Cardiovascular Diseases ; prevention & control ; China ; Humans

Objective To investigate the effect of the lack of intestinal bile on liver regeneration after hepatectomy.Methods The model of interference with intestinal bile acid metabolism in rats was established by feeding rats with 0.2% cholic acid(cholic acid loading group), 2% cholestyramine resin(lack of bile group)and feeding the standard diet as the control group.Liver regeneration was compared among the 3 groups at 0, 1, 2, 3, and 7 d after 70% partial hepatectomy(PH)in rats and mRNA expression of the rate-limiting enzyme of bile acid biosynthesis(CYP7a1)and farnesoid X receptor (FXR)were detected.Results The rate of liver regeneration was significantly lower on days 3 and 7after PH in the lack of bile group than in the other groups(P＜0.05).On day 1, the labeling indices of PCNA and Ki-67 in the lack of bile group(22.21% ±2.31%、 17.25 % ± 6.50 %)were lower than those in the cholic acid loading group(44.4%±4.92%、 30.83% ± 3.91%)and control group (38.74% ±6.42% 、27.04% ±7.22%)and the peaking of labeling indices was delayed.After PH, the mRNA expression of FXR was significantly lower in the lack of bile group than in other groups.However, CYP7al mRNA had a trend towards increase after PH and was higher than that in other groups.Conclusion Lack of intestinal bile results in delayed liver regeneration of normal rat liver accompanied by decreased expression of FXR mRNA after hepatectomy.

Cardiovascular Diseases ; etiology ; prevention & control ; Humans ; Metabolic Syndrome

Autoimmune Diseases ; Child ; Humans

The Farnesoid X receptor (FXR) is a member of the nuclear receptor superfamily and has emerged as a key player in the control of multiple metabolic pathways. Bile acids are the major endogenous ligands for FXR, and by activating FXR have a variety of target genes, many of which are geared toward pre- venting synthesis and uptake and promoting excretion of bile acids. Here we summarized the latest results from studies on FXR target genes and functions in bile acids metabolism in this article.

The liver regeneration is closely related to the bile acids. To avoid the toxic effects of bile acids on hepatocyte, the state of bile secretion, the rate-limiting enzyme of the bile acid synthesis, bile acids composition as well as the transporter changes at the process of liver regeneration. In vivo and in vitro experiments show that bile acids can promote liver cell proliferation, liver regeneration may be related to the signal which is released under the bile acid imbalance. The relationship between the liver regeneration and bile acid metabolism has an important practical significance in liver regeneration.

Cardiovascular Diseases ; psychology ; Humans ; Life Style

Cardiovascular Diseases ; prevention & control ; China ; Humans

Objective To compare the clinical characteristics of pregnant women with gestational diabetes mellitus (GDM) and normal gestational glucose metabolism at the 25th weeks of pregnant. Methods Sixty-eighty patients with GDM (GDM group) and 68 patients with normal blood glucose(control group) were enrolled in this study. During 25 weeks of pregnancy, oral glucose tolerance test (OGTT), blood pressure, fasting insulin, glycosylated hemoglobin, uric acid, triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol were measured and body mass index (BMI), homeostasis model of assessment for insulin resistence index (HOMA-IR), insulin sensitivity index (ISI) were computed. The results were compared between two groups. Results The age in GDM group was significantly higher than that in control group: (31.38 ± 0.54) years vs. (29.50 ± 0.56) years, P<0.05. The systolic pressure in two groups had no significant difference (P>0.05), but diastolic blood pressure in GDM group was significantly higher than that in control group:(73.2 ± 0.8) mmHg vs. (70.9 ± 0.8) mmHg, 1 mmHg=0.133 kPa, P<0.05. The body weight and BMI in GDM group were significantly higher than that in control group:(65.67 ± 1.76) kg vs. (57.76 ± 1.11) kg, (24.77 ± 0.61) kg/m2 vs. (22.11 ± 0.42) kg/m2, P<0.01. The levels of glycosylated hemoglobin, fasting insulin and HOMA- IR in GDM group were significantly higher than those in control group (5.546 ± 0.746)% vs. (5.085 ± 0.034)% , (17.870 ± 1.015) mU/L vs. (14.400 ± 0.634) mU/L, 4.192 ± 0.271 vs. 2.645 ± 0.128, but the level of ISI in GDM group was significantly lower than that in control group:0.014 ± 0.001 vs. 0.020 ± 0.001, and there were significantly differences (P<0.01). The levels of uric acid, triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol in two groups had no significant differences (P>0.05). Conclusions Compared to those with normal blood glucose, the patients with GDM have the characteristics of higher age, higher body weight, higher BMI, higher diastolic blood pressure , higher level of insulin, insulin resistance and decreased insulin sensitivity.

Objective To investigate the clinical value of serum endocan and procalcitonin (PCT) in early diagnosis and prognosis evaluation of sepsis.Methods The patients with systemic inflammatory response syndrome (SIRS,n = 26) and sepsis (n = 78) admitted to intensive care unit (ICU) of the Third Hospital of Hebei Medical University from December 2014 to December 2016 were enrolled. According to the severity of disease, the sepsis patients were divided into general sepsis group (n = 20), severe sepsis group (n = 24), and septic shock group (n = 34). The cases were divided into survival group (n = 55) and non-survival group (n = 23) according to 28-day mortality. The serum endocan, PCT, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, and sequential organ failure assessment (SOFA) score were recorded when the patients were admitted into ICU. The differences in endocan, PCT, APACHE Ⅱ, SOFA score between SIRS and sepsis groups and within sepsis subgroups were compared. Spearman correlation analysis was used to analyze the correlation between the indexes of sepsis patients. Receiver operation characteristic curve (ROC) was used to evaluate the value of endocan and PCT for the diagnosis and prognosis of sepsis.Results ① Serum endocan, PCT, APACHE Ⅱ, SOFA score and 28-day mortality in the sepsis group were significantly higher than those in the SIRS group [endocan (μg/L): 4.28 (10.64) vs. 1.03 (0.69), PCT (μg/L): 3.94 (10.75) vs. 0.43 (0.39), APACHE Ⅱ:18.81±9.17 vs. 9.35±3.78, SOFA: 9.00 (7.20) vs. 4.50 (1.50), 28-day mortality: 29.49% vs. 11.54%, allP < 0.01]. The area under the ROC curve (AUC) of endocan, PCT, APACHE Ⅱ, SOFA score for sepsis diagnosis were 0.887, 0.842, 0.822, 0.835, respectively. When the cut-off value of endocan was 1.26μg/L, the sepsis diagnostic sensitivity was 87.2% and specificity was 81.8%. When the cut-off value of PCT was 0.75μg/L, the sepsis diagnostic sensitivity was 85.9% and specificity was 81.8%. ② With the severity of the disease increased, the index showed an increasing trend in patients with sepsis. Serum endocan, PCT, APACHE Ⅱ, SOFA score and 28-day mortality in septic shock group were significantly higher than those in severe sepsis group or general sepsis group [endocan (μg/L): 13.02 (6.70) vs. 3.33 (3.05), 1.60 (0.98); PCT (μg/L): 8.10 (17.68) vs. 5.47 (8.92), 1.57 (2.78); APACHE Ⅱ: 25.00 (9.50) vs. 18.00 (9.00), 9.50 (5.75); SOFA: 13.00 (4.50) vs. 8.00 (3.00), 5.00 (3.50); 28-day mortality: 52.94% vs. 20.83%, 0%; allP < 0.01]. There was a significantly positive correlation between endocan, PCT, APACHE Ⅱ, SOFA, indicating that the endocan and PCT can be used to assess the severity of sepsis. ③ Serum endocan, PCT, APACHE Ⅱ and SOFA score in non-survival group were significantly higher than those in the survival group [endocan (μg/L): 15.05 (9.23) vs. 2.32 (4.81), PCT (μg/L):18.40 (16.99) vs. 3.10 (6.67), APACHE Ⅱ: 28.13±7.56 vs. 14.91±6.64, SOFA: 14.70±3.65 vs. 7.38±3.26, allP < 0.01]. The AUC of endocan, PCT, APACHE Ⅱ, SOFA score for the prediction of non-survival sepsis were 0.915, 0.763, 0.899, 0.930. When the cut-off value of endocan was 4.37μg/L, the septic death prediction sensitivity was 95.7% and specificity was 70.9%. When the cut-off value of PCT was 7.68μg/L, the septic death prediction sensitivity was 65.2% and specificity was 78.2%.Conclusions Serum endocan is more clinically valuable than PCT in early diagnosis and prognosis assessment of sepsis.