Liver cirrhosis-related cardiomyopathy (CCM) is a common and easily overlooked complication associated with liver cirrhosis. Because of the high incidence and impact on success of the liver transplantation and the transcarotid intrahepatic portosystemic shunt surgery, it has attracted the attention of researchers in the field recently. Liver cirrhosis patients have liver morphological alterations, which result in increased serum level of total bile acids and changes in bile acid composition. The increased bile acid concentrations are cardiotoxic and change cardiac functions. This study discussed and summarized recent advancements in the role of bile acids in cirrhosis-related cardiomyopathy in three aspects, i.e., changes in bile acid metabolism in liver cirrhosis patients, effects of bile acid on changes in cardiac functions, and ursodeoxycholic acid as a potential therapeutic agent for CCM. This review expects to provide novel approaches for future prevention and treatment of CCM.

Objective To study the current situation of chronic diseases among island residents who have drunken desalinated water for a long time， and to reveal the relationship between drinking desalinated water and water from other sources and the prevalence of chronic diseases among the population. Methods According to the different drinking water sources of island residents， the research subjects were divided into seawater desalination group （residents of Gouqi Township， Shengsi County）， mixed water source group （residents of Shengshan Town， Shengsi County） and freshwater group （residents of Huanglong Township， Shengsi County）. Through the chronic disease network report and resident health file system， the current situation of chronic diseases in different water groups was investigated and analyzed. Results There were significant differences in the prevalence of malignant tumor among drinking water sources （ χ ²=23.867， P <0.001）， with the prevalence of mixed water group >desalination group >fresh water group. There were significant differences in the prevalence of coronary heart disease （ χ ²=194.883， P <0.001）， with the prevalence of mixed water group >desalination group >fresh water group. There were significant differences in the prevalence of stroke （ χ ²=35.637， P <0.001）， with the prevalence of fresh water group > mixed water group > desalination group. There was no significant difference in the prevalence of diabetes mellitus （ χ ²=2.808， P =0.246）， but there was significant difference in the age of onset of diabetes mellitus （ χ ²=7.368， P =0.001）， and significant difference in the prevalence of diabetes mellitus in the age group ≥55 （ χ ²=17.144， P <0.001）， and the onset age and prevalence were all in the order of fresh water group > desalination group > mixed water source group. There was no significant difference in the prevalence of hypertension （ χ ²=3.962， P =0.138）， but there was significant difference in the prevalence of hypertension in the age group ≥55 （ χ ²=20.734， P <0.001）， with the prevalence of fresh water group > desalination group > mixed water source group. Conclusion Long-term consumption of desalinated water by residents is correlated with malignant tumors， coronary heart disease and stroke， and has no correlation with diabetes and hypertension.

Objective:To compare the efficacy of fusion and non-fusion hybrid operation with Dynesys system with the traditional fusion operation with rigid instrumentation in the patients with multi-segment lumbar degenerative disease.Methods:A total of 30 patients with multi-segment lumbar degenerative disease who were subjected to operation from January 2017 to October 2019 in Shenzhen People's Hospital were included in the study. There were 13 males and 17 females, age: 60.8±13.2 years, range: 25 to 83 years. 28 patients with two segments, 1 with three segments, and 1 with four segments. The patients were divided into two groups, i.e the hybrid operation group (13 cases, 9 males and 4 females, average age: 56.6 years, range: 25 to 83 years) versus the traditional fusion group (17 cases, 4 males and 13 females, average age: 63.9 years, range: 46 to 80 years). The main outcome measures were visual analogue scale (VAS), Oswestry disability index (ODI), range of motion (ROM), adjacent segment degeneration (ASD) and complications.Results:There were no statistically significant differences in operation data, such as operation time, intraoperative blood loss, postoperative drainage volume and length of hospitalization, between the two groups. There were no significant differences for ROM in the surgical segments between the two groups before operation (hybrid group and traditional group were 9.6°±4.9° vs. 8.9°±6.1°, t=0.341, P=0.736, respectively). However, after 12 months follow-up, the ROM disappeared in the traditional group and was partially preserved in the hybrid group, with statistically significant differences (hybrid group and traditional group were 5.4°±2.7° vs. 0°, t=9.104, P=0.001, respectively). There was a statistical difference in intervertebral disc height between the two groups at 12 months post-operation, though no statistical difference was found before operation (8.8±1.9 mm vs. 10.5±1.7 mm, t=2.927, P=0.006). There was no statistically significant difference in the intervertebral disc height of the upper adjacent vertebrae between the two groups before and after operation. There were statistically significant differences in ODI scores before operation (63.4%±11.0% vs. 71.3%±9.2%, t=2.146, P=0.041), and 12 months post-operation (17.2%±2.1% vs. 15.5%±2.3%, t=2.091, P=0.046), while no statistical difference was found in VAS scores. Conclusion:The fusion and non-fusion hybrid operation with Dynesys system has comparable clinical efficacy with the traditional fusion operation with rigid instrumentation in the treatment of multisegment lumbar degenerative disease. Meanwhile, the hybrid surgery can preserve the motion of surgical segments and provide a dynamic stability of the vertebral body. The hybrid surgery can be used as a new surgical method for multi-segment lumbar degenerative disease.

Objective:To investigate the expression and clinical significance of F0 ATP synthase C subunit (Csub) in patients with ischemic heart disease (IHD).Methods:The 101 patients with chest pain admitted to the department of emergency of the People's Hospital of Yuhuan from May 2019 to December 2020 were enrolled, including 59 patients with acute myocardial infarction (AMI) and 42 patients with unstable angina pectoris (UAP). At the same time, 50 age-matched healthy subjects in the health examination center were selected as the healthy control (HC). All patients had completed blood sampling before the intervention of drugs or other intervention measures in the emergency room. The content of serum Csub was detected by enzyme linked immunosorbent assay (ELISA), and the relationship between Csub and clinical characteristics was analyzed. At the same time, the contents of hypersensitivity cardiac troponin T (hs-cTnT) and MB isoenzyme of creatine kinase (CK-MB) in blood were detected by electrochemical luminescence. The receiver operator characteristic curve (ROC curve) was drawn to evaluate the value of Csub, hs-cTnT, and CK-MB in the early diagnosis of IHD.Results:The baseline data such as age, gender, and history of the three groups were balanced. There were significant differences in low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), CK-MB, hs-cTnT and B-type natriuretic peptide (BNP), but there were no significant differences in other biochemical indexes. The Csub content in the AMI group and the UAP group were significantly higher than those in the HC group [8.96% (6.37%, 11.53%), 4.27% (3.23%, 6.49%) vs. 1.56% (1.07%, 2.33%), both P < 0.01]. Moreover, the Csub in the AMI group with more severe myocardial ischemia was higher than UAP group [8.96% (6.37%, 11.53%) vs. 4.27% (3.23%, 6.49%), P < 0.01]. A total of 59 patients with AMI were treated with percutaneous coronary intervention (PCI). According to the median of Csub, AMI patients were subdivided into above-median group (29 cases) and below-median group (30 cases). The results showed that there were no significant differences in the number of coronary artery lesion branches, the number of stent implantation and postoperative medication between the two groups. ROC curve analysis showed that the area under the curve (AUC) and 95% confidence interval (95% CI) of Csub, hs-cTnT and CK-MB in the diagnosis of IHD were 0.98 (0.95-1.00), 0.99 (0.99-1.00), 0.94 (0.89-0.99), respectively. The diagnostic efficacy of Csub was slightly lower than that of hs-cTnT but higher than that of CK-MB. When the cut-off value of Csub was 4.74%, the sensitivity and specificity for the diagnosis of IHD were 100% and 87.0%, respectively. Conclusions:Csub increased significantly in the serum of IHD patients, and further increased with the severity of ischemia. It can be used as a new diagnostic biomarker for the diagnosis and evaluation of the development of myocardial ischemia.

BACKGROUND:At present, vertebroplasty and spinal canal decompression are common methods for treatment of metastatic spinal tumors. Iodine-125 (125 I) radioactive seed implantation has been shown to control the tumor. However, there were few clinical studies on combined therapy using above-mentioned methods. OBJECTIVE:To compare the differences of 125I radioactive seed implantation combined with vertebroplasty and titanium al oy nail-rod fixation and vertebroplasty combined with titanium al oy nail-rod fixation for treating thoracolumbar metastases on pain control, general performance and improvement of the spinal cord function, and to evaluate clinical value of 125 I radioactive seed implantation combined with therapeutic plans. METHODS:Thoracolumbar metastases patients undergoing titanium al oy nail-rod fixation were selected in the Department of Spinal Surgery, Shenzhen Municipal People’s Hospital in China from October 2009 to March 2013. They were assigned to experimental and control groups according to with or without 125 I radioactive seed implantation. Improvement in neurological function was observed before and 2 weeks, 1, 6, and 12 months after titanium al oy nail-rod fixation in both groups. RESULTS AND CONCLUSION:Al patients were fol owed up for 7 to 29 months, averagely 15.8 months. There was no loosening of titanium al oy nail-rod fixation and the position of bone cement was good. No seed migration or radioactive spinal cord injury was observed. No relapse or diffusion in the surgical site was observed during fol ow up. Visual Analogue Scale and Karnofsky Performance Status scores were higher in the experimental group than in the control group (P<0.05). Frankel level was obviously improved after fixation in both groups compared with preoperation. No significant difference in the improvement of neurological function was detected between the two groups (P>0.05). Results indicated that 125 I radioactive seed implantation combined with vertebroplasty and titanium al oy nail-rod fixation for treatment of metastatic spinal tumors showed obvious outcomes in relieving cancer pain.

ObjectiveTo evaluate the one-year follow-up of the therapeutic efficacy of human umbilical cord derived-mesenchymal stem cell (UC-MSC) transplantations in decompensated liver cirrhosis patients with ascites.MethodsFifty-four liver cirrhosis patients with ascites in Research Center for Biological Therapy in 302 Military Hospital were divided into treatment group (n=38) and control group (n=16) in a prospective controlled single-blinded trial.UC-MSC (0.5-1.0) × 106/kg and saline were intravenously transplanted into patients monthly for 3 times in treatment group and control group,respectively.The liver function,hepatitis B virus (HBV) DNA level,ascites and the model for end-stage liver disease(MELD)scores at different time points were compared between two groups.The comparison between groups was done by Mann-Whitney U test,and the data before and after transplantations were compared by Wilcoxon signed rank sum test.ResultsThere were no significant differences of alanine transaminase (ALT),total bilirubin (TBil),cholinesterase (CHE),HBV DNA positive rate and MELD scores at different time points between two groups (P＞0.05).However, the albumin ( A1b)level was significantly increased after 36 weeks of UC-MSC transplantation in treatment group, which were (28.47±4.45)g/L at week 0 and ( 34.82±4.50)g/L at week 48 (P=0.046). Meanwhile, the ascites reduced markedly in treatment group with (46.6 ±30.6) mm at week 0 and (6.6±13.6) mm at week 48,which were significantly different from control group at the end of follow-up (P =0.037). Conclusion UC-MSC transplantations may help to increase A1b level and reduce ascites in patients with decompensated liver cirrhosis.

BACKGROUND: Recent researches indicate that ischemia and hypoxia can lead to abnormal brain metabolism and even energy failure, which is an important reason for brain damage and necrosis and identifies energy metabolism disorder as the key event in brain ischemia-reperfusion (IR)injury. Glucose transporter-3 plays the vital role in brain energy metabolism.OBJECTIVE: To observe the changes of cerebral infarct volume and glucose transporter-3 mRNA and protein expressions in cerebral cortical penumbra at different stages of focal cerebral ischemia and reperfusion in rats.DESIGN: Randomized controlled experiment.SETTING: Department of Neurosurgery, Second Hospital Affiliated to Sun Yat-sen University.MATERIALS: This experiment was conducted in the Animal Laboratory of Medical Research Center, Second Hospital Affiliated to Sun Yat-sen University between August and October 2002.Totally 56 SD rats were randomized into 3 groups which were subjected to ① ischemia for 1 hour followed by reperfusion (n=28), ② ischemia for 3 hours followed by reperfusion (n=24), and ③ sham operation (n=4). The rats in the first group were subdivided into 7 subgroups for examination at 1, 3, 6, 12, 24, and 72hours and 1 week after ischemia, with 7 rats in each subgroup; the rats in the second ischemia group were also subdivided in similar manner but without a 1 hour postischemic subgroup. The rats in the sham operation group only received the operation but without arterial occlusion.METHODS: Focal cerebral ischemia-reperfusion (IR) injury model was induced in the rats in the two ischemic groups by means of insertion of suture for arterial occlusion, and the ratio of central ischemic area to cerebral infarct volume in the ischemic penumbra was examined at the specified time points. Reverse transcription-PCR (RT-PCR) was used to detect the expression of glucose transporter-3 mRNA in the cerebral cortex in ischemic penumbra region, and semi-quantitative immunohistochemistry (IHC) employed to detect the level of glucose transporter-3 protein.MAIN OUTCOME MEASURES: Cerebral infarct volume after IR injury, changes of transporter-3 mRNA and protein expressions after IR injury.RESULTS: Totally 56 rats were used in this experiment and all entered result analysis. The post-IR cerebral infarct volume was obviously smaller in 1-hour ischemia group than in 3-hour ischemia group. Glucose transporter-3 mRNA expression began to increase 3 hours after ischemia in 1-hour ischemia group, reaching the peak level at 24 hours and still mainrained higher level than that of the sham operation 1 week; in 3-hour ischemia group, the mRNA expression was slightly decreased at 3 hours but began to increase afterwards till reaching the peak level at 24 hours, followed then by recovery of normal level at 1 week. The changes in glucose transporter-3 protein and mRNA expressions followed almost the same pattern.CONCLUSION: Glucose transporter-3 expression is up-regulated in the ischemic penumbra region, possibly as a protective response to cerebral IR injury.

AIM: To investigate the volume percentage of infarct and expression of glucose transporter-1 (GLUT1) transcription and protein levels at different ischemic time point and different reperfusion time point in rat focal cerebral ischemic penumbra. METHODS: Focal ischemic models of middle cerebral artery occlusion (MCAO) in rats were made by inserting nylon thread. Brain samples were harvested from ischemic penumbra. Infarct volume were analyzed quantitively by Kontron IBAS 2.5 image auto-analyses system. The expressien of GLUT1 mRNA was assessed by RT-PCR, and the expression of GLUT1 protein was assessed by immunohistochemistry. RESULTS: The infarction volume in MCAO 1 h/reperfusion (R) group was obviously smaller than that in MCAO 3 h/R group. GLUT1 increased at (1 h) MCAO 1 h/R group, climbed to climax at 24 h and remained higher than normal at 1 week. In contrast, in the MCAO 3 h/R group, the corresponding index was at 3 h, 24 h and 1 week, but the increasing degree of GLUT1 was slighter than MCAO 1 h/R. GLUT1 protein began to ascend at 1 h, reached climax at 24 h and was higher than normal at 1 week in MCAO 1 h/R group, while in MCAO 3 h/R group, the corresponding index was at 3 h, 24 h and 1 week. CONCLUSION: GLUT1 expression is notably up-regulated in the penumbra region after focal cerebral ischemia, it may be a protective reaction against ischemic injury. [

AIM: To investigate the volume percentage of infarct and expression level of glucose transporter-3 (GLUT3) transcription and protein at different ischemic time points and different reperfusion time points in rat focal cerebral ischemic penumbra. METHODS: Focal ischemic models of middle cerebral artery occlusion (MCAO) in rats were made by inserting nylon thread. Brain samples were harvested from ischemic penumbra. Infarct volume was analyzed quantitatively by Kontron IBAS 2.5 image auto-analyses system. The change of GLUT3 mRNA was assessed by RT-PCR, and the expression of GLUT3 protein was assessed by immunohistochemistry. RESULTS: The infarction volume in MCAO 1 h/R group was obviously smaller than that in MCAO 3 h/R group. GLUT3 began to ascend at 3 h in MCAO 1 h/R group, reached to climax at 24 h and remained higher than normal at 1 week. In contrast, in the MCAO 3 h/R group, GLUT3 had a descent at 3 h. Later on, it ascended rapidly, and reached climax at 24 h. At 1 week, it approached to normal. The expression level of GLUT3 protein corresponds with that of mRNA. CONCLUSION: GLUT3 expression is up-regulated in the penumbra region after focal cerebral ischemia, it may be a protective reaction against ischemia/reperfusion injury. [