Medium- and long-chain triglyceride (MCT/LCT) propofol is widely used as an intravenous anesthetic, especially in the intensive care unit. The present study aimed to assess whether MCT/LCT propofol is safe in the hyperlipidemic population for long-term use. Free fatty acids (FFAs) were used to establish high-fat stimulation of HepG2 and Huh7 cells. Subsequently, these cells were treated with propofol at the concentration of 0, 4, or 8 µg/ml for 24 and 48 h. The results indicated that the cell viability was notably decreased when the cells were stimulated with 2 mmol/L FFAs and treated with 12 µg/ml MCT/LCT propofol. Accordingly, we chose 2 mmol/L FFAs along with 4 and 8 µg/ml MCT/LCT propofol for the subsequent experiments. Four and 8 µg/ml MCT/LCT propofol inhibited FFA-induced lipid accumulation in the cells and significantly reversed acetyl coenzyme A carboxylase (ACC) activity. In addition, MCT/LCT propofol not only significantly promoted the phosphorylation of AMPK and ACC, but also reversed the FFA-induced decreased phosphorylation of AMPK and ACC. In conclusion, MCT/LCT propofol reverses the negative effects caused by FFAs in HepG2 and Huh7 cells, indicating that MCT/LCT propofol might positively regulate lipid metabolism.
Acetyl-CoA Carboxylase ; AMP-Activated Protein Kinases ; Cell Survival ; Fatty Acids, Nonesterified ; Hepatocytes ; Intensive Care Units ; Lipid Metabolism ; Liver ; Metabolism ; Phosphorylation ; Propofol ; Triglycerides

Objective To discover the rules of distribution and combination of common syndrome elements in vital hepatitis cirrhosis( VHC) patients based on the method of combination of syndrome and diseases, so as to guide the TCM clinical practice. Methods A national multicenter and cross-section epidemiological survey was conducted by using Information Collection form of Vital Hepatitis Cirrhosis drafted by the research group to collect the TCM symptoms, tongue manifestation and pulse condition . Based on consensuses on clinical diagnosis and treatment of VHC literature review, Standard of Hepatitis Cirrhosis Syndrome Elements Differentiation was established after two-round experts approval, on which the syndrome elements of 801 patients were determined. Descriptive statistics and Chi-square test were applied. Results Altogether 7 syndrome elements of disease nature lied in 801 patients with viral hepatitis cirrhosis:517 cases of qi deficiency, 503 cases of blood stasis, 462 cases of water retention, 448 case of yin deficiency, 438 cases of qi stagnation, 428 cases of yang deficiency and 257 cases of damp heat, in addition, the frequency of qi deficiency, blood stasis, damp heat and yang deficiency was higher at discompensation stage than that of the compensation stage ( P < 0. 05 ) . In 314 patients of compensation stage, the frequency of blood stasis (36. 36%) , qi deficiency&qi stagnation(20. 00%) , qi deficiency & yin deficiency & blood stasis ( 11. 32%) , qi deficiency & yang deficiency & yin deficiency & qi stagnation ( 16. 13%) and qi deficiency & yang deficiency & yin deficiency & qi stagnation & blood stasis(45. 1%) was the highest in distribution of single and combination of syndrome elements, respectively. In 487 patients of discompensation stage, the frequency of water retention (90. 91%), qi deficiency & water retention(57. 45%), qi deficiency & blood stasis & water retention (26. 44%) , qi deficiency & yang deficiency & blood stasis & water retention ( 23. 40%) and qi deficiency&yang deficiency&qi stagnation&blood stasis&water retention(25. 00%) was the highest, respectively. With regard to combination of six types of syndrome elements, water retention was not included in 60. 00% patients at compensation stage, and damp heat was not included in 59. 61% patients at discompensation stage. Conclusion Single type of element and combinations of two, three, four or five types of syndrome elements were more in patients of compensation, by contrast, combination of three, four, five, six or seven types of elements were more in patients of discompensation. Qi deficiency and blood stasis were the basic pathogenesis in patients of compensation and discompensation stage, and pathogenesis features showed differently at different stages.

Objective To compare the levels of serum adrencortical hormone ( Adrenocorticotropic hormone, ACTH) , and glucocorticoid ( Glucocorticoid, GC ) between patients of hepatitis cirrhosis at compensated and decompensated stages, and to evaluate their correlation with common TCM pattern elements.Methods Using a unified “hepatitis cirrhosis clinical information collection list”, which is formulated by this team, we conducted a national multi-center cross-sectional epidemiological survey, to collect the general condition of patients, their symptoms and other information.We also collected their blood samples for standardized laboratory tests. Previously published consensus and guidelines on diagnosis and treatment of hepatic cirrhosis were reviewed.With reference to literature review of clinical investigation, and finally we came up with a“common pattern element identification standard for hepatitis cirrhosis” after two rounds of expert consensus verification process.According to this standard, we can analyze the pattern elements and compare the differences between serum ACTH and GC levels during compensated and decompensated stages, as well as those between the pattern elements of blood stasis, yin deficiency, damp heat, qi stagnation, Qi deficiency, Yang deficiency, and water retention.Results Compared with patients at compensated stage, ACTH and GC levels in patients at decompensated stage were elevated, with significant difference in GC levels (P<0.05).In patients at decompensated stage, levels of ACTH in patients with Yang deficiency group was significantly lower than those in groups without it (P<0.05);In patients with blood stasis at decompensated stage, the level of ACTH was significantly higher than those in groups without it ( P<0.05) , but GC was higher than that of the other groups ( P<0.05) in terms of pattern elements ( except water retention).Conclusion ACTH and GC levels in patients with hepatitis cirrhosis could reflect the severity of disease, and may suggest a certain correlation with TCM pattern elements of class of common diseases.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.