysaccharide production, inhibited the liver TLR4/NF-κB pathway, and ultimately attenuated NPs-induced liver inflammation and steatosis in mice. Interestingly, ablation of the gut microbiota by antibiotic treatment reversed, to some extent, the protective effects of LYC on the NPs-induced disturbances in liver function and lipid metabolism. The fecal transplantation experiment showed that the mice transplanted with microbiota from the NPs + LYC mice had similar phenotypes to those of donor mice, including alleviated liver injury and lipid metabolism disorder. In conclusion, LYC treatment ameliorates liver damage and lipid metabolism disorder caused by NPs, possibly through the modulation of the gut microbiota/liver TLR4/NF-κB signaling axis. This supports LYC as a potential dietary therapy for treating liver steatosis caused by NPs.

Prolonged Formalin Exposure on Liver and Kidney Function Associated with TP53 Gene Expression in Quail Birds (Coturnix coturnix)

Background: This study was the first to highlight the deleterious effect of formalin gas on gene expression of the tumor protein TP53 in the digestive and urinary system. This experiment was conducted according to animal ethics and regulations of the College of veterinary medicine/the University of Al-Qadisiyah. Method: Three groups were exposed to two hours of formalin gas twice daily, two hours in the morning and evening, for 30 days, and the fourth group was the control with the same environmental conditions except for formalin. Then, quails were killed on different days (10, 20, and 30 days), and Liver, kidney, and blood specimens were collected for gene expression, histological, and biochemical studies. Result: displayed that formalin gas caused by disturbances in liver and kidney functions, in addition to the great pathological liver and kidney changes, showed acute hepatitis and nephritis. 5% of the formalin gas significantly increased the expression of TP53in the liver and kidney regularly with a period of exposure, Conclusion: that P53 might be considered a suitable biomarker of molecular for formalin impaction in humans and animals especially the birds.

Hepatotoxicity Induced by Some Metal Nanoparticles In Vivo: Review

Nanotechnology has witnessed a revolution in our current era and has penetrating into consumer industries, biomedical and electronic fields, and environmental treatments, due to the chemical-physical properties of nanoparticles, especially metal ones, and the advantage of large surface area to volume. Thus, the growing consumption of these minutes has increased the exposure of living organisms to potential risks associated with their toxicity, especially vital organs as liver. The present review summarizes the potential hepatotoxicity in vivo (rat model) of experimentally exposed metal nanoparticles or their oxides. Most of the literature indicates that the induced hepatotoxicity is due to oxidative stress, cytotoxicity, and disturbance of liver function depending on the concentrations and method of exposure to these nanoparticles. Therefore, the toxic potential must be taken into account and the damage that may be caused to other vital organs in the body must be constantly evaluated in order to reach safe use of these nanoparticles.

A clinical study evaluating the combination of LISA and SNIPPV for the treatment of respiratory distress syndrome in preterm infants

To compare the therapeutic effect of less invasive surfactant administration (LISA) followed by synchronized nasal intermittent positive pressure ventilation (SNIPPV) and traditional intubate-Surfactant-Extubate (InSurE) strategy for the treatment of neonatal respiratory distress syndrome (NRDS). A single-center, non-randomized and single- blinded study Tertiary neonatal intensive care unit 89 infants enrolled were preterm with gestational age < 366/7 weeks and clinically diagnosed with neonatal RDS (NRDS) Interventions: 32 infants were assigned to the LISA + SNIPPV group and 57 infants to the InSurE + nCPAP group. No statistically significant differences were noted in the baseline characteristics of the enrolled infants. A lower proportion of infants developed BPD in the LISA + SNIPPV group compared to the InSurE + CPAP group [10 (31.25%) vs. 21 (36.84%), P > 0.05]; however, there was no statistically significant difference. The number needed to treat (NNT) with LISA + SNIPPV to prevent BPD development is 18. The mortality rate was not significant between our study arms [1 (3.13%) vs 2 (3.51%), P > 0.05]. There were no statistically significant differences in the durations (days) of MV [(12.18 ± 13.89) vs. (11.35 ± 11.61), P > 0.05], oxygen therapy [(35.03 ± 19.13) vs. (39.75 ± 17.91), P > 0.05] and re-intubation rates [(0.19 ± 0.40) vs. (0.21 ± 0.45), P > 0.05] between the two study groups. In terms of complications, the incidence of patent ductus arteriosus (PDA) [24 (75.00%) vs. 27 (47.37%), P < 0.05] was higher and a lower rate of disturbed liver function [1 (3.23%) vs. 19 (33.33%), P < 0.05] were observed in the LISA + SNIPPV group. Acid–base imbalances were reportedly significantly higher in the InSurE group (P < 0.05). No significant differences in other complications were noted. In the interventional group, FiO2 requirements were significantly lower up until the 3rd week of treatment [FiO2 at day 0, (30.75 ± 4.78) vs. (34.66 ± 9.83), P < 0.05; FiO2 at day 21, (25.32 ± 3.74) vs. (29.11 ± 8.17), P < 0.05], as was RSS on days 2 [(0.77 ± 0.38) vs. (1.94 ± 0.75), P < 0.05] and 3 [(0.66 ± 0.33) vs. (1.89 ± 0.82), P < 0.05] after treatment. Additionally, infants in the standard group had a significantly prolonged hospital stay (days) [(45.97 ± 16.93) vs. (54.40 ± 16.26), P < 0.05]. The combination of LISA and SNIPPV for NRDS can potentially lower the rate of BPD, FiO2 demand and shorten the length of hospitalization.

Assessing the hypolipidemic and gastro-liver protective activity of herbal combination with emphasis on PPI amid selected multiple antihypertensive drug combination in experimental animal models.

Peptic ulcer (PU) and hypertension are chronic diseases affecting up to 10% and 30% of the adult population worldwide. Most of these patients will require treatment with a combination of antihypertensive medicines, which have adverse effects on the body's different organs. This study specifically focused on antihypertensive multi-drug induced PU disease and disturbance of liver function. During a 14-day oral administration of antihypertensive drugs, Cilnidipine (1 mg/kg), Rosuvastatin (1 mg/kg), Bisoprolol (0.52 mg/kg), and Clopidogrel (7.81 mg/kg) were observed for their effects on the stomach lining and liver function in Wister albino rats. This study aimed to assess the potential of an herbal combination of (BO) + (BA) + (ZO) 0.26 mg/kg body weight (b.w.) Powder and water mixture on the ulcer, lipid profile, and liver function for 14 days in the treatment of the indomethacin-induced gastric ulcers in rats at doses of 30 mg/kg b.w. for three days. Esomeprazole (20 mg/kg b.w.) is used as a standard reference to evaluate antiulcer activity in rat models. The experiment suggests that the gastroprotective effect of the herbal combination can be attributed to its reducing effect on the peptic and the Serum Glutamic Pyruvic Transaminase (SGPT) levels and within the normal range of 34.67 ± 0.88 IU/L. The results for Total Cholesterol (TC), Triglyceride (TG), High-density lipoprotein (HDL) and Low-density lipoprotein (LDL) of the herbal combination were 52 ± 9.81495 (mg/dl), 70 ± 12.12435 (mg/dl), 23.33 ± 6.06446 (mg/dl), 14.5 ± 1.32790 (mg/dl), respectively, where the standard group (atorvastatin) 5 mg/kg TC, TG, HDL and LDL were 69.77 ± 9.92 (mg/dl), 47.7 ± 10.35 (mg/dl), 33.43 ± 5.70 (mg/dl), 26.8 ± 3.70 (mg/dl), and control group total cholesterol, triglyceride, HDL and LDL were 68.67 ± 2.20 (mg/dl), 124.07 ± 2.94 (mg/dl), 49.14 ± 1.05 (mg/dl), 54.11 ± 1.15 (mg/dl). CThis investigation reported that antihypertensive drugs did not produce gastrointestinal (GI) toxicity, and the morphological structure of the organ was not changed. So, it could be concluded that the herbal combination used in this experiment has a promising role in controlling lipid profile, liver function, and antiulcer effects. Moreover, multiple drug therapy for hypertension does not cause any harm to the stomach. Further investigations might be carried out on a larger scale to make these statements more valid.

Nanoplastic Exposure at Environmental Concentrations Disrupts Hepatic Lipid Metabolism through Oxidative Stress Induction and Endoplasmic Reticulum Homeostasis Perturbation.

In this study, we investigated the mechanism underlying the perturbation of hepatic lipid metabolism in response to micro/nanoplastic (MP/NP) exposure at environmentally relevant concentrations. Polystyrene (PS) MPs/NPs with different sizes (0.1, 0.5, and 5.0 μm) were studied for their effects on the homeostasis and function of Nile tilapia (Oreochromis niloticus) liver. Results showed that PS MPs/NPs were readily internalized and accumulated in various internal organs/tissues, especially in fish liver and muscle. Smaller-sized NPs caused more severe toxicity than larger MPs, including hepatic steatosis, inflammatory response, and disturbed liver function. Mechanistically, PS NPs with a particle size of 100 nm perturbed protein homeostasis in the endoplasmic reticulum (ER) by inhibiting the expression of chaperone proteins and genes involved in ER-associated degradation. This led to the activation of the PERK-eIF2α pathway, which caused dysfunction of hepatic lipid metabolism. Induction of oxidative stress and activation of the Nrf2/Keap1 pathway were also involved in the PS NP-induced hepatic lipid accumulation. These findings highlight the potential adverse effects of environmental MPs/NPs on aquatic organisms, raising concerns about their ecotoxicity and food safety.

Perbandingan Kadar SGPT Pada Sampel Serum Darah Yang Segera Diperiksa Dengan Ditunda Selama 24 Jam dan 48 Jam Pada Suhu Ruang

Serum Glutamic Pyruvic Transaminase (SGPT) examination is an examination to determine the presence of disturbances in liver function. The SGPT enzyme is often used as an enzyme screening of basic parameter for a diagnosis and follow-up of disorders liver function. The types of specimens were used for SGPT examinations were serum, plasma heparin ora EDTA, and this study used serum samples. This study aimsto determine whether there are differences between the examination of SGPT levels which are immediately examined of postponed for 24 hours and 48 hours. This research is a cross sectional research with Posttest Only Control Group Design. This research was conducted at the Palembang Health Laboratory Center (BBLK) of South Sumatra Province on 28-30 December 2021 with the respondents of Diploma Medical Laboratory Technology Students level 2 and 3 with 30 samples. The results showed that the average SGPT level which immediately checked was 0.14, the average SGPT level delayed 24 hours was 0.13 and the SGPT level delayed 48 hours was 0.11. the results of the Two Way ANOVA test showed p value &lt; 0,05, so it can be concluded that there was a change in the level of SGPT which immediately examined by being delayed for 24 hours and 48 hours at roon temperature

Is Hydroxyurea Treatment Changing the Life of Children with Sickle Cell Disease?

Background: Sickle cell disease (SCD) is a prevalent hemoglobinopathy involving sickled hemoglobin that causes multiorgan disease due to chronic recurrent vaso-occlusion and hemolysis. Fetal hemoglobin (HbF) being present showed reduction in disease severity, owing to which hydroxyurea has gained significant recognition. The latter’s exact mechanism of action is yet unknown, but it has been demonstrated that the resulting rise in HbF raises hemoglobin levels and lessens the incidence of acute chest syndrome and vaso-occlusive crises. In the United Arab Emirates, our study is the first to assess the effects of hydroxyurea therapy in pediatric SCD patients. Methods: We conducted a retrospective cross-sectional study on 100 patients aged 2–13 years who were diagnosed with SCD, under regular outpatient follow-up with pediatric hematology clinic and receiving hydroxyurea therapy for at least 2 years. Basic hematologic parameters, frequency of SCD complications, and need for blood transfusions were studied. Results: Our analysis has shown a statistically significant (p < 0.05) correlation between hydroxyurea therapy and improved baseline hemoglobin and HbF levels; it decreased the incidence of painful crises and acute chest syndrome episodes; reduced the demand for blood transfusions; and recorded no side effects (pancytopenia or liver function disturbance). Conclusions: This study is the first of its kind in the UAE, and our findings support those of international data. The use of hydroxyurea therapy in SCD significantly improved hematologic and clinical parameters, thus markedly improving the patient’s quality of life. The side-effect profile is also limited, which further supports the fact that hydroxyurea is a relatively safe drug.

The influence of liver transplantation on the interplay between gut microbiome and bile acid homeostasis in children with biliary atresia.

Biliary atresia (BA) causes neonatal cholestasis and rapidly progresses into cirrhosis if left untreated. Kasai portoenterostomy may delay cirrhosis. BA remains among the most common indications for liver transplantation (LT) during childhood. Liver function and gut microbiome are interconnected. Disturbed liver function and enterohepatic signaling influence microbial diversity. We, herein, investigate the impact of LT and reestablishment of bile flow on gut microbiome-bile acid homeostasis in children with BA before (pre, n = 10), 3 months (post3m, n = 12), 12 months (post12m, n = 9), and more than 24 months (post24 + m, n = 12) after LT. We analyzed the intestinal microbiome of BA patients before and after LT by 16S-rRNA-sequencing and bioinformatics analyses, and serum primary and secondary bile acid levels. The gut microbiome in BA patients exhibits a markedly reduced alpha diversity in pre (p = 0.015) and post3m group (p = 0.044), and approximated healthy control groups at later timepoints post12m (p = 1.0) and post24 + m (p = 0.74). Beta diversity analysis showed overall community structure similarities of pre and post3m (p = 0.675), but both differed from the post24 + m (p < 0.001). Longitudinal analysis of the composition of the gut microbiome revealed the Klebsiella genus to show increased abundance in the post24 + m group compared with an age-matched control (p = 0.029). Secondary bile acid production increased 2+ years after LT (p = 0.03). Multivariable associations of microbial communities and clinical metadata reveal several significant associations of microbial genera with tacrolimus and mycophenolate mofetil-based immunosuppressive regimens. In children with BA, the gut microbiome shows strongly reduced diversity before and shortly after LT, and approximates healthy controls at later timepoints. Changes in diversity correlate with altered secondary bile acid synthesis at 2+ years and with the selection of different immunosuppressants.

Dengue Serotype Prevalence and Laboratory Profile Correlation in a Tertiary Care Hospital in Gandhinagar

Background: Dengue fever and dengue haemorrhagic fever currently rank highly among the newly emerging infectious diseases and are the most important arboviral disease worldwide. Dengue virus can be distinguished by both serological and molecular methods. This study was aimed at analysing the prevalence and laboratory dynamics of the four dengue serotypes in tertiary care patients attending GMERS Medical College Gandhinagar. Material &amp; methods: This study was an observational retrospective study. A total 105 samples were tested for Dengue serotyping by RT-PCR. Results: Among positive patients Dengue virus serotype-2 was the most common serotype 94 (89%) followed by DENV3 7(6%) and DENV4 2(2%). Co-infection with DENV 2/4 was 2(2%). A higher prevalence of dengue haemorrhagic fever was noted in serotype 2 compared to serotypes 3, 4, and coinfection. Thrombocytopenia was present in all serotypes of infection. There was a significant difference in the disturbance of liver function in DENV2, as compared to others serotype. Dengue serotype 2 was very common in rural areas, while dengue serotype 3 was seen in the urban Gandhinagar zone. Discussion: Dengue is the most extensively spread mosquito-borne disease.As per previous studies most common prevalent and severity of serotype wasDENV2,however in our study we were able to identify DENV3, DENV4 and confection with serotypes (DENV2 &amp; DENV4).

Correlation of Increased Serum Ferritin with SGOT, SGPT, and Albumin Levels in Children with β-Thalassemia Major

Background: Routine transfusion in β-thalassemia major children will cause excess iron in organs, especially the liver, as illustrated by the serum ferritin value. Excess iron in the liver can cause disturbances in liver enzymes and liver function, which can be assessed using SGOT, SGPT, and albumin examination parameters. This study intends to assess the relationship between increased serum ferritin levels with SGOT, SGPT, and albumin levels in β-thalassemia major children. Methods: This is an observational cross-sectional study which was conducted at the dr. Zainoel Abidin Hospital in Banda Aceh. Research subjects underwent examination of serum ferritin, SGOT, SGPT, and albumin. Results: A total of 37 β-thalassemia major children between 1 until &lt;18 years of age were included in this study. The mean serum ferritin, SGOT, SGPT and albumin levels in β-thalassemia major patients were 4596 ± 2750.07 ng/mL, 57.32 ± 44.20 U/L, 57.46 ± 54.77 U/L, and 4.34 ± 0.22 g/dL respectively. The correlation coefficient between ferritin levels and SGOT was 0.768 (p-value &lt;0.05). While, the correlation coefficient between ferritin and SGPT levels was 0.708 (p-value &lt; 0.05). On the other hand, the correlation value between ferritin and albumin levels was -0.114 (p-value &gt; 0.05). Conclusion: Increased serum ferritin levels in β-thalassemia major children are related to SGOT and SGPT levels. But there is no relationship between increased serum ferritin and albumin levels in β-thalassemia major children.

Changes in immunological reactivity of patients with pulmonary tuberculosis and allergic and toxic-allergic reactions

BACKGROUND. The spread of tuberculosis in Ukraine forces doctors to use intensive chemotherapy, which leads to adverse reactions and promotes to the spread of drug-resistant tuberculosis. Toxic-allergic reactions take a protracted course and are difficult to respond to corrective therapy, which requires additional research.&#x0D; OBJECTIVE. To determine changes in immunological reactivity in patients with pulmonary tuberculosis with allergic and toxic-allergic reactions by cellular immunity research.&#x0D; MATERIALS AND METHODS. The results of clinical, laboratory and immunological examination of patients were analyzed depending on the presence/absence of clinical signs of allergic reactions to antituberculosis drugs using the method of flow cytofluorimetry and assessment of phagocytic link of immunity.&#x0D; RESULTS AND DISCUSSION. There were detected the activation of all studied subpopulations of T- and B-lymphocytes and an increase in the absolute and percentage number of natural killers in the blood of patients without adverse reactions. It is a positive factor for the destruction of mycobacteria. The development of allergic reactions support the inhibition of the activity of the general pool of T-lymphocytes, their subpopulations, B-lymphocytes, natural killers, the absorption activity of phagocytes. It is an unfavorable factor that can lead to the formation of anergy of immunocytes. Increased activity of the inflammatory process and deepening of the immunological imbalance were detected in patients with clinical and laboratory signs of toxic-allergic reactions. It is not accompanied by an inhibitory effect on blood lymphocytes and phagocytes, is revealed. It indicates a special pathogenesis of toxic-allergic reactions with involvement of disturbed liver functions.&#x0D; CONCLUSSION. Identified differences in the immune status will allow to adjust the treatment.

HNF1B-MODY Masquerading as Type 1 Diabetes: A Pitfall in the Etiological Diagnosis of Diabetes

Hepatocyte nuclear factor-1B (HNF1B) maturity-onset diabetes of the young (MODY), also referred to as “renal cysts and diabetes syndrome” or MODY-5, is a rare form of monogenic diabetes that is caused by a deletion or a point mutation in the HNF1B gene, a developmental gene that plays a key role in regulating urogenital and pancreatic development. HNF1B-MODY has been characterized by its association with renal, hepatic and other extrapancreatic features.We present the case of a 39-year-old female patient who was first diagnosed with type 1 diabetes, but then, owing to the absence of anti-islet autoantibodies and to the disease’s progression, was labeled later on as having atypical type 2 diabetes. She was finally recognized as having HNF1B-MODY, a diagnosis that had been suggested by the lack of metabolic syndrome and by the presence of unexplained chronically disturbed liver function tests and hypomagnesemia. There was a 10-year delay between the onset of diabetes and the molecular diagnosis. An atypical form of diabetes, especially in patients with multisystem involvement, should raise suspicion for an alternative etiology. A timely diagnosis of HNF1B-MODY is of utmost importance since it can greatly impact diabetes management and disease progression as well as family history.

Linoleic acid pathway disturbance contributing to potential cancerization of intrahepatic bile duct stones into intrahepatic cholangiocarcinoma

BackgroundIntrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy with poor prognosis. Intrahepatic bile duct stone (IBDS) is one of the key causes to ICC occurrence and can increase morbidity rate of ICC about forty times. However, the specific carcinogenesis of IBDS is still far from clarified. Insight into the metabolic phenotype difference between IBDS and ICC can provide potential mechanisms and therapeutic targets, which is expected to inhibit the carcinogenesis of IBDS and improve the prognosis of ICC.MethodsA total of 34 participants including 25 ICC patients and 9 IBDS patients were recruited. Baseline information inclusive of liver function indicators, tumor biomarkers, surgery condition and constitution parameters etc. from patients were recorded. ICC and IBDS pathological tissues, as well as ICC para-carcinoma tissues, were collected for GC–MS based metabolomics experiments. Multivariate analysis was performed to find differentially expressed metabolites and differentially enriched metabolic pathways. Spearman correlation analysis was then used to construct correlation network between key metabolite and baseline information of patients.ResultsThe IBDS tissue and para-carcinoma tissue have blurred metabolic phenotypic differences, but both of them essentially distinguished from carcinoma tissue of ICC. Metabolic differences between IBDS and ICC were enriched in linoleic acid metabolism pathway, and the level of 9,12-octadecadienoic acid in IBDS tissues was almost two times higher than in ICC pathological tissues. The correlation between 9,12-octadecadienoic acid level and baseline information of patients demonstrated that 9,12-octadecadienoic acid level in pathological tissue was negative correlation with gamma-glutamyl transpeptidase (GGT) and alkaline phosphatase (ALP) level in peripheral blood. These two indicators were all cancerization marker for hepatic carcinoma and disease characteristic of IBDS.ConclusionLong-term monitoring of metabolites from linoleic acid metabolism pathway and protein indicators of liver function in IBDS patients has important guiding significance for the monitoring of IBDS carcinogenesis. Meanwhile, further insight into the causal relationship between linoleic acid pathway disturbance and changes in liver function can provide important therapeutic targets for both IBDS and ICC.

Aspirin Use to Prevent Preeclampsia and Related Morbidity and Mortality: US Preventive Services Task Force Recommendation Statement

(JAMA. 2021;326:1186–1191) Preeclampsia is a common cause of maternal morbidity and mortality around the world. In the United States, preeclampsia complicates 4% of pregnancies and contributes to 6% of preterm births and 19% of medically indicated preterm births. Preeclampsia is defined by a maternal blood pressure of 140/90 mm Hg or more on 2 separate office visits after 20 weeks of pregnancy, accompanied by maternal proteinuria. Preeclampsia is an inflammatory syndrome that can lead to multiple maternal risks including impaired liver function, thrombocytopenia, renal insufficiency, cerebral or visual disturbances, and pulmonary edema. It can lead to fetal risks including low birth weight, fetal growth restriction, and preterm birth from a lack of blood flow to the placenta. As the placenta develops, it may cause an overactive systemic inflammatory response and oxidative stress resulting in the development of preeclampsia.

Metabolic Profiling, Chemical Composition, Antioxidant Capacity, and In Vivo Hepato- and Nephroprotective Effects of Sonchus cornutus in Mice Exposed to Cisplatin.

Sonchus cornutus (Asteraceae) is a wild. edible plant that represents a plentiful source of polyphenolic compounds. For the first time, the metabolic analysis profiling demonstrated the presence of anthocyanidin glycosides, coumarins, flavonoids and their corresponding glycosides, and phenolic acids. The total phenolic compounds were determined to be 206.28 ± 14.64 mg gallic acid equivalent/gm, while flavonoids were determined to be 45.56 ± 1.78 mg quercetin equivalent/gm. The crude extract of S. cornutus exhibited a significant 1,1-diphenyl-2-picrylhydrazyl free radical scavenging effect with half-maximal inhibitory concentration (IC50) of 16.10 ± 2.14 µg/mL compared to ascorbic acid as a standard (10.64 ± 0.82 µg/mL). In vitro total antioxidant capacity and ferric reducing power capacity assays revealed a promising reducing potential of S. cornutus extract. Therefore, the possible protective effects of S. cornutus against hepatic and renal toxicity induced by cisplatin in experimental mice were investigated. S. cornutus significantly ameliorated the cisplatin-induced disturbances in liver and kidney functions and oxidative stress, decreased MDA, ROS, and NO levels, and restored CAT and SOD activities. Besides, it reversed cisplatin-driven upregulation in inflammatory markers, including iNOS, IL-6, and IL-1β levels and NF-κB and TNF-α expression, and elevated anti-inflammatory IL-10 levels and Nrf2 expression. Additionally, the extract mitigated cisplatin alteration in apoptotic (Bax and caspase-3) and anti-apoptotic (Bcl-2) proteins. Interestingly, hepatic, and renal histopathology revealed the protective impacts of S. cornutus against cisplatin-induced pathological changes. Our findings guarantee a protective effect of S. cornutus against cisplatin-induced hepatic and renal damage via modulating oxidative stress, inflammation, and apoptotic pathways.

Isavuconazole in the Treatment of Aspergillus fumigatus Fracture-Related Infection: Case Report and Literature Review.

Aspergillus fracture-related infection (FRI) is a rare, but severe complication in trauma surgery. The optimal antifungal treatment for Aspergillus osteomyelitis, including FRI, has not been established yet, as only cases have been documented and data on bone penetration of antifungal drugs are scarce. We describe a patient with Aspergillus fumigatus FRI of the tibia who was treated with isavuconazole after developing liver function disturbances during voriconazole therapy. Isavuconazole, the active moiety formed after hydrolysis of the prodrug isavuconazonium sulfate by plasma esterases, was administered in a maintenance dose of 200 mg q24 h, followed by 150 mg q24 h. The patient completed a six-month antifungal treatment course. Although fracture union was not achieved during six months of follow-up after therapy cessation, no confirmatory signs of FRI were observed. Additionally, two literature searches were conducted to review available data on antifungal treatment of Aspergillus osteomyelitis and bone penetration of antifungals. One hundred and eight cases of Aspergillus osteomyelitis, including six (5.6%) FRI cases, were identified. Voriconazole and (lipid formulations of) amphotericin B were the most commonly used antifungals. In three (2.8%) cases isavuconazole was prescribed as salvage therapy. Data on antifungal bone penetration were reported for itraconazole, voriconazole, amphotericin B, anidulafungin and 5-fluorocytosin. Isavuconazole might be a promising alternative for the treatment of Aspergillus osteomyelitis. However, standardized case documentation is needed to evaluate the efficacy of isavuconazole and other antifungals in the treatment of Aspergillus osteomyelitis, including FRI.

Minimally Invasive Surgery in Chronic Subdural Hematoma: Prognosis and Recurrence Factors of 516 Cases in a Single Center.

Objective: To investigate the effects of minimally invasive surgery (MIS) using a novel YL-1 puncture needle and summarize the risk factors of recurrence in chronic subdural hematoma (CSDH). Methods: We performed a retrospective analysis in 516 hospitalized patients with CSDH from January 2013 to December 2018 in Northern Jiangsu People’s Hospital. Patients’ gender, age, history of trauma, use of anticoagulants, history of disturbed liver or renal function, history of heart disease, history of malignant tumor, history of diabetes, hemodialysis, coagulopathy, alcoholism, imaging indicators, and postoperative application of urokinase or atorvastatin were recorded. Recurrence is defined by imaging examination with or without clinical presentation three months after discharge. Results: In total, 483 patients (93.60%) benefited from MIS by YL-1 needle. Gender, age, history of head trauma, history of disturbed liver function, history of heart disease, history of malignant tumor, history of diabetes, history of hemodialysis, coagulopathy, alcoholism, hematoma location, hematoma densities, septum formation, maximum thickness, encephalatrophy, and use of atorvastatin and urokinase were shown to be non-significantly associated with postoperative recurrence (p > 0.05). The use of anticoagulants was significantly associated with postoperative recurrence (p > 0. 05). Logistic analysis showed that the use of anticoagulants is an independent factor predicting postoperative recurrence (p > 0. 05). Conclusions: The novel YL-1 puncture needle turned out to be a safe and effective minimally invasive surgery, and the use of anticoagulants is an independent risk factor predicting postoperative recurrence in CSDH, which can provide MIS and early therapeutic strategies for neurosurgeons.