Cardiovascular Diseases ; prevention & control ; China ; Humans

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

Cardiovascular Diseases ; psychology ; Humans ; Life Style

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 ; prevention & control ; China ; Humans

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.

Objective:To observe the clinical treatment effects of Tangkang Xifang in the patients with type 0 diabetes foot ( DF) . Methods:Totally 73 patients with type 0 DF were randomly divided into the treatment group (n=37) and the control group (n=36). All the patients discontinued other medications for 7d before the treatment. Base on the blood glucose control with the traditional treat-ment by metformin hydrochloride (1. 5 g·d-1), the treatment group was additionally given warm water foot bath with Tangkang Xi-fang, while the control group was additionally given warm water foot bath, 30 min per time and twice a day for 60 days. The changes in the clinical symptoms, ankle brachial index ( ABI) , motor nerve conduction velocity ( MCV) and some other indices were measured before and after the treatment. Results:In comparison with the control group (58. 3%), the treatment group had higher total effective rate (86. 5%), and the usage of Tangkang Xifang also significantly improved the physiopathologic syndromes of peripheral artery dis-ease and neuropathy (P<0. 01). The ABI and MCV in the treatment group were significantly better than those in the control group (P<0. 05 or P<0. 01). Conclusion:Tangkang Xifang can effectively improve the clinical symptoms of type 0 DF, which is suitable for the clinical application.

Objective To explore the serum lactic acid,transaminase and their relationship with liver pathological damage in sepsis rats,whether a correlation exists between serum lactate clearance rate and transaminase in sepsis rats,and whether they can be used as indicators for the prediction and evaluation of septic rats liver injury.Methods A total of 150 clean Sprague-Dawley (SD) rats was divided into normal group (n =50),sham operated group (n =50),and the cecal ligation and puncture (CLP) (n =50).Ten rats were killed after successful surgery at the 6th,12th,24th,48th,and 72nd hour in CLP group,respectively.At each time point,10 normal rats and 10 sham-operated rats were taken as a control in the corresponding time point.The liver tissue was obtained for pathological analysis.The levels of lactate and liver transaminase were detected and the lactate clearance rate was calculated.The levels of lactate and transaminase at each time point were statistically compared.The correlation analysis was performed among serum lactate,transaminase,and liver damage pathological changes.Results The rat hepatocytes in CLP group begin to appear at the 6th hour,and the damage was gradually enhanced at the 12th,24th,and 48th,and up to the worst damage at the 48th time point.The levels of lactate and alanine aminotransferase (ALT)in CLP group at the 12th and 24th hour were significantly elevated compared with the normal and sham operation groups (P ＜0.05); The level of aspartate aminotransferase (AST) in CLP group at the 6th,12th,24th,48th,and 72nd hour was significantly elevated compared with the normal and sham operation groups (P ＜ 0.05).A positive correlation was found between the levels of ALT and lactate (r =0.766,P ＜0.05),and a negative correlation was found between lactate clearance rate and ALT (r =-0.712,P ＜0.05).Conclusions In septic rats,both lactate and lactate clearance rate were correlated with ALT,and they were correlated with liver pathological damage.The level of lactate,lactate clearance rate,and ALT could be used as the key indicators to predict liver damage in septic rats.

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.

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.