ObjectiveTo investigate the impact of anticentromere antibody （ACA） on the clinical features and prognosis of patients with primary biliary cholangitis （PBC） by comparing clinical classification， ursodeoxycholic acid （UDCA） response， GLOBE score， and UK-PBC score between ACA-positive PBC patients and ACA-negative PBC patients. MethodsA total of 749 patients who were admitted to Beijing Ditan Hospital， Capital Medical University， from August 2013 to December 2022 and were diagnosed with PBC were enrolled and divided into ACA-positive group with 147 patients and ACA-negative group with 602 patients. According to their conditions on admission， the two groups were compared in terms of the distribution of clinical types， i.e.， chronic progression-type PBC， portal hypertension-type PBC， and standard jaundice/liver failure-type PBC. There were 261 patients with complete data after 1-year follow-up， among whom there were 53 patients with positive ACA and 208 with negative ACA. A statistical analysis was performed， and propensity score matching was performed based on sex and age at a ratio of 1∶2. The two groups were compared in terms of 1-year UDCA response rate， GLOBE score， and UK-PBC score before and after matching. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. ResultsCompared with the ACA-negative group， the ACA-positive group had a significantly higher age （61.28±10.35 years vs 56.74±12.17 years， t=4.164， P<0.001）， a significantly higher proportion of female patients （93.9% vs 77.6%， χ²=20.221， P<0.001）， a significantly higher proportion of patients with portal hypertension （48.3% vs 27.6%， χ²=23.289， P<0.001）， and a significantly lower proportion of patients with jaundice/liver failure （24.5% vs 38.5%， χ²=10.205， P<0.001）. After 1-year follow-up， for the 261 PBC patients with complete data， there was no significant difference in UDCA response rate before propensity score matching between the ACA-positive group and the ACA-negative group （41.5% vs 41.8%， P>0.05）， and there was a significant difference in the proportion of patients with a GLOBE score of >0.3 between the ACA-positive group and the ACA-negative group （92.5% vs 80.3%， χ²=3.935， P=0.047）. There were 53 patients in the ACA-positive group and 106 patients in the ACA-negative group after propensity score matching， and there were no significant differences between the two groups in UDCA response rate， GLOBE score， and UK-PBC score （all P>0.05）. ConclusionACA-positive patients tend to have an older age， with a higher proportion of female patients or patients with portal hypertension， while there is a relatively low proportion of patients with jaundice/liver failure. Positive ACA has no significant impact on UDCA response rate， GLOBE score， and UK-PBC score.

Objective To investigate the differences in clinical features between the primary biliary cholangitis(PBC)patients with negative or positive anti-mitochondrial antibody(AMA)by analyzing related immune and biochemical parameters.Methods This study was conducted among the patients who attended Beijing Ditan Hospital,Capital Medical University,from January 2013 to December 2022 and were diagnosed with PBC,and they were divided into AMA negative group with 139 patients(24.5%)and AMA positive group with 428 patients(75.5%).Propensity score matching at a ratio of 1∶1 was performed with age and sex as matching factors and a matching tolerance of 0.06.Liver function,coagulation,and immune parameters on admission were analyzed,as well as the changes in liver function and other indicators after 6 months of treatment and the response to ursodeoxycholic acid(UDCA)at 6 and 12 months of treatment.The independent-samples t test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups;the chi-square test was used for comparison of categorical data between two groups.Results There were 139 AMA-negative PBC patients and 139 AMA-positive PBC patients after propensity score matching.Compared with the AMA positive group on admission,the AMA negative group had significantly lower levels of direct bilirubin and globulin(Glo)and significantly higher levels of albumin,albumin/globulin ratio,prealbumin,and fibrinogen(all P<0.05).After 6 months of UDCA treatment,there were significant differences in Glo and prealbumin between the AMA negative group and the AMA positive group(P<0.05).Both the AMA negative group and the AMA positive group had an increase in prealbumin after 6 months of treatment,and the AMA negative group had a significantly greater increase than the AMA positive group(U=41.00,P=0.015).After UDCA treatment for 6 and 12 months,there was no significant difference in treatment response to UDCA between the AMA negative group and the AMA positive group(all P>0.05).Conclusion After matching for age and sex,compared with the AMA-positive PBC patients,the AMA-negative PBC patients tend to have a milder degree of liver inflammation and damage,significantly greater improvements in inflammation and liver synthesis ability after UDCA treatment,and better response to UDCA.

Objective To investigate the clinical features of patients with Polygonum multiflorum preparation-related liver injury with or without positive autoantibody based on propensity score matching, as well as the influence of positive autoantibody on the prognosis of such patients. Methods A total of 364 patients with Polygonum multiflorum preparation-related liver injury who were hospitalized in Beijing Ditan Hospital, Capital Medical University, from August 2008 to June 2021 were enrolled, and according to whether autoantibodies were detected, they were divided into negative autoantibody group (H0 group) with 157 patients and positive autoantibody group (H1 group) with 207 patients. After adjustment for confounding factors by propensity score matching, the two groups were compared in terms of biochemical parameters, severity of liver injury, classification of liver injury, and disease outcome when liver injury reached the peak. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Mann-Whitney U rank sum test was used for comparison of categorical data or ranked data between two groups. The Cox regression model was used to analyze the influencing factors for liver function recovery. The Kaplan-Meier method was used to plot survival curves, and the Log-rank test was used for comparison between groups. Results A total of 98 pairs of cases were successfully matched after propensity score matching. Comparison of biochemical parameters between the two groups at the peak of liver injury showed that compared with the H0 group, the H1 group had significantly higher levels of alkaline phosphatase (ALP), globulin, and total bile acid and a significantly lower level of albumin (all P < 0.05). There was no significant difference in the classification of liver injury between the two groups ( P > 0.05), and there was a significant difference in the severity of liver injury between the two groups ( Z =1.710, P =0.045). Antinuclear antibody (ANA) was the main positive autoantibody and accounted for 49%, and there was a significant difference in the severity of liver injury between the patients with different ANA antibody titers ( Z =20.252, P =0.001). Comparison of disease outcome in terms of whether liver function returned to normal within 6 months showed that the normalization rate of liver function within 6 months was 90.8% in the H0 group and 75.5% in the H1 group, and the H1 group had a lower normalization rate of liver function ( χ 2 =8.199, P =0.004). The Cox regression analysis showed that autoantibody (hazard ratio [ HR ]=5.248, 95% confidence interval [ CI ]: 1.554-17.718, P =0.008) and ALP ( HR =1.013, 95% CI : 1.002-1.025, P =0.026) were independent risk factors for liver function recovery. The Kaplan-Meier survival curve analysis showed that compared with the negative autoantibody group, the positive autoantibody group had a significantly higher risk of failure in liver function recovery after 6 months ( χ 2 =8.802, P =0.003). Conclusion Autoantibody has no significant influence on the classification of Polygonum multiflorum preparation-related liver injury, and compared with the patients with negative autoantibody, the patients with positive autoantibody tend to have more severe liver injury and a more obvious tendency of chronicity.

In this study, we aimed to construct a non-replication mRNA platform and explore the side effects of electroporation-mediated delivery of mRNA on the mice as well as the expression features of the mRNA. With luciferase gene as a marker, in vitro transcription with T7 RNA polymerase was carried out for the synthesis of luciferase-expressed mRNA, followed by enzymatic capping and tailing. The mRNA was delivered in vivo by electroporation via an in vivo gene delivery system, and the expression intensity and duration of luciferase in mice were observed via an in vivo imaging system. The results demonstrated that the mRNA transcripts were successfully expressed both in vitro and in vivo. The electroporation-mediated delivery of mRNA had no obvious side effects on the mice. Luciferase was expressed successfully in all the mRNA-transduced mice, while the expression intensity and duration varied among individuals. Overall, the expression level peaked on the first day after electroporation and rapidly declined on the fourth day. This study is of great importance for the construction of non-replication mRNAs and their application in vaccine or antitumor drug development.
Animals ; Electroporation/methods* ; Gene Transfer Techniques ; Luciferases/metabolism* ; Mice ; RNA, Messenger/genetics*

Autoimmune hepatitis (AIH) is a progressive chronic inflammatory liver disease with unknown etiology. At present, genetic susceptibility and environmental factors are universally recognized as the etiological factors for AIH. With the deepening of research in recent years, other etiological factors, such as immune cells, immune factors, liver transplantation, and drugs, have attracted more and more attention. This article briefly describes related research findings in the past five years.

Objective To investigate the effect of thrombin and hemoglobin on aquaporin (AQP) and the correlation between AQP and hydrocephalus.Methods Eighty-four clean grade healthy male SD rats were randomly divided into 3 groups:a control group,a thrombin group,and a hemoglobin group using the random number table method.A hydrocephalus model was induced by injecting isotonic saline (0.3 ml),thrombin (0.3 ml[10,U/ml]) and hemoglobin (0.3 ml[150 mg/ml]),respectively into the cisterna magna.According to the deficiency and complement way,each group maintained 24 rats.The relative area of the lateral ventricles,the expression of AQP1 and AQP4,and the correlation between AQP and the area of the lateral ventricles were observed at 1,3,7,and 14 d after molding.Results (1) Compared with the control group,both the thrombin group and hemoglobin group showed hydrocephalus at 1 ,3 ,7 and 14 d,and they were most obvious at 1 day (6.94±0.19% and 6.58±0.15% vs.3.40±0.13%,6.06±0.12% and 5.79±0.09% vs.3.55±0.15%,5.80±0.13% and 5.58±0.08% vs.3.78±0.18%,5.66±0.14% and 5.47±0.13% vs.3.52±0.18 %,respectively).There were significant differences (all P<0.01).(2) The increase of AQP1 was mainly in the basal membrane and apical membrane of ventricular choroid plexus epithelial cells,and the increase of AQP4 was mainly in the ependymal cell of ventricle.The relative expression levels of AQP1 and AQP4 at 1,3,7,and 14 d in the control group were 1.09±0.07 and 1.30±0.15,0.91±0.06 and 1.18±0.12,1.33±0.17 and 1.16±0.08,1.22±0.11 and 1.00±0.10,respectively;the thrombin group were 4.40±0.14 and 3.69±0.11,3.88±0.11 and 3.17±0.07,3.55±0.07 and 2.86±0.13,and 3.36±0.07 and 2.70±0.07,respectively,the hemoglobin group were 4.24±0.07 and 3.55±0.10,3.77±0.08 and 3.04±0.09,3.46±0.07 and 2.76±0.08,and 3.31±0.10 and 2.62±0.08,respectively;the relative expression levels of AQP1 and AQP4 of the thrombin group and hemoglobin group at each time point were significantly higher than those of the control group.There were significant differences among the groups (all P<0.01).There were no significant differences in the relative expression levels of AQP1 and AQP4 mRNAs in the hemoglobin group at each time point (P>0.05);in the thrombin group and hemoglobin group,compared with those at 1 d,the expression levels of AQP1 and AQP4 at 3,7,and 14 d were significantly decreased (all P<0.01);compared with those at 3 d,AQP1 was decreased significantly at 7 and 14 d (P<0.05).The differences were statistically significant (P<0.05).(3) The relative expression levels of AQP1 (r=0.983,P<0.01) and AQP4 (r=0.987,P<0.01) in the thrombin group at each time point were positively correlated with the contralateral ventricular area;and the relative expression levels of AQP1 (r=0.964,P<0.01) and AQP4 (r=0.962,P<0.01) in the hemoglobin group at each time point were positively correlated with the contralateral ventricular area Conclusions After injecting thrombin and hemoglobin into subarachnoid space,it could cause the increased expression levels of AQP1 and AQP4 of ventricles and their surrounding areas.Thrombin and hemoglobin may be the important mediating factors of hydrocephalus after subarachnoid hemorrhage.

Autoimmune hepatitis is a chronic progressive inflammatory disease of the liver, which is mediated by the abnormal autoimmune response. Immunosuppressive therapy is the major therapeutic method for this disease, and liver transplantation can be performed for patients in the advanced stage. At present, the internationally acknowledged standard therapeutic method is prednisone or prednisone combined with azathioprine. Most patients can achieve clinical remission, but the recurrence rate is high and some patients fail to respond to the treatment. This article briefly reviews the therapies except corticosteroid therapy and substitutive therapy after treatment failure, introduces the application of integrated traditional Chinese and Western medicine therapy for autoimmune hepatitis, and points out that non-hormonal therapies are the new directions for the treatment of autoimmune hepatitis, which still needs to be further investigated.

Objective To investigate the optimal condition for transforming alkanna tinctoria pigment into shikonin. Methods Transformation rate of shikonin served as index. Transformation temperature, time, ratio of 2% NaOH to alkanna tinctoria pigment (v/w) was optimized. Results With ratio of 2% NaOH to alkanna tinctoria pigment being 4.5 mL·mg-1, temperature 35℃ and the reaction time 4 h, the transformation rate reached the highest, and the average transformation rate was 64.86%. Conclusion This method is easy and simple, and suitable for industrialized production.

OBJECTIVETo evaluate the renal function of 298 liver cirrhosis cases among the patient population of Beijing Ditan Hospital.

METHODSThe medical database of Beijing Ditan Hospital was retrospectively searched for patients with liver cirrhosis (compensated and decompensated). Patients were excluded from the study according to the presence of concomitant serious diseases, such as hypertension, diabetes, and malignancies.The consistency of renal insufficiency was evaluated by the glomerular filtration rate (eGFR) or serum creatinine (SCr) level, which were applied to the simplified modification of diet in renal disease (MDRD) equation.The renal function was compared between groups stratified according to compensated/decompensated status, sex, and age.The factors affecting renal insufficiency were screened.Measurement data were compared using the t-test and count data were compared using the chi-square test.Multiple sets of data were compared using analysis of variance.Correlations were assessed using multivariate logistic regression analysis, and the confounding variables were controlled with the Mantel-Haenszel method.

RESULTSA total of 298 hospitalized patients with liver cirrhosis were included in the study, among which 41 had compensated cirrhosis and 257 had decompensated cirrhosis.Twenty patients (6.7%) with renal insufficiency were identified by SCr measurement and 62 patients (20.8%) were identified by eGFR, and the number identified was significantly different between the two groups (x2=42.00, P less than 0.05).Fifty-six (21.8%) patients had decompensated cirrhosis and 6 (14.6%) patients had decompensated cirrhosis with renal dysfunction; the eGFR levels for these two groups were (117.75 +/- 32.60) ml/min/(1.73 m2)-1 and (112.72 +/- 24.01) ml/min/(1.73 m2) respectively and the difference was not statistically significant (P more than 0.05).The incidence of renal dysfunction among female patients was 22.7% (17/75), and the incidence among male patients was 20.2% (45/223); the eGFR levels for these two groups were (110.07 +/- 26.60) ml/min/(1.73 m2)1 and (112.49 +/- 33.05) ml/min/(l.73 m2) respectively, and the difference was not statistically significant (P more than 0.05).The rate of renal dysfunction among patients aged 20 to 40 years-old, more than 40 to 60 years-old, and more than 60 years years-old was 5.7% (4/70), 22.5% (40/178), and 36.0%(18/50) respectively; the eGFR values for these two groups were (123.43 +/- 24.42) ml min/(l.73 m2), (111.18+/- 33.57) ml/min/(1.73 m2), and (98.20 +/- 27.04) ml/min/(1.73 m2), and the differences were not statistically significant (P less than 0.05).After stratification of the study population by age, the patient sex and the cirrhosis stage were not significantly different (P more than 0.05).Multivariate logistic regression analysis identified age as a risk factor of hepatitis B-related cirrhosis and renal dysfunction (P less than 0.05).

CONCLUSIONThe simplified MDRD equation can help clinicians determine whether patients have kidney injury.Development of renal dysfunction in patients with liver cirrhosis is not associated with patient sex and cirrhosis stage, but is precisely correlated with patient age.

Adult ; Female ; Glomerular Filtration Rate ; Humans ; Kidney Diseases ; physiopathology ; Liver Cirrhosis ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors

Objective To explore the appropriate nursing care of acute hyperlipidemic pancreatitis and increase nursing level.Methods The clinical data of 3 cases of hyperlipidemic pancreatitis misdiagnosed as acute appendicitis were analyzed retrospectively and the nursing experience was summarized.Results The blood sample of all 3 cases represented dramatically high level of serum triglyceride (14.1～61.0 mmol/L).Obvious inducing factors were observed in one case.Besides upper abdominal symptom and physical sign continued in spite of the right lower abdominal discomfort,ascites was discovered by early B-ultrasound.There was no significant increase of serum or urine amylase.After correct diagnosis,all of the 3 cases recovered well by close observation,mental nursing,anti-hyperlipidemic nursing,drainage nursing and health education.Conclusions The knowledge of hyperlipidemic pancreatitis should be well understood during nursing practice.Comprehensive nursing evaluation and close observation can help doctors to analyze and estimate the disease.Integrated nursing techniques can accelerate the recovery of the patients.Health education,anti-hyperlipidemic therapy,and removal of the inducing factors are the keys of prevention.