OBJECTIVETo observe the changes of systemic and pulmonary hemodynamics and the plasma levels of inducible nitric oxide synthase (iNOS) and endothelin-1 (ET-1) and investigate their association in patients with hepatopulmonary syndrome (HPS).

METHODSTwenty-six patients with HPS undergoing orthotopic liver transplantation (OLT) were enrolled in this study with 20 patients without hypoxemia as the control group. Blood samples were taken one day before OLT to measure the plasma levels of iNOS and ET-1 using fluorescence quantitative polymerase chain reaction (FQ-PCR) and radioimmunoassay, respectively, with 10 healthy volunteers serving as the healthy control group. Before the operation for OLT, the parameters of systemic and pulmonary hemodynamics were monitored after anesthesia induction.

RESULTSThe systemic and pulmonary hemodynamics in patients without hypoxemia was characterized by high cardiac output and low resistance, and by comparison, the patients with HPS showed even higher cardiac output and lower mean pulmonary artery pressure, pulmonary artery wedge pressure, systemic vascular resistance and pulmonary vascular resistance. The two patient groups had comparable plasma iNOS and ET-1 levels, which were both higher than those in the healthy control group.

CONCLUSIONThe hemodynamics in patients with end-stage liver disease exhibit a pattern of high cardiac output and low resistance, which is more obvious in HPS patients possibly in association with elevated plasma levels of iNOS and ET-1.

Adult ; Aged ; Case-Control Studies ; Endothelin-1 ; blood ; Female ; Hemodynamics ; physiology ; Hepatopulmonary Syndrome ; blood ; physiopathology ; Humans ; Male ; Middle Aged ; Nitric Oxide Synthase Type II ; blood ; Pulmonary Circulation ; physiology ; Young Adult

OBJECTIVETo comprehensively evaluate the effect of interventions on obesity in Chinese pupils.

METHODSA literature research was carried out in China National Knowledge Infrastructure, Wanfang Data, VIP Database for Chinese Technical Periodicals, PubMed and the Excerpts Medica Database (EMBASE) databases to collect articles published between 1979 and 2010 concerning the effect of interventions for preventing obesity in Chinese pupils. Rate difference (RD) of the rate of obesity as the evaluation indicator was selected to Meta-analyze the effect of interventions on obesity. There are total 215 articles, in which 211 articles were written in Chinese and other articles were written in English.

RESULTS17 literatures were used for Meta-analysis by the uniform inclusion and exclusion criteria. The results showed that the RD of obesity rate for the students in the intervention group was 3% (95%CI: 1% - 5%) after the intervention. However, the RD of obesity rate for the students in the control group was -2% (95%CI: -4% - -1%) after the intervention. Results of stratified analysis for the RD of obesity rate showed that the obesity rate for the students in the intervention group were decreased significantly after the intervention of combined programs with health education, physical exercise and nutrition interventions with moderate intervention time (1 to 2 years), the RD (95%CI) of obesity rate were 5% (2% - 8%), 3% (1% - 4%), respectively. For the studies whose baseline obesity rates was insignificant difference between the intervention group and the control group, the obesity rate for the students in the intervention group was 4% (95%CI: -7% - -1%) lower than the obesity rate for the students in the control group after the intervention.

CONCLUSIONHealth-education-based comprehensive intervention is effective on obesity prevention in Chinese pupils; combined intervention programs with moderate intervention time (1 to 2 years) were effective in improving efficiency of obesity prevention in pupils.

Child ; China ; Health Education ; Humans ; Obesity ; prevention & control ; Students

Objective Retrospectively study of the effects of interferon-α therapy on height and weight of children with chronic hepatitis B (CHB).Methods Total of 116 hospitalized cases of CHB children in Adolescent Liver Centre, 302 Military Hospital of China from January 2010 to December 2011 were respectively studied.Heights and weights of all the subjects at baseline, 24 weeks, 48 weeks, 72 weeks and 96 weeks of treatment, and 24 weeks, 48 weeks and 96 weeks of follow-up were measured.The weight Z score (WAZ), height Z score (HAZ) and body mass index (BMI) Z score of subjects with hepatic fibrosis (S) <3 and S≥3 were compared.The differences of HAZ and WAZ between baseline and treatment or follow-up in groups of subjects aged 1-6 years and 6-16 years were also compared.T test or rank sum test was used for comparison between groups.Results Among the study of all 116 patients studied, median baseline values of HAZ, WAZ and BMI Z score were 0.76, 0.38 and-0.04, respectively.For patients with hepatic fibrosis S<3, the median HAZ and WAZ were 0.83 and 0.32, respectively.For patients with hepatic fibrosis S≥3, the median HAZ and WAZ were 0.52 and 0.15, respectively.The differences were not statistically significant (both P>0.05).At 48 weeks of treatment, the median HAZ was 0.50, and the median WAZ was 0.20;after a follow-up period of 24 weeks, the median HAZ was-0.32, and the median WAZ was-0.18;after a follow-up period of 48 weeks, the median HAZ was 0.09 and the median WAZ was 0.06.All the above median values of HAZ and WAZ were significantly different from those at baseline (all P<0.05).The difference of HAZ at baseline and 96 weeks of treatment in group aged 6-16 years was significantly different from that in group aged 1-6 years (-0.74±0.69 vs-0.53±0.35, t=1.85, P<0.05).Also, the difference of WAZ at baseline and 96 weeks of treatment in group aged 6-16 years was significantly different from that in group aged 1-6 years (-0.69±0.41 vs-0.17±0.75, t=3.74, P<0.05).The difference of HAZ at baseline and 96 weeks after treatment in group aged 6-16 years was significantly different from that in groups aged 1-6 years (-1.12±0.81 vs-0.05±0.69, t=2.06, P=0.022).Conclusions Interferon-α treatment for children with chronic hepatitis B does have influence on their height and weight, which restores to some degree after the treatment finished.Physicians should pay more attention to the influence of interferon-α treatment on height and weight in children aged 6-16 years.

Objective To evaluate the associations between polymorphisms of LEPR Gln223Arg,LEPR Pro 1019Pro and the risk on obesity.Methods A computerized search on literature was carried out in Wanfang,CNKI,VIP databases and CBM,PubMed,EMBASE databases to collect articles published between 1979 and 2010 concerning the associations between polymorphisms of LEPR Gln223Arg and/or LEPR Pro 1019Pro and risk of obesity in the Chinese population.Odds ratios (ORs) were used to assess the strength of the association,and 95％ confidence intervals (CIs) to present the precision of the estimates.Meta-analysis was performed using the STATA statistical software.Results Fifteen literature were collected for Meta-analysis by the uniform inclusion and exclusion criteria.There were 1096 obese patients and 949 controls for polymorphisms of LEPR Gln223Arg in 9 papers,together with 961 obese patients and 818 controls for polymorphisms of LEPR Prol019Pro in 8 papers.Overall,there were significant associations between decreased risk of obesity and LEPR Gln223Arg polymorphisms (-668 A→G) (G versus A,OR=0.66,95％CI:0.49-0.89; AG and GG versus AA,OR=0.50,95％CI:0.32-0.77; respectively).There were significant associations between increased risk of obesity and LEPR Prol019Pro polymorphisms (-3057 G→A) (A versus G,OR=1.61,95％CI:1.15-2.26; AG and AA versus GG,OR=1.50,95％CI:1.08-2.08; respectively).Conclusion Variant alleles at both LEPR-668 and LEPR-3057 were associated with obesity in the Chinese Han-dominated population.

BACKGROUNDExperimental autoimmune myocarditis (EAM) in rats is a T-cell-mediated disorder. The initiation and maintenance of autoimmune responses in EAM depend on the maturation state of dendritic cells. IL-10 is a pleiotrophic immunomodulatory cytokine that functions at different levels of the immune response, so it has emerged as a promising therapeutic factor for the treatment of autoimmune/inflammatory diseases. This study was designed to test the hypothesis that IL-10 gene modified bone marrow-derived immature dendritic cells (iDCs) ameliorate EAM and to explore the underlying mechanisms.

METHODSEAM was induced using the methods of cardiac myosin immunization on day 0 and day 7. Immature and mature bone marrow-derived dendritic cells (BMDCs) were generated without or with the stimulation by lipopolysaccharide (LPS) and the phenotype was analyzed by flow cytometry. Some of the iDCs were transfected by pcDNA3-IL-10 plasmid. 2 x 10(6)/per rat mature DC (mDC), immature DC (iDC), pcDNA3 transfected iDC, pcDNA3-IL-10 transfected iDC or phosphate buffered saline (PBS) were injected intravenously for treatment 5 days after the first immunization. On day 21, HE staining was performed to detect the myocardial inflammation and T lymphocyte proliferation assay was used to determine the effects of IL-10 gene transfected iDC on autoreactive T cell proliferation. Expression of IkappaB, the inhibitor of NF-kappaB pathway, was determined by Western blot.

RESULTSBMDCs generated in a medium supplemented with granulocyte-macrophage-colony-stimulating factor (GM-CSF) were relatively immature, as determined by flow cytometry. However, stimulation with LPS induced these cells to become mature (m) DCs with higher levels of surface major histocompatibility complex (MHC)-II and costimulatory molecules. Intravenous administration of iDCs, especially pcDNA3-IL-10 transfected iDC, ameliorated the histopathological severity of the myosin induced-EAM, and the effect was lost after the DCs underwent maturation induced by in vitro exposure to LPS. IL-10 gene modified iDC inhibited the antigen specific T cell responses towards cardiac myosin. IkappaB protein was up-regulated significantly in the IL-10 gene modified iDC group.

CONCLUSIONSIL-10 gene modified iDC induced antigen-specific tolerance in EAM. The underlying mechanisms may be related to costimulatory molecules down-regulation and NF-kappaB pathway inhibition.

Animals ; Autoimmune Diseases ; immunology ; Dendritic Cells ; physiology ; Immune Tolerance ; Interleukin-10 ; genetics ; Lymphocyte Activation ; Male ; Myocarditis ; immunology ; Myosins ; immunology ; NF-kappa B ; physiology ; Rats ; Rats, Inbred Lew ; Signal Transduction ; Transfection

BACKGROUNDTo evaluate treatment effectiveness and safety of bicyclo tablets in children with chronic hepatitis B or C.

METHODSA randomized controlled trial was conducted in 148 children with chronic hepatitis B or C for evaluating safety, tolerability, and efficacy of treatment with bicyclo tablets or Hugan tablets. Children in therapy group were treated with bicyclo tablets and control group treated with Hugan tablets.

RESULTS(1) ALT and AST level decreased more prominently in therapy group than in control group (P<0.01). (2) Bicyclo was more effective than Hugan tablets (P<0.01). (3) Symptoms were ameliorated more prominently in bicyclo group than in control group (P<0.01). (4) Both groups had no significant adverse events.

CONCLUSIONSatisfactory therapeutic effect and safety were obtained with bicyclo tablets in children with chronic hepatitis B or C.

Adolescent ; Biphenyl Compounds ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Hepatitis B, Chronic ; drug therapy ; Hepatitis C, Chronic ; drug therapy ; Humans ; Tablets ; Treatment Outcome

OBJECTIVETo study the mechanism of acupuncture and moxibustion in adjusting apoptosis of colonic epithelial cells of the rat of ulcerative colitis (UC).

METHODSUC rats were randomly divided into four groups including normal control group (NC), model control group (MC), herbs-partitioned moxibustion group (HPM) and electroacupuncture group (EA). The HPM and EA groups were respectively treated with herbs-partitioned moxibustion and electroacupuncture at "Qihai" (CV 6) and bilateral "Tianshu" (ST 25). Then the colon of the rat was taken and the changes of the tissue structure and the cell apoptosis were observed by electron microscope and flow cytometer respectively.

RESULTSThe colon tissue showed histopathological changes, and apoptosis of epithelial cells increased in the model mice of UC as compared with the normal rat. Electroacupuncture and drug-separated moxibustion could significantly decrease the abnormal apoptosis of epithelial cells.

CONCLUSIONThe adjustment of the abnormal apoptosis of epithelial cells is one of the mechanisms of drug-separated moxibustion and electroacupuncture treating UC.

Acupuncture Points ; Animals ; Apoptosis ; Colitis, Ulcerative ; therapy ; Epithelial Cells ; Humans ; Moxibustion ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the efficacy and safety of ademetionine for treatment of cholestatic or mixed-type drug-induced liver disease (DILD) in children.

METHODSThe children with DILD were divided into the treated group and control group. Yinzhihuang Granule was orally administered and Compound Glycyrrhizin Injection intravenously given in patients of both groups. Those patients in the treated group were additionally treated with intravenous infusion of 250-1000 mg ademetionine for 28 d. The incidence of pruritus and adverse effects as well as biochemical parameters in all the patients and compared between the 2 groups. For statistical analysis, Chi2 test was used for between-group comparison and t test for processing the data.

RESULTS1) Before treatment, severe pruritus was found in 17 and 16 children in the treated and control group, respectively. Two weeks after the treatment, the symptom was significantly relieved in 14 and 3 patients in the treated and control group, respectively (Chi2 = 4.52, P < 0.05). 2) As for comparisons between the 2 groups, a P value of 0.0014 for AST level was found 4 weeks, 0.045 and 0.007 for disappearance and recovery rate of jaundice, 0.0014 and 0.0006 for decrease in TBA level and 0.0003 for gammaGT level 2 and 4 weeks after the treatment.

CONCLUSIONIntravenous administration of ademetionine is safe in children with DILD and it can effectively alleviate pruritus, promote the recovery of various biochemical parameters and fasten liver functional recovery in these children. Therefore, ademetionine can be widely used for treatment of intrahepatic cholestasis in children.

Adolescent ; Chemical and Drug Induced Liver Injury ; drug therapy ; Child ; Child, Preschool ; Female ; Humans ; Male ; S-Adenosylmethionine ; adverse effects ; therapeutic use ; Treatment Outcome

OBJECTIVETo discuss the efficacy of Leucogen tablets treatment lessen the hematological reaction and raise the efficacy therapy of interferon in chronic hepatitis B treated with PEG-alpha interferon and alpha interferon.

METHODSA total of 395 patients with HBeAg-positive chronic hepatitis B (CHB) inpatients from January 2002 to February 2011. Group: All the patients were assigned to A or B according as during the treatment added Leucogen tablets or not.

RESULTS(1) All of 35.9% patients had neutrophil counts decrease under 1 x 10(9)/L, A group had 29.6%, B had 42.8% patients, P = 0.01; neutrophil counts < or = 0.75 x 10(9)/L A group had 12.6% ,B group had 26.4%, P = 0.02; neutrophil counts < or = 0. 5 x 10(9)/L A group had 4.8%, B group had 16.4%, P = 0.04. (2) A group had 8.2% patients interferon-alpha dose decreased, all the patient finished the period of therapy. B group had 23.3% patients interferon-alpha dose decreased, 2.1% of patients had paused. A group had 40.3% of patients interferon-alpha beyond conventional dose, B group had only 5.2%. (3) All of 9.8% patients had hematoblast decrease under 100 x 10(9)/L, A group had 8.7%, B had 11.1% patients; hematoblast < or = 80 x 10(9)/L A group had 5.3%, B group had 7.9%; hematoblast < or = 50 x 10(9)/L A group had 1.0%, B group had 2.6%. A group had the trend of reducing hematoblast decrease. (4) At the end of therapy A group had 67.4% patients HBVDNA < 100IU/ml, 54.3% e antigen negative, 40.7% e antigen conversed; B group had 53.9%, 41.2%, 26.9%, P was respectively 0.02, 0.01, 0.01.

CONCLUSIONLeucogen tablets treatment and prevention interferon-alpha-related neutrophil counts hematological reaction in CHB treated with alpha-interferon, and had the trend of reducing interferon-alpha-related hematoblast decrease, farther improved the efficacy of alpha-interferon treatment CHB.

Adolescent ; Adult ; Aged ; Antiviral Agents ; adverse effects ; Child ; Child, Preschool ; Female ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Interferon-alpha ; adverse effects ; Male ; Middle Aged ; Neutropenia ; prevention & control ; Polyethylene Glycols ; adverse effects ; Recombinant Proteins ; adverse effects ; Tablets ; Thiazolidines ; therapeutic use

BACKGROUNDStimulation of the heart beta 3-adrenoceptor (AR) may result in a negative inotropic effect. Being up-regulated, beta 3-AR plays a more important role in the regulation of cardiac function during heart failure. However, the effect of chronic blocking of beta 3-AR on heart failure has not been fully elucidated. In this study, we used a selective beta 3-AR antagonist SR59230A to treat a well defined heart failure rat model chronically, then evaluated its effect on cardiac function and investigated the mechanism.

METHODSMale Wistar rats were chosen randomly as controls (n = 8). Isoproterenol induced heart failure rats were randomly divided into ISO group (n = 10) and SR group (n = 10). The ISO group received intraperitoneal injection of 1 ml saline twice a day; the SR group received intraperitoneal injection of SR59230A 85 nmol in 1 ml saline twice a day; and the control group received no treatment. The treatment was started 24 hours after the last isoproterenol injection and continued for 7 weeks. Then we measured the following indexes: the ratio of heart weight to body weight (HW/BW) and the ratio of left ventricular weight to body weight (LVW/BW), collagen volume fraction (CVF), left ventricular end diastolic dimension (LVEDd), left ventricular end systolic dimension (LVESd), ejection fraction (EF), fractional shortening (FS) and the ratio of E wave to A wave (E/A), the mRNA and protein expression of beta 3-AR and eNOS, and cGMP level in the heart.

RESULTSThe ratios HW/BW and LVW/BW were significantly increased in the ISO group compared with the control group (P < 0.01), but they were limited in the SR group (P < 0.05 compared with the ISO group). CVF increased in the ISO group and the SR group (P < 0.01), but it was significantly attenuated in the SR group (P < 0.01). LVEDd, LVESd and E/A ratio were significantly increased in the ISO group compared with the control group (P < 0.01), while EF and FS were significantly decreased (P < 0.01). Compared with the ISO group, the SR group showed that LVEDd, LVESd and E/A ratio were significantly decreased (P < 0.01), whereas EF and FS were significantly increased (P < 0.01). beta(3)-AR and eNOS mRNA and protein in the ISO group were significantly increased when compared with the control group (P < 0.01). These increases were all attenuated in the SR group compared with the ISO group (P < 0.01). The level of cGMP in myocardial tissue was significantly increased in the ISO group compared with the control group (P < 0.01), whereas SR59230A treatment normalized this increment (P < 0.01).

CONCLUSIONSChronic blocking of beta 3-AR could ameliorate cardiac function in heart failure rats and its mechanism involves inhibition of the negative inotropic effect and attenuation of cardiac remodeling.

Adrenergic beta-3 Receptor Antagonists ; Adrenergic beta-Antagonists ; pharmacology ; therapeutic use ; Animals ; Blotting, Western ; Disease Models, Animal ; Echocardiography ; Enzyme-Linked Immunosorbent Assay ; Heart Failure ; drug therapy ; physiopathology ; Male ; Myocardium ; pathology ; Nitric Oxide Synthase Type III ; genetics ; Propanolamines ; pharmacology ; Rats ; Rats, Wistar ; Receptors, Adrenergic, beta-3 ; physiology ; Reverse Transcriptase Polymerase Chain Reaction ; Ventricular Function, Left ; drug effects