[ ABSTRACT] AIM:To investigate the effect of insulin resistance ( IR) on the biological function of hepatocellu-lar carcinoma ( HCC) and sensitivity to cisplatin.METHODS:IR was induced in HepG2 cells via incubation with a high concentration of insulin.Afterwards, the effects of IR on adhesion, migration, invasion and sensitivity to cisplatin of the cells were detected.RESULTS:The results indicated that glucose consumption was reduced in the IR cells.The expres-sion of the insulin receptor and glucose transporter 2 was down-regulated.Furthermore, HepG2/IR cells displayed marked-ly enhanced adhesion, migration, and invasion.These cells exhibited a lower sensitivity to cisplatin.On the contrary, HepG2/IR cells exhibited decreased adhesion and invasion after treatment with the insulin sensitizer pioglitazone hydrochlo-ride.CONCLUSION:IR is closely related to drug resistance, adhesion, migration and invasion in HepG2 cells.These findings may help explain the clinical observation of the limited efficacy of chemotherapy on a background of IR.

Objective To study salinomycin (Sal) enhance the sensitivity of liver cancer cell to 5‐fluorouracil (5‐FU) and its mechanism ,and to provide drug‐resistant primary hepatocellular carcinoma (HCC) patients with a new treatment .Methods Hepa‐toma cell line HepG2 ,SMMC‐7721 ,M HCC‐97H were used for the research .The effect of Sal combined with 5‐FU on the cell pro‐liferation inhibition rate ,colony formation ,apoptosis and tumor stem cell proliferation were detected by the M TT assay ,colony for‐mation assay ,flow cytometry .And the effect on Wnt/‐catenin when Sal combined with 5‐FU were detected by Western‐blot . Results Sal combined with 5‐FU significantly inhibited the liver cancer cell proliferation and colony formation and induced cell ap‐optosis ,showed the synergistic effect .5‐FU promoted the proliferation of hepatocarcinoma stem ,but Sal reduced the function of 5‐FU .At the same time Sal could inhibit the Wnt/‐catenin signal pathway .Conclusion The Sal can increase the sensitivity of hepato‐cellular carcinoma cells to 5‐FU by inhibiting Wnt/‐catenin signal pathway ;Sal combined with 5‐FU could provide drug‐resistant HCC patients with a new treatment .

Objective To discuss the clinical relationship between changes of the parameter of the peripheral blood cells and liver cirrhosis.Methods The parameter of the peripheral blood cells of 321 patients with cirrhosis of liver was analyzed.Results Changes of the parameter of the peripheral blood cells of patients with liver cirrhosis were abnormal obviously.Changes of Hb,RBC,HCT and RDW were well correlate to the degree of impairment of liver function.With the progression of impairment of liver function,Hb RBC and HCT decreased,RDW increased gradually in patients with liver cirrhosis(P

AIM:To investigate the effect of Astragalus polysaccharides ( APS) on chronic heart failure and its mechanism.METHODS:Male SD rats (n=32) were randomly divided into control group , sham group, model group and APS group (8 rats in each group).The left coronary artery ligation in the rats was conducted to establish myocardial infarc -tion heart failure model.After modeling, the rats in APS group were given APS (3 g· kg-1· d-1) by intragastric adminis-tration for 6 weeks.Left ventricular diastolic diameter (LVD), left ventricular systolic diameter (LVS), left ventricular ejection fraction ( LVEF) and fractional shortening ( FS) were detected by echocardiography .HE staining was used to ob-serve the pathological changes .The concentrations of free fatty acid ( FFA) in the serum and myocardium were observed by the method of acetyl coenzyme A synthetase and acetyl coenzyme A oxidase ( ACS-ACOD ) .The protein levels of total AMP-activated protein kinase (AMPK), phosphorylated AMP-activated protein kinase (p-AMPK), fatty acid translocase (FAT/CD36) and carnitine palmitoyltransferase I (CPT-1) were measured by Western blotting.RESULTS: No signifi-cant difference in each index between sham group and control group was observed .Compared with control group , LVEF and FS in model group was significantly decreased , while LVD and LVS was significantly increased ( P<0.05 ) .The LVEF and FS in APS group were significantly improved compared with model group ( P<0.05 ) , and there was no significant difference between APS group and control group .LVD and LVS in APS group were obviously improved compared with mo-del group (P<0.05), and the difference was significant compared with control group (P<0.05).Compared with control group, focal myocardial necrosis increased , and residual myocardial cells reduced in model group , while those was much better in APS group as compared with model group (P<0.05).The FFA concentrations in the serum and myocardium in model group increased significantly compared with control group ( P<0.05 ) , while those decreased significantly in APS group as compared with model group (P<0.05).The protein levels of p-AMPK, CPT-1, and cell membrane FAT/CD36 in model group decreased significantly compared with control group (P<0.05), and those in APS group increased obvious-ly compared with control group (P<0.05).CONCLUSION:APS improves chronic heart failure by activating the AMPK pathway and promoting myocardial ingestion and utiliation of FFA .

[ ABSTRACT] AIM:To study the protective effect of Astragalus polysaccharides ( APS) on free fatty acid-induced injury in human umbilical vein endothelial cells (HUVECs).METHODS: Cultured HUVECs were divided into control group, APS group [ APS (200 mg/L) treated for 24 h], free fatty acid group [free fatty acid (0.25 mmol/L) treated for 24 h], free fatty acid plus APS group [free fatty acid (0.25 mmol/L) and APS (200 mg/L) treated for 24 h], and com-pound C group [ free fatty acid (0.25 mmol/L) and APS (200 mg/L) and AMPK inhibitor compound C (10 μmol/L) treated for 24 h] .The cell viability was detected by MTT assay.Nitric oxide ( NO) content in the medium was determined by nitrate reductase assay.The protein levels of total adenosine monophosphate-activated protein kinase (AMPK), phos-phorylated adenosine monophosphate-activated protein kinase (p-AMPK), endothelial nitric oxide synthase (eNOS) and phosphorylated endothelial nitric oxide synthase ( p-eNOS) were measured by Western blot.RESULTS: No significant difference of all indexes between APS group and control group was observed.The cell viability in free fatty acid group de-creased significantly compared with control group.The cell viability in free fatty acid plus APS group was significantly im-proved as compared with free fatty acid group.The cell viability in compound C group was almost the same as that in free fatty acid group.The No content and protein levels of p-AMPK and p-eNOS in free fatty acid group decreased obviously as compared with control group, while the NO content and protein levels of p-AMPK and p-eNOS in free fatty acid plus APS group increased obviously compared with free fatty acid group.No significant difference of the p-AMPK and p-eNOS protein levels between free fatty acid plus APS group and free fatty acid group was observed.No significant difference of the AMPK and eNOS protein levels in all groups was found.CONCLUSION:APS attenuates the free fatty acid-induced injury, and its mechanism is related to the AMPK-eNOS signal pathway.

Objective To investigate the effect of astragalus polysaccharides (APS) on the growth and proliferation of hepatocellular carcinoma cells and its effect on adenosine monophosphate activated pro-tein kinase (AMPK) activity.Methods Hepatocellular carcinoma HepG2 cells cultured for 12,24,and 48 hours were treated with 200,300,and 400 mg/L concentration of astragalus polysaccharides.The cell inhibition rate was detected with methyl thiazolyl tetrazolium (MTT),and apoptosis was observed under the fluorescence microscope.Western blot method was used to measure the expression of total AMPK,phosphorylated AMPK (p-AMPK),and phosphorylate mammalian target of rapamycin (p-mTOR) protein expressions.Results Astragalus polysaccharides of each concentration significantly inhibited the proliferation of human hepatoma HepG2 cells (P ＜ 0.01),and the effect of 300 mg/L concentration astragalus polysaccharides was more significant than that of the 200 mg/L concentration (P ＜0.01);while inhibitory effect of 400 and 300 mg/L Astragalus polysaccharides on the proliferation of human hepatoma cell line HepG2 was not significant difference.We found that Astragalus polysaccharides of each concentration could promote the apoptosis of HepG2 cells,and the effect of 300 mg/L Astragalus polysaccharides was more significant.However,astragalus polysaccharide of 400 mg/L concentration could promote the apoptosis no more than the 300 mg/L concentration,which was observed by fluorescent microscope.Western blot results showed that astragalus polysaccharides could increase the expression of p-AMPK (P ＜ 0.05),and inhibit its downstream protein expressions of p-mTOR (P ＜ 0.05).The proliferation effect of astragalus polysaccharides was weakened after accession of AMPK antagonist compound C on hepatocellular carcinoma cells.Conclusions APS can inhibit the growth and proliferation of hepatocarcinoma cells,and its mechanism is related to the AMPK-mTOR pathway.

OBJECTIVETo determine the age-and education-corrected control values for the number connection test (NCT) and digit symbol test (DST) psychometric measures to increase their accuracy for diagnosis of minimal hepatic encephalopathy (MHE).

METHODSThe NCT Part A (NCT-A) and DST were administered to 843 healthy volunteers (age range:16-65 years; education:more than 1 year) and 429 patients with liver cirrhosis (with Child-Pugh classification of liver function). The normal values were defined as the mean ± 2 standard deviations (2SD);MHE was defined by abnormal results on at least one psychometric test. The statistical significance of differences in MHE diagnosis according to the various control values (age and education-corrected or not) was assessed by the chi-square test and logistic regression analysis.

RESULTSNCT-A and DST were found to be influenced by age (standard coefficient 0.405, P =0.000 and standard coefficient-0.527, P =0.000 respectively) and education (standard coefficient-0.347, P =0.000 and standard coefficient 0.405, P =0.000 respectively). Among the 120 patients with liver cirrhosis who were diagnosed with MHE (27.97%), 113 had abnormal NCT-A results (26.34%), 54 had abnormal DST results (12.59%),and 47 had abnormal results on both tests (10.96%). Among these 120 MHE-positive patients, 21 were classified as Child-Pugh A (19.81%), 46 as Child-Pugh B (23.71%), and 53 as Child-Pugh C (41.09%);the MHE-positive rate was significantly greater in the patients with Child-Pugh C classification than those with either Child-Pugh B or Child-Pugh A (P < 0.01). Logistic analysis showed that when the control data was corrected for age and education, the MHE diagnosis was related with liver function (P =0.000), regardless of age (P =0.328) and education (P =0.563). When the control data was uncorrected, the MHE diagnosis was not only influenced by liver function (P =0.000) but also by age (P =0.000) and education (P =0.005).

CONCLUSIONAge and education-corrected control values can increase the accuracy of MHE diagnosis by NCT-A and DST.

Objective To investigate the significance of serum IL-6,CRP,CA19-9 and CEA in patients with gastric cancer.Methods From January 2012 to April 2015,72 patients with gastric cancer in our hospital were selected as the cancer group,and 72 gastritis patients were selected the same period in our hospital for diagno-sis and treatment as the control group,two groups of serum IL-6,CRP,CA19-9 and CEA were given detec-tion,the prognosis and risk factors in the gastric cancer group were given analysis.Results The serum IL-6, CRP,CEA and CA199 contents in the gastric cancer group were(8.03 ± 0.98)pg/mL,(11.33 ± 1.45)mg/L, (90.93 ± 22.11)U/mL and(13.44 ± 5.03)ng/mL that were significantly higher than the control group of(1. 56 ± 0.44)pg/mL,(5.09 ± 1.22)mg/L,(28.98 ± 10.43)U/mL and(3.24 ± 0.34)ng/mL(P<0.05).Gastric cancer patients were followed up for 1 years,there were 62 patients survived,10 patients were mortality,the survival rate was 86.1%.Single factor Cox regression analysis results showed that the IL-6,CRP,CA19-9, CEA,lymph node metastasis were related to the prognosis in patients with gastric cancer(P< 0.05),Cox multivariate analysis showed that IL-6,CRP,CA19-9,CEA as the main independent risk factors(P<0.05). Conclusion The high expression of IL-6,CRP,CA19-9 and CEA in patients with gastric cancer,they are inde-pendent risk factorsfor the survival rate of gastric cancer,and they have good prognostic values for clinical de-tection.

Refractory constipation is a common gastrointestinal functional disease.Studies have shown that intestinal flora disorders are closely related to the occurrence and development of constipation.Fecal bacterial transplantation (FMT) is regarded as a special organ transplantation,which transplants the intestinal flora of healthy people into the gastrointestinal tract of patients to reconstruct the intestinal flora with normal function.FMT has been successfully applied to the treatment of Clostridium difficile infection.This article reviews the relationship between fecal bacterial transplantation and refractory constipation.