Chronic Disease ; Humans ; Liver Diseases

Objective To evaluate the feasibility and safety of transjugular liver biopsy( TJLB) by using the LABS 200 liver access and biopsy set ( Cook Inc, USA) .Methods Five minipigs were operated though TJLB puncture under the imaging guidance.The liver biopsies were analyzed by histological examination.Results Technical success of TJLB was achieved in all the 5 minipigs.No procedure-related complications occurred, and sufficient amount of specimen for histological examination was obtained in all cases.Conclusions Our preliminary results indicate that transjugular liver biopsy with the use of Cook LABS 200 liver access and biopsy set is clinically safe and feasible, and provide technical support for its clinical application.

Objective To evaluate the changes of left ventricular (LV) bulk rotation and untwisting in transplanted hearts using 2-dimensional speckle tracking imaging(STI).Methods Basal and apical LV short-axis images were acquired in 15 heart transplant recipients 3 months post surgery(HT group) and 56 healthy control subjects.Basal and apical rotation versus time profiles were drawn using 2-dimensional STI software.Appropriate values were chosen from the dataset obtained and compared between two groups.Results ①Compared with the control group,the heart rate,anterior-posterior diameter of left atrium,enddiastolic interventricular septum thickness,left ventricular posterior wall thickness,isovolumic relaxation time and E/e ratio were significantly increased,e and a values were decreased significantly in HT group (P ＜ 0.05).② No significant difference was noticed in the peak degrees of LV bulk rotation,the degrees of LV bulk rotation at the time of aortic valve closure and mitral valve opening (P =0.700,0.984,0.495,respectively) between 2 groups.In both groups,systolic rotation reached its maximum at end-systole [(96.1 ± 8.4) ％ in HT group vs (100.5 ± 6.3) ％ in control group,P =0.065].③Significant decreases in untwisting rate and trend untwisting variables were observed in the HT group(P ＜0.001).Conclusions 3 months after transplanted,left ventricular bulk rotation of cardiac allografts remained normal,and significant decreases in both untwisting rate and trend untwisting variables showed that the diastolic function of cardiac allografts was impaired.

Objective　To collect data of fungi isolated from a fungus monitoring network in Hainan Province from 2013 to 2022, and analyze the drug resistance characteristics of Candida and the results of serological tests, with an aim to provide a basis for clinical diagnosis and treatment. Methods　In accordance with the National Fungal Drug Resistance Monitoring Network technical scheme, the qualifying fungal data were extracted from the microbial identification system database using SQL language, and the data information was then analyzed, with statistical processing done using SPSS 26.0 software. Results　Among 5 503 fungal isolates from clinical specimens between 2013 and 2022, cervical orifice secretions accounted for 30.37%(1 671 strains), mid-stream urine for 23.55%(1 296 strains), lower respiratory tract specimens for 25.24% (1 389 strains)[(sputum for 20.37%(1 121 strains) and alveolar lavage fluid for 4.87%(268 strains)], wound pus for 9.59%(528 strains), ascites for 5.60%(308 strains), blood for 3.67%(202 strains), cerebrospinal fluid for 0.38%(21 strains), and joint fluid for 0.04%(2 strains), with the highest number of strains isolated in 2022 and the lowest in 2013, the 2022 figure is about 2.6 times that of 2013. Among yeast-like fungi, Candida albicans had the highest proportion with 3 312 strains accounting for 60.2%; The highest resistance rate of Candida albicans was to fluconazole at 16.7%, with 2.5% being non-wild type (NWT) for amphotericin B; Candida tropicalis had the highest rate of resistance to fluconazole at 36.0%, with NWT at 41.1% for fluconazole and 3.1% for amphotericin B; Candida glabrata had a resistance rate to fluconazole of 2.8%, dose-dependent susceptibility (SDD) of 97.2%, NWT of 15.5% for fluconazole, and NWT of 8.6% for itraconazole; Candida parapsilosis had the highest resistance rate to fluconazole at 15.7% and and NWT of 8.3% for amphotericin B; Candida krusei had a 0.0% resistance rate to caspofungin; and Candida dubliniensis was 100.0% NWT to fluconazole. Of 70 cases of blood culture-positive specimens, 64 cases were detected by G test and 25 cases by Mn test, and the positive blood cultures were statistically significant when compared with the G test and Mn test, respectively (P<0.01). Conclusions　 Fungal serological test can make up for the deficiency of blood culture and distinguish fungal invasion and colonization, thus providing a basis for the effective control of fungal infection in clinical practice.

Objective:To study the tonifying Qi and producing blood mechanism of Jianpi Shengxue tablets. Methods: SD rats were randomly divided into the normal group,FeSO4group, and low, medium and high dosage groups(0.65,1.3,2.6 g·kg-1). All the groups except the normal group received low iron diet,to induce anemia. After the two-week intragastric administration, real-time PCR was carried out to identify the changes of Hepcidin mRNA expression, while western blot was applied to test the changes of DMT-1 protein expression. Results:The medium and high dosage groups could significantly increase the DMT-1 expression compared with the normal group,while FeSO4 could reduced the DMT-1 expression. The Hepcidin expression in liver was increased along with the in-crease of the dosage. Conclusion:The Chinese medicine ingredients in Jianpi Shengxue tablets is beneficial to the expression of DMT-1 protein and the expression of Hepcidin mRNA in liver, which can finally improve the iron supply in the body.

Objective To verify and assess diagnostic value of noninvasive diagnostic model of liver fibrosis in primary biliary cirrhosis (PBC) based on conventional laboratory markers.Methods Seventythree patients with PBC diagnosed by liver biopsy between January 2003 and June 2011 in Beijing Friendship Hospital,Capital Medical University were recruited in this study.Correlation analysis and logistic regression analysis between the conventional laboratory markers and histology stages were assessed.A liver fibrosis diagnostic model was established based upon aforementioned biomarkers and verified by its sensitivity and specificity for predicting the liver fibrosis.Results The predictive model ( H index) consisting of five conventional laboratory markers,i.e.,platelet count,serum cholinesterase,albumin,HDL-C and prothrombin time activity,could predict advanced fibrosis ( stages Ⅲ-Ⅳ ) with an AUCROC of 0.861.The sensitivity of predicting the absence of advanced fibrosis using H index ＜ - 2.20 was 96.6％ and the specificity of predicting the presence of advanced fibrosis using H index ＞ 0.41 was 93.2％.Conclusion The established noninvasive diagnostic model consisting of five laboratory markers could accurately distinguish pathological changes of early stage PBC ( stages Ⅰ - Ⅱ ) from advanced stage PBC ( stages Ⅲ-Ⅳ).

Liver cirrhosis is the leading cause of liver-related death globally, and the most common causes of liver cirrhosis are chronic hepatitis B and C, alcoholic liver disease, and nonalcoholic fatty liver disease. Recent studies have shown that despite an increase in the number of deaths due to liver cirrhosis around the world, there is a reduction in age-standardized death. In China, there are increases in number of patients with liver cirrhosis, prevalence rate of liver cirrhosis, number of deaths due to liver cirrhosis, and mortality rate of liver cirrhosis, while there are reductions in age-standardized prevalence rate and mortality rate; chronic hepatitis B remains the main cause of liver cirrhosis, with a gradual increase in the proportion of liver cirrhosis cases caused by alcoholic and nonalcoholic fatty liver diseases.

In recent years , many studies have found that vitamin D insufficiency is associated with osteomalacia , hyperten-sion, diabetes, metabolic syndrome and other diseases .Vitamin D must be hydroxylated in the liver by a 25-hydroxylase for the first time, and then in the kidney by a 1α-hydroxylase for the second time to form the active metabolite 1,25-dihydroxy vitamin D ,which binds to the intracellular vitamin D receptor and exerts its effects .This paper reviewed the relationship between vitamin D and disease , present research situation of gene polymorphism of vitamin D receptor , and the advantages and limitations of several methods of vitamin D detection, and proposed the best method for detecting vitamin D receptor gene polymorphism and the importance of the detection state to guide clinicians to use drug rationally .

Objective To confirm the hepatotoxicity of valproic acid (VPA ) and its metabolites (2-propyl-4-pentenoic acid ,3-hydroxy valproic acid ,5-hydroxy valproic acid) on human liver cells .Methods Cells were divided into control group and VPA-treated group .The control group was conventionally cultured while the VPA-treated group was treated with valproic acid and its metabolites . The rate of cell proliferation was assayed by CCK 8 protocol . The mRNA levels of CYP1A1 , CYP1A2 ,PCNA ,Bax and Bcl-2 were measured by real time PCR .The correlated protein levels were measured by Western Blotting .The activity of LDH ,AST and ALT were also detected .Results Compared to the control group ,with the increases of concentrations and reaction time of VPA and its metabolites ,the proliferation rate of L02-cell was reduced ,the mRNA and protein levels of CYP1A1 ,CYP1A2 ,and Bax was increased ,the mRNA and protein level of PCNA and Bcl-2 was decreased , AST ,ALT ,and LDH were also elevated in the treated group .Conclusion Valproic acid and its metabolites were positively re-lated to hepatotoxicity .

Objective:To study the efficacy of direct intrahepatic portosystemic shunt (DIPS) in treatment of Budd-Chiari syndrome (BCS).Methods:From January 1, 2015 to June 31, 2017, consecutive patients with BCS who were treated with DIPS at the Department of Interventional Therapy of Beijing Shijitan Hospital, the Liver Disease Research Center of Beijing Friendship Hospital and the General Surgery Department of Beijing Ditan Hospital were retrospectively analyzed. The symptoms, physical signs (including abdominal distension, ascites, pleural effusion, splenomegaly, hepatic encephalopathy) and perioperative laboratory results of these patients were collected and analyzed. Biochemical indicators including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil), and portal pressure gradient were compared before and 2 weeks after treatment. The patients were followed up for at least 3 years to assess their clinical symptoms, patency of shunt, oncological status and survival.Results:Of 67 patients with BCS who were included in the study, there were 45 males and 22 females, aged (38.12±23.22) years. The BCS classification of these patients were hepatic vein type ( n=65), including 62 patients with complete hepatic vein obstruction, 3 patients with hepatic vein occlusion due to thrombosis, and 2 patients with mixed hepatic vein and inferior vena cava occlusion. All 67 patients underwent DIPS with 93 stents being implanted. In addition, 43 patients underwent gastric coronary vein embolization, and 2 patients with mixed type of BCS underwent inferior vena cava stenting. The portal pressure gradient decreased from (22.17±9.16) mmHg (1 mmHg=0.133 kPa) to (9.87±4.75) mmHg, the difference was statistically significant ( P<0.05). Abdominal distension was relieved, at one month and ascites completely subsided in 3 months after operation. The liver congestion and swelling were obviously relieved. Comparison of patients 2 weeks after operation and before operation, ALT decreased from (65.28±27.75) U/L to (28.43±13.46)U/L, AST from (68.75±29.23) U/L to (26.92±13.33)U/L, TBil from (175.31±80.48)μmol/L to (45.08±26.54)μmol/L, DBil from (127.55±44.65)μmol/L to (35.12±10.77)μmol/L, and albumin increased from (31.56±7.22) g/L to (44.18±11.36)g/L, the difference was statistically significant (all P<0.05). All patients were followed up for at least 3 years. Shunt stenosis was detected in 5 patients (7.46%) with shunt expansion being performed, variceal bleeding in 2 patients (2.99%), ascites recurrence in 4 patients (5.97%) and hepatic encephalopathy in 2 patients (2.99%). No patients were diagnosed with hepatic cancer, and no patients died. Conclusion:DIPS was efficacious, safe and reliable to that BCS patients. It rapidly reduced portal venous pressure, relieved liver congestion, and restored liver morphology and liver function in these patients.