OBJECTIVETo investigate the correlation between the stage of hepatic fibrosis and ultrasonographic findings of the liver, spleen and gallbladder and establish a sensitive ultrasonographic semi-quantitative scoring system for screening compensated liver cirrhosis.

METHODSTotalling 248 patients with chronic hepatitis B and hepatitis C virus infection underwent liver biopsy and ultrasonic examination. The images of the liver surface, parenchymal echo, intrahepatic vessels, gallbladder, spleen and diameter of portal vein were analyzed.

RESULTSThe stages of hepatic fibrosis were not correlated to ultrasonographic findings of the liver surface or diameter of portal vein, but hepatic fibrosis of different stages showed significant differences in parenchymal echo, intrahepatic vessels, gallbladder and splenomegaly. In cases with normal liver parenchymal, intrahepatic vessels, gallbladder and spleen, the negative predictive value of the ultrasonographic semi-quantitative scoring system for diagnosing compensated liver cirrhosis amounted to 96.3%. The sensitivity of a score not lower than 5 was 90% for detecting compensated cirrhosis. With a score not lower than 7, the diagnostic accuracy and specificity was 85.9% and 95.2%, respectively, but the sensitivity was lowered to 37.5%.

CONCLUSIONThe ultrasonic images of the liver parenchyma, intrahepatic vessels, gallbladder and spleen in patients with compensated liver cirrhosis vary significantly in patients with hepatic fibrosis of different stages, and this ultrasonographic scoring system allows for a sensitive diagnosis of compensated cirrhosis.

Female ; Fibrosis ; Gallbladder ; diagnostic imaging ; Hepatitis B, Chronic ; complications ; Hepatitis C ; complications ; Humans ; Liver ; diagnostic imaging ; pathology ; virology ; Liver Cirrhosis ; complications ; diagnosis ; Male ; Reproducibility of Results ; Sensitivity and Specificity ; Spleen ; diagnostic imaging ; Splenomegaly ; diagnostic imaging ; Ultrasonography ; methods

OBJECTIVETo explore the correlation between ultrasonic scores, routine blood tests and stages of hepatic fibrosis in patients with chronic hepatitis B (CHB), and identify non-invasive indexes to establish a diagnostic model for liver cirrhosis.

METHODSA retrospective analysis of 428 patients with CHB undergoing liver biopsies was conducted. The patients' hematology, serum biochemical indexes, serum alpha fetal proteins (AFP), serum HBeAg status and ultrasonic scores were statistically analyzed. A diagnostic model was established by stepwise discriminant analysis, and aspartate aminotransferase (AST) to platelet ratio index (APRI) was used to estimate the diagnostic value.

RESULTSPartial correlation analysis indicated that platelet, serum albumin, bilirubin, AST, ratio of AST to alanine aminotransferase, prothrombin time and ultrasonic scores were correlated to the stages of liver fibrosis, and significantly differed between patients with and without liver cirrhosis. Logistic regression analysis identified ultrasonic scores, platelet, serum bilirubin, albumin and AST as indexes affecting the diagnosis of compensated cirrhosis. The area under receiver operation curve of model was 0.907. The cirrhosis index (CI) of -0.94 for this model was suitable for screening, with specificity of 85.0%, sensitivity of 81.7%, and accuracy of 84.3%. About 56.2% of the patients' CI was lower than -2.0 with the negative predictive value of 97.0% and the rate of missed diagnosis of 3.0%. About 18.2% of the patients' cirrhosis probabilities were above 0.15, with positive predictive value of 77.3%, and only 2.7% of the patients had mild fibrosis (F2), suggesting that nearly 75% of the patients did not have to receive liver biopsies.

CONCLUSIONThis diagnostic model integrates the ultrasonic scores, platelet, serum bilirubin, albumin and AST to enable effective screening and prediction of compensated cirrhosis, and can reduce the number of patients required to undergo liver biopsy by about 75%.

Adult ; Aspartate Aminotransferases ; blood ; Bilirubin ; blood ; Female ; Hepatitis B, Chronic ; complications ; Humans ; Liver Cirrhosis ; blood ; diagnosis ; diagnostic imaging ; Logistic Models ; Male ; Platelet Count ; Retrospective Studies ; Sensitivity and Specificity ; Serum Albumin ; analysis ; Ultrasonography

Adult ; Asian Continental Ancestry Group ; Elasticity ; Elasticity Imaging Techniques ; Humans ; Liver ; physiology ; Male ; Middle Aged

BACKGROUNDIntegrin-linked kinase (ILK) dysregulation is involved in the progression of diabetic nephropathy (DN). The aim of this study was to investigate the effects of angiotensin II receptor blocker (ARB), irbesartan, on ILK expression and podocyte injury in DN.

METHODSDN was induced by the combined feeding of high-sucrose, high-fat diet and intra-peritoneal injection of low dose of streptozotocin (35 mg/kg) in spontaneously hypertensive rats. Diabetic rats were treated with irbesartan (50 mg×kg(-1)×d(-1)) by gavage for 8 weeks. The renal morphologic changes and podocyte injury were investigated by light and electron microscopy, and the ILK expression was evaluated by real-time RT-PCR and Western blotting analysis.

RESULTSDiabetic rats exhibited with the similar clinical feature of type 2 DN. Morphologically, they were characterized by expansion of mesangial matrix, loss of podocyte and podocyte injury. Impressively, compared to controls, the ILK expression in diabetic rats were upregulated, which were positively correlated with both podocyte injury and albuminuria. Irbesartan significantly prevented ILK overexpression, along with the amelioration of podocyte injury and albuminuria.

CONCLUSIONSILK plays an important role in mediating podocyte injury in DN; irbesartan inhibits ILK upregulation and attenuates podocyte injury, which might offer a new insight into the role of ARB in preventing DN progression.

Angiotensin Receptor Antagonists ; therapeutic use ; Animals ; Biphenyl Compounds ; therapeutic use ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; Enzyme Activation ; drug effects ; Male ; Podocytes ; drug effects ; Protein-Serine-Threonine Kinases ; metabolism ; Rats ; Rats, Inbred SHR ; Tetrazoles ; therapeutic use

Adolescent ; Adult ; Child ; Collagen Type III ; blood ; Collagen Type IV ; blood ; Female ; Hepatitis B, Chronic ; complications ; Humans ; Hyaluronic Acid ; blood ; Laminin ; blood ; Liver Cirrhosis ; diagnosis ; Male ; Middle Aged ; ROC Curve

Klotho is highly expressed in the kidney, while soluble Klotho is detectable in the blood, urine, and cerebrospinal fluid, and has multiple hormone-like functions. The role of Klotho in kidney injury has attracted more and more attentions from researchers. Emerging evidence revealed that the transient deficiency of Klotho is an early event of acute kidney injury (AKI), whereas, in chronic kidney disease, this deficiency is sustained not only in the kidney, but also in other organ systems. Therefore, Klotho could be a potential biomarker for early diagnosis of AKI, as well as for its progression to chronic kidney disease. Moreover, Klotho might have therapeutic value to renal injury. Nevertheless, there are only few studies on the involvement of Klotho in post AKI repair. This review focused on the role of Klotho in not only kidney injury, but also its repair, in particular the relationship between Klotho and cell fate (autophagy/apoptosis/necrosis), repair/regeneration, Wnt/β-catenin and erythropoietin receptor, one of the Klotho effectors.
Acute Kidney Injury ; metabolism ; Biomarkers ; Disease Progression ; Glucuronidase ; physiology ; Humans ; Kidney ; metabolism ; pathology ; Signal Transduction

Objective:To explore the relationship between relapse tendency and childhood maltreatment in methamphetamine-dependent youths,and the role of impulsivity and quality of life in the relationship.Methods:To-tally 287 methamphetamine-dependent youths(160 females,127 males)were selected in compulsory drug rehabili-tation centers.The Relapse Tendency Questionnaire(RTQ),Childhood Trauma Questionnaire-Short Form(CTQ-SF),Barrett Impulsivity Scale(BIS-11)and Quality of Life for Drug Addicts(QOL-DA)for Drug Addicts were used to conduct the survey.SPSS macro program PROCESS was used to test the mediating role.Results:The BIS-11 total scores acted as a partial mediator between the total scores of CTQ-SF and RTQ,with an effect value of 0.03(95％CI:0.01-0.05),the QOL-DA total scores acted as a full mediator between the total scores of CTQ-SF and RTQ,with an effect value of 0.05(95％CI:0.02-0.08),and the scores of BIS-11 and QOL-DA acted as chain mediators between total scores of CTQ-SF and RTQ,with an effect value of 0.01(95％CI:0.00-0.03).Conclusion:Childhood maltreatment,impulsivity,and quality of life may be associated with relapse tendencies in methamphetamine-dependent youths.

OBJECTIVETo investigate the factors influencing the success rate and stability of transient elastography(FibroScan)for assessment of liver fibrosis.

METHODSLiver stiffness was assessed using transient elastography in totally 637 subjects including healthy subjects, asymptomatic hepatitis B virus (HBV) carriers, patients with chronic hepatitis B and patients with HBV-related cirrhosis. Of these subjects, 302 received 2 examinations and totalling 939 examinations were performed. In each case, one operator performed 2 consecutive series of 10 validated measurements, or 2 operators performed a series of 10 validated measurements. The factors including gender, age, body mass index (BMI) and the state of diseases were analyzed for their association with the success of the examination. Intraclass correlation coefficient (ICC) was used to evaluate the reproducibility of the operation.

RESULTSFailure of the measurement occurred in 14 cases (2.2%), which was not associated with the age of the subjects and the state of diseases. The success rate of measurement decreased as the BMI increased (t=3.112, P=0.002), and was lower in female subjects (t=-2.193, P=0.029). The intra- and inter-operator stability of liver stiffness measurement was satisfactory, with ICC of 0.970 and 0.847, respectively. But for healthy subjects and asymptomatic HBV carriers, the stability was lower, with ICC of 0.736 and 0.639, respectively. Liver stiffness in patients with liver cirrhosis was positively correlated to complications and Child-Turcotte-Pugh (CTP) score.

CONCLUSIONLiver stiffness measurement has high stability with FibroScan, and high BMI could lower success rate of the measurement. Liver stiffness as measured by FibroScan allows prediction of the liver function and presence of complications in patients with liver cirrhosis.

Adolescent ; Adult ; Aged ; Child ; Elasticity Imaging Techniques ; instrumentation ; methods ; Female ; Hepatitis B, Chronic ; complications ; Humans ; Liver Cirrhosis ; diagnosis ; etiology ; Male ; Middle Aged ; Sensitivity and Specificity ; Young Adult

Hepatitis B, Chronic ; complications ; Humans ; Liver ; diagnostic imaging ; pathology ; Liver Cirrhosis ; diagnostic imaging ; etiology ; pathology ; Ultrasonography

Objective To develop an ECG monitoring and management system based on the smartphone platform to transmit ECG data to the doctor in daily life or working environment.Methods The system was composed of an ECG signal acquisition device and a smartphone App.The ECG signal acquisition device used MSP430F149 microcontroller as the core unit,which executed ECG signal extraction by adopting right leg drive,active filters,dual instrumentation amplifier and moving average algorithm,applied differential threshold method to accurately detecting R wave,calculated heart rate and then sent ECG data to the smartphone through Bluetooth 4.0 module.The smartphone App was developed based on cross-platform mobile development framework Cordova,and used Cordova plugins,JavaScript,HTML5 and CSS to receive the data from the acquisition device,draw and store ECG,show heart rate and remind abnormalities in heart rate as well as to transmit ECG data to the doctor through the mobile medicine App and social App.Then the doctor provided advices on prevention,treatment and etc after analyzing the received data.Results Compared with the ECG machine,the system had the relative errors of heart rate,P duration,QRS duration and QT duration being 2.7％,4.5％,4.3％ and 3.3％ respectively.All the above four parameters having significant correlations,and the correlation parameters were 0.955,0.948,0.91 and 0.834 respectively (P＜0.05).The system had 8-h endurance in case of being fully charged.Concluslon The system gains advantages in power consumption,accuracy,noise,cost,volume,weight,safety,reliability as well as easy operation and maintenance,and facilitates the ECG conditions to be mastered timely by the doctor.