The current study was performed to evaluate the liver function status as well as molecular characterization of the recovered worms in rats experimentally infected with F. hepatica. Sixteen male Wister rats aged 30 day...The current study was performed to evaluate the liver function status as well as molecular characterization of the recovered worms in rats experimentally infected with F. hepatica. Sixteen male Wister rats aged 30 days were randomly allocated into two groups (n = 8). The first group was infected orally with 15 viable encysted metacercaria of F. hepatica per animal. The other group was kept non-infected (control group). At zero time (before infection), the 2<sup>nd</sup>, 4<sup>th</sup>, 6<sup>th</sup>, 8<sup>th</sup>, 10<sup>th</sup>, 12<sup>th</sup> and 14<sup>th</sup> weeks post-infection (WPI), blood and serum samples were collected via puncture of retro-orbital plexus of veins from each rat. Serum enzyme level (AST and ALT) and total protein were measured, and the serum protein profile was carried out using agarose gel electrophoresis. During the period of the experiment, serum ALT and AST activities and serum total globulins significantly increased while serum total proteins and albumin markedly decreased in the infected group. On the 14<sup>th</sup> WPI, the data of the electropherogram showed that globulin fractions (α1-, β- and γ-globulin) levels were significantly increased while α2-globulin was markedly decreased in the infected group. The molecular analysis confirmed the amplification of the ITS1, ITS2 and NDI genes of F. hepatica recovered from the infected liver of rats with amplicon sizes of 630, 510 and 560 bp, respectively. Sequencing of the amplified ITS gene resulted in the determination of 3 strains (PP108836, PP108837, and PP108838). Also, analysis of the ITS2 gene resulted in obtaining 3 isolates under the accession numbers (PP109065, PP109066, and PP109067). In conclusion, fasciolosis in the rat model is suitable for routine experimental infections and caused a pronounced liver dysfunction with discharging of the Fasciola eggs in the faeces and the development of adult stages in the bile ducts. Furthermore, molecular techniques are a sensitive tool for the identification and characterisation of the Fasciola parasite.展开更多
BACKGROUND This case report describes a protocol developed by Danaun Medical Clinic for the introduction of a pioneering intervention comprising intravenous human placen-tal extract(HPE)therapy to improve the liver fu...BACKGROUND This case report describes a protocol developed by Danaun Medical Clinic for the introduction of a pioneering intervention comprising intravenous human placen-tal extract(HPE)therapy to improve the liver function of patients with chronic liver disease(CLD).CASE SUMMARY This study involved data from patients whose chief complaint was reduced quality of life attributable to CLD.The new treatment approach resulted in improvements in the liver function and fatty liver of 30 patients with CLD.Im-provements were observed using abdominal ultrasonography.Unlike traditional methods,this protocol provided more sustainable and meaningful results.Treat-ment with 10 mL of HPE administered intravenously once or twice per week significantly improved liver function.The observed improvements in fatty liver and liver function suggest the utility of this approach for the management of patients with CLD.CONCLUSION This case series highlights the potential of innovative treatments for patients with CLD that could improve the quality of life of the patients.展开更多
Objective Rheumatoid arthritis(RA)is a systemic autoimmune disease that affects the small joints of the whole body and degrades the patients’quality of life.Zhengqing Fengtongning(ZF)is a traditional Chinese medicine...Objective Rheumatoid arthritis(RA)is a systemic autoimmune disease that affects the small joints of the whole body and degrades the patients’quality of life.Zhengqing Fengtongning(ZF)is a traditional Chinese medicine preparation used to treat RA.ZF may cause liver injury.In this study,we aimed to develop a prediction model for abnormal liver function caused by ZF.Methods This retrospective study collected data from multiple centers from January 2018 to April 2023.Abnormal liver function was set as the target variable according to the alanine transaminase(ALT)level.Features were screened through univariate analysis and sequential forward selection for modeling.Ten machine learning and deep learning models were compared to find the model that most effectively predicted liver function from the available data.Results This study included 1,913 eligible patients.The LightGBM model exhibited the best performance(accuracy=0.96)out of the 10 learning models.The predictive metrics of the LightGBM model were as follows:precision=0.99,recall rate=0.97,F1_score=0.98,area under the curve(AUC)=0.98,sensitivity=0.97 and specificity=0.85 for predicting ALT<40 U/L;precision=0.60,recall rate=0.83,F1_score=0.70,AUC=0.98,sensitivity=0.83 and specificity=0.97 for predicting 40≤ALT<80 U/L;and precision=0.83,recall rate=0.63,F1_score=0.71,AUC=0.97,sensitivity=0.63 and specificity=1.00 for predicting ALT≥80 U/L.ZF-induced abnormal liver function was found to be associated with high total cholesterol and triglyceride levels,the combination of TNF-αinhibitors,JAK inhibitors,methotrexate+nonsteroidal anti-inflammatory drugs,leflunomide,smoking,older age,and females in middle-age(45-65 years old).Conclusion This study developed a model for predicting ZF-induced abnormal liver function,which may help improve the safety of integrated administration of ZF and Western medicine.展开更多
BACKGROUND Autoimmune liver diseases,including primary biliary cholangitis(PBC),autoi-mmune hepatitis(AIH),and their overlap syndrome(OS),involve immune-mediated liver injury,with OS occurring in 1.2%-25%of PBC patien...BACKGROUND Autoimmune liver diseases,including primary biliary cholangitis(PBC),autoi-mmune hepatitis(AIH),and their overlap syndrome(OS),involve immune-mediated liver injury,with OS occurring in 1.2%-25%of PBC patients.OS carries a higher risk of cirrhosis,hepatocellular carcinoma,and reduced survival.While its pathogenesis remains unclear,gut microbiota dysbiosis and serum metabolite alterations may play key roles.This study uses 16S rRNA sequencing and liquid chromatography-mass spec-trometry(LC-MS)metabolomics to compare gut microbiota and serum metabolites among PBC,AIH,and OS patients,and explores their associations with liver function.AIM To differentiate OS from PBC and AIH based on gut microbiota,serum metabolites,and liver function.METHODS Gut microbiota profiles were analyzed using 16S rRNA sequencing,while untargeted serum metabolomics was conducted via LC-MS.Comparative analyses were performed to identify differences in microbial composition and serum metabolite levels among PBC,AIH,and OS groups.Correlation analyses and network visualization tech-niques were applied to elucidate the interactions among liver function parameters,gut microbiota,and serum metabolites in OS patients.RESULTS Compared to patients with PBC or AIH,OS patients demonstrated significantly reduced microbial diversity and richness.Notable taxonomic shifts included decreased abundances of Firmicutes,Bacteroidetes,and Actinobacteria,alongside increased levels of Proteobacteria and Verrucomicrobia.Distinct serum metabolites,such as pentadecanoic acid and aminoimidazole carboxamide ribonucleotide,were identified in OS patients.Correlation analysis revealed that aspartate aminotransferase(AST)levels were negatively associated with the bacterial genus Fusicatenibacter and the metabolite L-Tyrosine.A microbial-metabolite network diagram further confirmed a strong association between Fusicatenibacter and L-Tyrosine in OS patients.CONCLUSION OS patients show decreased gut microbiota diversity and unique serum metabolites.Multi-omics linked AST,Fusicatenibacter,and L-Tyrosine,revealing OS mechanisms and diagnostic potential.展开更多
This editorial comment is on the article by Xu et al.It offers an in-depth analysis of liver function assessment tools and their prognostic roles in non-malignant liver diseases,with a focus on the albumin-bilirubin(A...This editorial comment is on the article by Xu et al.It offers an in-depth analysis of liver function assessment tools and their prognostic roles in non-malignant liver diseases,with a focus on the albumin-bilirubin(ALBI)score.ALBI’s components,grading system,and clinical relevance across various liver conditions are reviewed and compared with traditional models such as the Child-Pugh and model for end-stage liver disease scores.We included recent studies evaluating ALBI’s role in estimating liver function,suggesting it may help differentiate patients who appear similar under other staging systems,and assist in guiding clinical decisions.Although ALBI is primarily used as an indicator of hepatic reservoir in hepatocellular carcinoma,it has been demonstrated a positive correlation with overall survival,tumor recurrence,and post-hepatectomy liver failure in patients undergoing potentially curative treatments such as liver resection,liver transplantation,and local ablation.Moreover,several studies suggest that ALBI can also predict survival outcomes,treatment-related toxicity,and liver-related complications in patients receiving trans-arterial chemoembolization,radioembolization,external-beam radiotherapy,or systemic therapies.Its growing use in nonmalignant liver diseases,including primary biliary cholangitis,cirrhosis,acute and chronic liver failure,and viral hepatitis highlights the need for large,prospective studies.Further studies are warranted to validate the integration of ALBI into routine clinical practice and to clarify its role in guiding prognosis and treatment planning.展开更多
BACKGROUND:Preoperative liver function in children with congenital heart disease is often compromised to varying degrees because of the unique pathophysiology.We aimed to investigate the relationships between liver fu...BACKGROUND:Preoperative liver function in children with congenital heart disease is often compromised to varying degrees because of the unique pathophysiology.We aimed to investigate the relationships between liver function indicators at hospital admission and mortality in children receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO)support following cardiac surgery.METHODS:We retrospectively analysed the clinical data of pediatric patients who received postcardiotomy VA-ECMO support at Fuwai Hospital between January 2010 and June 2020.Univariable and multivariable-adjusted Cox proportional hazard models were constructed to evaluate the risk factors associated with 30-day and 180-day mortality.The cut-off values for the liver function variables measured at hospital admission were categorized into high and low groups and then compared using Kaplan-Meier survival curves and log-rank tests.RESULTS:Our study included 96 pediatric patients who received VA-ECMO support after cardiotomy.Among the patients receiving VA-ECMO,the 30-day and 180-day mortality rates were 37.5% and 52.1%,respectively.The level of aspartate aminotransferase(AST)at admission was associated with 30-day mortality(hazard ratios[HRs]=1.852,95%CI 1.010-3.398,P=0.046).The AST and alkaline phosphatase(ALP)levels were predictors of 180-day mortality,with adjusted HRs of 1.799(95%CI 1.074-3.014;P=0.025)and 1.384(95%CI 1.050-1.825;P=0.021),respectively.The cut-off value for AST to predict mortality at 30 d was 77 U/L,and that for ALP to predict mortality at 180 d was 269 U/L.CONCLUSION:Liver function indicators,including AST and ALP,at hospital admission are associated with mortality risk in children with congenital heart disease receiving VA-ECMO after cardiac surgery.展开更多
BACKGROUND Diabetes mellitus(DM)and metabolic-associated fatty liver disease(MAFLD)are common metabolic disorders,and their coexistence can exacerbate the progression of either disease.Human umbilical cord mesenchymal...BACKGROUND Diabetes mellitus(DM)and metabolic-associated fatty liver disease(MAFLD)are common metabolic disorders,and their coexistence can exacerbate the progression of either disease.Human umbilical cord mesenchymal stem cell(hUCMSC)therapy has shown promising potential in the treatment of several metabolic diseases.AIM To investigate how hUC-MSCs affect liver metabolism in diabetic rats with MAFLD and assess their therapeutic potential and underlying mechanisms.METHODS A streptozotocin-induced rat model of DM with MAFLD was established,and hUC-MSCs were administered via tail vein injection.Changes in body weight,fasting blood glucose(FBG),and serum triglyceride(TG),alanine aminotransferase,aspartate aminotransferase levels,and pathological changes of liver were evaluated.Receiver operating characteristic analysis was used to assess the diagnostic value of differential metabolites and their ability to predict the therapeutic effects of hUC-MSCs.Spearman correlation was employed to analyze the relationships between liver metabolites and key biochemical markers.RESULTS hUC-MSC treatment significantly reduced FBG and TG levels in diabetic rats with MAFLD and improved histological steatosis and injury in the liver.Metabolomic analysis indicated that hUC-MSCs significantly ameliorated liver metabolic disturbances via their regulatory effect on several key metabolic pathways related to carbohydrate,amino acid,and lipid metabolism.Receiver operating characteristic curve analysis revealed that 70 differential metabolites had good diagnostic value for DM with MAFLD and could effectively predict the therapeutic effect of hUC-MSCs.Moreover,Spearman correlation analysis confirmed that significant correlations existed between differential liver metabolites and the concentrations of biochemical markers(FBG,TG,alanine aminotransferase,aspartate aminotransferase).CONCLUSION hUC-MSCs alleviate liver metabolic disturbances in diabetic rats with MAFLD,thereby mitigating the pathological state of DM and slowing the progression of MAFLD.展开更多
BACKGROUND Research has shown that several factors can influence postoperative abnormal liver function;however,most studies on this issue have focused specifically on hepatic and cardiac surgeries,leaving limited rese...BACKGROUND Research has shown that several factors can influence postoperative abnormal liver function;however,most studies on this issue have focused specifically on hepatic and cardiac surgeries,leaving limited research on contributing factors in other types of surgeries.AIM To identify the risk factors for early postoperative abnormal liver function in multiple surgery types and construct a risk prediction model.METHODS This retrospective cohort study involved 3720 surgical patients from 5 surgical departments at Guangdong Provincial Hospital of Traditional Chinese Medicine.Patients were divided into abnormal(n=108)and normal(n=3612)groups based on liver function post-surgery.Univariate analysis and LASSO regression screened variables,followed by logistic regression to identify risk factors.A prediction model was constructed based on the variables selected via logistic re-gression.The goodness-of-fit of the model was evaluated using the Hosm-er–Lemeshow test,while discriminatory ability was measured by the area under the receiver operating characteristic curve.Calibration curves were plotted to visualize the consistency between predicted probabilities and observed outcomes.RESULTS The key factors contributing to abnormal liver function after surgery include elevated aspartate aminotransferase and alanine aminotransferase levels and reduced platelet counts pre-surgery,as well as the sevoflurane use during the procedure,among others.CONCLUSION The above factors collectively represent notable risk factors for postoperative liver function injury,and the prediction model developed based on these factors demonstrates strong predictive efficacy.展开更多
BACKGROUND Insulin resistance is a cardiometabolic risk factor characterized by elevated insulin levels.It is associated with fatty liver disease and elevated liver function tests(LFT)in cross-sectional studies,but da...BACKGROUND Insulin resistance is a cardiometabolic risk factor characterized by elevated insulin levels.It is associated with fatty liver disease and elevated liver function tests(LFT)in cross-sectional studies,but data from cohort studies are scarce.AIM To investigate the association between insulin and pathological LFT,liver disease,and cirrhosis in a populationbased retrospective cohort study.METHODS Anthropometric and cardiometabolic factors of 857 men and 1228 women from prospective cohort studies were used.LFT were obtained at two time points 8 years to 24 years after baseline.Liver disease diagnoses were obtained from nationwide registries.The association between insulin levels and the development of elevated LFT or liver disease and cirrhosis was analyzed.RESULTS Total follow-up was 54054 person-years for women and 27556 person-years for men.Insulin levels were positively correlated with elevated LFT during follow-up,whereas physical activity and coffee consumption were negatively correlated.Individuals with both insulin levels in the upper tertile and alcohol consumption above MASLD thresholds had an increased risk for both liver disease,adjusted hazard ratio(aHR)of 4.3(95%CI:1.6-14.6)and cirrhosis(aHR=4.8,95%CI:1.6-14.6).CONCLUSION This population-based study provides evidence that high insulin levels are a risk factor for development of elevated liver enzymes and clinically manifest liver disease.The results support the concept of metabolic dysfunction associated liver disease.展开更多
BACKGROUND The treatment of patients with liver cancer after surgery with the artificial liver support system combined with traditional Chinese medicine(TCM)for strengthening the body and removing blood stasis is a ne...BACKGROUND The treatment of patients with liver cancer after surgery with the artificial liver support system combined with traditional Chinese medicine(TCM)for strengthening the body and removing blood stasis is a new idea.AIM To analyze the post-surgical effect of the artificial liver support system with TCM in patients with liver cancer.METHODS Ninety-eight patients with liver cancer who underwent surgical treatment at the Fifth People’s Hospital of Huai’an from January 2023-2024 were selected and divided into two groups(49 patients each)via random lottery method.Both groups underwent surgery.The control group received artificial liver support,and the observation group was additionally treated with TCM for strengthening the body and removing blood stasis.Gastrointestinal recovery,liver function,tumor marker levels,immune function,and safety were compared between both groups.RESULTS There were significant differences in the levels of indicators related to gastrointestinal recovery between the groups(P<0.05).After treatment,the levels of alanine aminotransferase,aspartate aminotransferase,total bilirubin,and gamma-glutamyl transpeptidase in the observation group were lower,whereas the albumin level was higher(P<0.05).After treatment,tumor marker levels in the observation group were relatively lower(P<0.05).After treatment,compared to the control group,the CD4+level in the observation group was higher and the CD8+level was lower(P<0.05).There was no significant difference in the incidence of adverse reactions between both groups(P>0.05).CONCLUSION Combining the artificial liver support system with TCM significantly improves liver and gastrointestinal functions,enhances immune responses,and reduces tumor marker levels with high safety,suggesting that it could be a promising approach for optimizing postoperative care and improving patient outcomes,potentially reducing complications and enhancing quality of life.展开更多
Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in ...Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in our hospital from May 2022 to July 2024 were selected as the research subjects.All patients underwent a B-ultrasound examination.According to the severity of the disease,they were divided into group A(mild,n=35),group B(moderate,n=44),and group C(severe,n=26).Another 30 healthy residents who came to the hospital for physical examination during the same period were selected as group D.The differences in blood lipids,blood glucose,and liver function indicators between groups were compared.Results:The triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL)levels in groups A,B,and C were higher than those in group D,while the high-density lipoprotein cholesterol(HDL)level was lower(P<0.05).The fasting plasma glucose(FPG)levels in groups B and C were higher than those in group D(P<0.05).The TG,LDL,and FPG levels in groups B and C were higher than those in group A(P<0.05).The TC level in group C was higher than that in group A,while the HDL level was lower(P<0.05).The TC and FPG levels in group C were higher than those in group B(P<0.05).The total bilirubin(TBil),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)levels in groups A,B,and C were higher than those in group D(P<0.05).The TBil and ALT levels in groups B and C were higher than those in group A(P<0.05).The AST level in group C was higher than that in group A(P<0.05).The AST and ALT levels in group C were higher than those in group B(P<0.05).Conclusion:Patients with non-alcoholic fatty liver disease have disordered glucose and lipid metabolism.Blood lipids,blood glucose,and liver function are closely related to the severity of the disease.Strengthening exercise and dietary intervention early on can help control the progression of simple fatty liver disease and reduce the risk of severe liver diseases such as steatohepatitis and cirrhosis.展开更多
Studies have shown that per-and polyfluoroalkyl substances(PFASs)may be hepatotoxic in animals or humans.However,data on clinical epidemiology are very limited.In this study,21PFASs were determined in patients with li...Studies have shown that per-and polyfluoroalkyl substances(PFASs)may be hepatotoxic in animals or humans.However,data on clinical epidemiology are very limited.In this study,21PFASs were determined in patients with liver diseases,with the highest median concentrations detected in the serum sample(26.7 ng/mL),followed by blood(10.7 ng/mL)and urine(5.02 ng/mL).Higher total PFAS concentrations were found in hepatocellular carcinoma(HCC)patients compared to non-HCC patients,with significant discrepancies in serum and blood samples.Besides,significant correlations were also found among PFAS concentrations and age,gender,body mass index(BMI),and liver function biomarkers levels.For example,PFAS concentrations are significantly higher in males than in females;Several serum PFASs concentrations increase with age and BMI,while the serum perfluorohexane sulfonic acid(PFHxS)concentrations are negatively correlated with age.In addition,multiple regression models adjusted for age,gender and BMI found that increased serum perfluorobutane sulfonic acid(PFBS),perfluoroheptane sulfonic acid(PFHpS)and perfluorohexylphosphonic acid(PFHxPA)conentrations are correlated with elevated alkaline phosphatase(ALP),aspartate aminotransferase(AST),and alpha-fetoprotein(AFP)(p<0.05).Our results provide epidemiological support for the future study on the potential clinical hepatotoxicity of PFAS.展开更多
BACKGROUND Hepatitis B cirrhosis(HBC)is a chronic disease characterized by irreversible diffuse liver damage and aggravated by intestinal microbial imbalance and metabolic dysfunction.Although the relationship between...BACKGROUND Hepatitis B cirrhosis(HBC)is a chronic disease characterized by irreversible diffuse liver damage and aggravated by intestinal microbial imbalance and metabolic dysfunction.Although the relationship between certain single probiotics and HBC has been explored,the impact of the complex ready-to-eat Lactobacillus paracasei N1115(LP N1115)supplement on patients with HBC has not been determined.AIM To compare the changes in the microbiota,inflammatory factor levels,and liver function before and after probiotic treatment in HBC patients.METHODS This study included 160 HBC patients diagnosed at the General Hospital of Ningxia Medical University between October 2018 and December 2020.Patients were randomly divided into an intervention group that received LP N1115 supplementation and routine treatment and a control group that received routine treatment only.Fecal samples were collected at the onset and conclusion of the 12-wk intervention period.The structure of the intestinal microbiota and the levels of serological indicators,such as liver function and inflammatory factors,were assessed.RESULTS Following LP N1115 intervention,the intestinal microbial diversity significantly increased in the intervention group(P<0.05),and the structure of the intestinal microbiota was characterized by an increase in the proportions of probiotic microbes and a reduction in harmful bacteria.Additionally,the intervention group demonstrated notable improvements in liver function indices and significantly lower levels of inflammatory factors(P<0.05).CONCLUSION LP N1115 is a promising treatment for ameliorating intestinal microbial imbalance in HBC patients by modulating the structure of the intestinal microbiota,improving liver function,and reducing inflammatory factor levels.展开更多
BACKGROUND This study was designed to investigate the clinical efficacy and safety of Gamma Knife®combined with transarterial chemoembolization(TACE)and immunotherapy in the treatment of primary liver cancer.AIM ...BACKGROUND This study was designed to investigate the clinical efficacy and safety of Gamma Knife®combined with transarterial chemoembolization(TACE)and immunotherapy in the treatment of primary liver cancer.AIM To investigate the clinical efficacy and safety of Gamma Knife®combined with TACE and immune-targeted therapy in the treatment of primary liver cancer.METHODS Clinical data from 51 patients with primary liver cancer admitted to our hospital between May 2018 and October 2022 were retrospectively collected.All patients underwent Gamma Knife®treatment combined with TACE and immunotherapy.The clinical efficacy,changes in liver function,overall survival(OS),and progression-free survival(PFS)of patients with different treatment responses were evaluated,and adverse reactions were recorded.RESULTS The last follow-up for this study was conducted on October 31,2023.Clinical evaluation of the 51 patients with primary liver cancer revealed a partial response(PR)in 27 patients,accounting for 52.94%(27/51);stable disease(SD)in 16 patients,accounting for 31.37%(16/51);and progressive disease(PD)in 8 patients,accounting for 15.69%(8/51).The objective response rate was 52.94%,and the disease control rate was 84.31%.Alanine aminotransferase,aspartate aminotransferase,lactate dehydrogenase,and alpha-fetoprotein isoform levels decreased after treatment compared with pretreatment(all P=0.000).The median OS was 26 months[95%confidence interval(95%CI):19.946-32.054]in the PR group and 19 months(95%CI:14.156-23.125)in the SD+PD group,with a statistically significant difference(P=0.015).The median PFS was 20 months(95%CI:18.441-34.559)in the PR group and 12 months(95%CI:8.745-13.425)in the SD+PD group,with a statistically significant difference(P=0.002).Common adverse reactions during treatment included nausea and vomiting(39.22%),thrombocytopenia(27.45%),and leukopenia(25.49%),with no treatment-related deaths reported.CONCLUSION Gamma Knife®combined with TACE and immune-targeted therapy is safe and effective in the treatment of primary liver cancer and has a good effect on improving the clinical benefit rate and liver function of patients.展开更多
Epidemiological data are scarce regarding the association of exposure to mixtures of per-and polyfluoroalkyl substances(PFASs)with liver injury in the general population.In the current study,therefore,we examined data...Epidemiological data are scarce regarding the association of exposure to mixtures of per-and polyfluoroalkyl substances(PFASs)with liver injury in the general population.In the current study,therefore,we examined data from the National Health and Nutrition Examination Survey(2009–2018).The PFAS exposure levels were defined by the serum concentrations of PFASs with over 70%detection in samples,namely perfluorooctanoic acid,perfluorononanoic acid,perfluorohexane sulfonic acid,perfluorodecanoic acid,and perfluorooctane sulfonic acid(PFOS).We evaluated liver injury from two aspects:first,the degree of liver inflammation was determined based on levels of the serum alanine aminotransferase,aspartate aminotransferase,glutamyltransferase,and total bilirubin;second,the degree of liver fibrosis was determined based on the fibrosis-4 index.We assessed the associations of individual or total PFAS exposure with these liver injury outcomes using multivariable linear and logistic regression models,restricted cubic splines,and weighted quantile sum regression.Among the samples of 7484 American adults,the median concentration of PFOS was the highest,followed by perfluorooctanoic acid and perfluorohexane sulfonic acid.Using multivariable linear regression,we observed positive correlations between all PFAS exposure and liver enzyme levels,such as alanine aminotransferase,aspartate aminotransferase,and total bilirubin.Additionally,the weighted quantile sum model indicated an overall positive association between exposure to the five PFASs and liver injury risk.For liver function biomarkers and liver fibrosis,perfluorononanoic acid and PFOS were the most heavily weighted chemicals,respectively.Our findings provide new epidemiological evidence indicating potential associations between PFAS exposure and adverse effects on liver injury biomarkers,highlighting the potentially harmful effects of PFAS exposure on human liver health.展开更多
BACKGROUND Hepatectomy is the first choice for treating liver cancer.However,inflammatory factors,released in response to pain stimulation,may suppress perioperative immune function and affect the prognosis of patient...BACKGROUND Hepatectomy is the first choice for treating liver cancer.However,inflammatory factors,released in response to pain stimulation,may suppress perioperative immune function and affect the prognosis of patients undergoing hepatectomies.AIM To determine the short-term efficacy of microwave ablation in the treatment of liver cancer and its effect on immune function.METHODS Clinical data from patients with liver cancer admitted to Suzhou Ninth People’s Hospital from January 2020 to December 2023 were retrospectively analyzed.Thirty-five patients underwent laparoscopic hepatectomy for liver cancer(liver cancer resection group)and 35 patients underwent medical image-guided microwave ablation(liver cancer ablation group).The short-term efficacy,complications,liver function,and immune function indices before and after treatment were compared between the two groups.RESULTS One month after treatment,19 patients experienced complete remission(CR),8 patients experienced partial remission(PR),6 patients experienced stable disease(SD),and 2 patients experienced disease progression(PD)in the liver cancer resection group.In the liver cancer ablation group,21 patients experienced CR,9 patients experienced PR,3 patients experienced SD,and 2 patients experienced PD.No significant differences in efficacy and complications were detected between the liver cancer ablation and liver cancer resection groups(P>0.05).After treatment,total bilirubin(41.24±7.35 vs 49.18±8.64μmol/L,P<0.001),alanine aminotransferase(30.85±6.23 vs 42.32±7.56 U/L,P<0.001),CD4+(43.95±5.72 vs 35.27±5.56,P<0.001),CD8+(20.38±3.91 vs 22.75±4.62,P<0.001),and CD4+/CD8+(2.16±0.39 vs 1.55±0.32,P<0.001)were significantly different between the liver cancer ablation and liver cancer resection groups.CONCLUSION The short-term efficacy and safety of microwave ablation and laparoscopic surgery for the treatment of liver cancer are similar,but liver function recovers quickly after microwave ablation,and microwave ablation may enhance immune function.展开更多
BACKGROUND Liver condition is a crucial prognostic factor for patients with hepatocellular carcinoma(HCC),but a convenient and comprehensive method to assess liver condition is lacking.Liver stiffness(LS)measured by t...BACKGROUND Liver condition is a crucial prognostic factor for patients with hepatocellular carcinoma(HCC),but a convenient and comprehensive method to assess liver condition is lacking.Liver stiffness(LS)measured by two-dimensional shear wave elastography may help in assessing liver fibrosis and liver condition.Chronic hepatitis B(CHB)is an important risk factor for HCC progression,but LS was found to be less reliable in assessing liver fibrosis following hepatitis viral eradication.We hypothesize that the status of hepatitis virus infection would affect the accuracy of LS in assessing the liver condition.AIM To test the feasibility and impact factors of using LS to assess liver condition in patients with HCC and CHB.METHODS A total of 284 patients were retrospectively recruited and classified into two groups on the basis of serum CHB virus hepatitis B virus(HBV)-DNA levels[HBV-DNA≥100.00 IU/mL as Pos group(n=200)and<100.00 IU/mL as Neg group(n=84)].Correlation analyses and receiver operating characteristic analyses were conducted to evaluate the relationship between LS and liver condition.RESULTS A significant correlation was found between LS and most of the parameters considered to have the ability to evaluate liver condition(P<0.05).When alanine aminotransferase(ALT)concentrations were normal(≤40 U/L),LS was correlated with liver condition indices(P<0.05),but the optimal cutoff of LS to identify a Child-Pugh score of 5 was higher in the Neg group(9.30 kPa)than the Pos group(7.40 kPa).When ALT levels were elevated(>40 U/L),the correlations between LS and liver condition indices were not significant(P>0.05).CONCLUSION LS was significantly correlated with most liver condition indices in patients with CHB and HCC.However,these correlations varied according to differences in HBV-DNA and transaminase concentrations.展开更多
Objective Cachexia occurs in approximately half of hepatocellular carcinoma(HCC)patients as the disease progresses and is correlated with a poor prognosis.Therefore,early identification of HCC patients at risk of deve...Objective Cachexia occurs in approximately half of hepatocellular carcinoma(HCC)patients as the disease progresses and is correlated with a poor prognosis.Therefore,early identification of HCC patients at risk of developing cachexia and their prognosis is crucial.This study investigated the functional liver imaging score(FLIS)derived from gadoxetic acid-enhanced magnetic resonance imaging(MRI)to identify cachexia in HCC patients and their prognosis.Methods Pretreatment clinical and MRI data from 339 HCC patients who underwent gadoxetic acid-enhanced MRI scans were retrospectively collected.Patient weights were recorded for 6 months following the MRI scan to diagnose cachexia.The FLIS was calculated as the sum of the enhancement quality score,the excretion quality score,and the portal vein sign quality score.A Cox proportional hazards model was used to determine the significant factors affecting overall survival(OS).Multivariable logistic regression was then conducted to identify variables predicting cachexia in HCC patients,which were subsequently used to predict OS.Results Cox regression analysis revealed a significant association between cachexia and worse OS.Both FLIS(0–4 vs.5–6 points)(OR,9.20;95%CI:4.68–18.10;P<0.001)andα-fetoprotein>100 ng/mL(OR,4.08;95%CI:2.13–7.83;P<0.001)emerged as significant predictors of cachexia in patients with HCC.Furthermore,FLIS(0–4 vs.5–6 points)(HR,1.73;95%CI:1.19–2.51;P=0.004)was significantly associated with OS.Patients in the FLIS 0–4 points group had shorter OS than those in the FLIS 5–6 points group[20 months(95%CI,14.7–25.3)vs.43 months(95%CI,27.7–58.3);P=0.001].Conclusion Cachexia was associated with worse OS.The functional liver imaging score emerged as a significant predictor of cachexia in HCC patients and their prognosis.展开更多
Objective:To explore the effect of transarterial chemoembolization(TACE)+CT-guided microwave ablation(MWA)on treating patients with primary liver cancer.Methods:78 primary liver cancer cases were enrolled and divided ...Objective:To explore the effect of transarterial chemoembolization(TACE)+CT-guided microwave ablation(MWA)on treating patients with primary liver cancer.Methods:78 primary liver cancer cases were enrolled and divided into groups according to their assigned surgical plans.The control group was treated with TACE alone,and the observation group was treated with TACE+CT-guided MWA.The efficacy of the treatment and the liver function indicators and follow-up results of the patients of the two groups were compared.Results:The efficacy of the treatment received by the observation group was higher than that of the control group.Besides,the patients in the observation group exhibited better improvement in liver function indicators after 3 months of treatment.Furthermore,the survival rates of 1 and 2 years after surgery of the observation group were all higher than those of the control group(P<0.05).Conclusion:TACE combined with CT-guided MWA is more effective in treating primary liver cancer compared to TACE alone.Besides,it resulted in better improvement of liver function and long-term survival rate.Therefore,this treatment regime should be popularized.展开更多
To study the effects of noise pollution on the functions of the liver and kidney of rats, a total of 40 male SPF Wistar rats were randomly divided into a control group and three experimental groups. The rats in the ex...To study the effects of noise pollution on the functions of the liver and kidney of rats, a total of 40 male SPF Wistar rats were randomly divided into a control group and three experimental groups. The rats in the experimental groups were respectively stimulated with 38, 55 and 70 dB noise for 15 days, and the levels of blood components were determined by an automatic biochemical analyzer. The results showed that in compari-son with the control group, the level of the blood glucose in the experimental groups increased by 23.53%, 52.94% and 88.24%, respectively, and the differences were statistically significant （P〈0.01）. The levels of triglyceride in the blood rose by 20.83%, 38.54% and 79.68%, respectively, and the differences were also statistically significant （P〈0.01）. The level of globulin in the blood increased by 16.49%, 21.13% and 51.78%, and the level of albumin in the blood rose by 9.51 %, 12.67% and 17.89%, respectively. The level of total bilirubin in the blood increased by 27.04%, 41.63% and 73.67%, respectively, and the differences were statistically significant （P〈0.01）. The level of creatinine in the blood rose by 9.72%, 10.21% and 20.99%, respectively. The level of amylase in the blood reduced by 6.6%, 13.05% and 23.89%, respectively. The level of creatine kinase in the blood decreased by 19.81%, 27.37% and 36.81 %, respectively, and the level of urea in the blood reduced by 11.19%, 12.77% and 19.26%, respectively. The results revealed that noise pollution could significantly affect the levels of blood components and the functions of the liver and kidney of rats.展开更多
文摘The current study was performed to evaluate the liver function status as well as molecular characterization of the recovered worms in rats experimentally infected with F. hepatica. Sixteen male Wister rats aged 30 days were randomly allocated into two groups (n = 8). The first group was infected orally with 15 viable encysted metacercaria of F. hepatica per animal. The other group was kept non-infected (control group). At zero time (before infection), the 2<sup>nd</sup>, 4<sup>th</sup>, 6<sup>th</sup>, 8<sup>th</sup>, 10<sup>th</sup>, 12<sup>th</sup> and 14<sup>th</sup> weeks post-infection (WPI), blood and serum samples were collected via puncture of retro-orbital plexus of veins from each rat. Serum enzyme level (AST and ALT) and total protein were measured, and the serum protein profile was carried out using agarose gel electrophoresis. During the period of the experiment, serum ALT and AST activities and serum total globulins significantly increased while serum total proteins and albumin markedly decreased in the infected group. On the 14<sup>th</sup> WPI, the data of the electropherogram showed that globulin fractions (α1-, β- and γ-globulin) levels were significantly increased while α2-globulin was markedly decreased in the infected group. The molecular analysis confirmed the amplification of the ITS1, ITS2 and NDI genes of F. hepatica recovered from the infected liver of rats with amplicon sizes of 630, 510 and 560 bp, respectively. Sequencing of the amplified ITS gene resulted in the determination of 3 strains (PP108836, PP108837, and PP108838). Also, analysis of the ITS2 gene resulted in obtaining 3 isolates under the accession numbers (PP109065, PP109066, and PP109067). In conclusion, fasciolosis in the rat model is suitable for routine experimental infections and caused a pronounced liver dysfunction with discharging of the Fasciola eggs in the faeces and the development of adult stages in the bile ducts. Furthermore, molecular techniques are a sensitive tool for the identification and characterisation of the Fasciola parasite.
文摘BACKGROUND This case report describes a protocol developed by Danaun Medical Clinic for the introduction of a pioneering intervention comprising intravenous human placen-tal extract(HPE)therapy to improve the liver function of patients with chronic liver disease(CLD).CASE SUMMARY This study involved data from patients whose chief complaint was reduced quality of life attributable to CLD.The new treatment approach resulted in improvements in the liver function and fatty liver of 30 patients with CLD.Im-provements were observed using abdominal ultrasonography.Unlike traditional methods,this protocol provided more sustainable and meaningful results.Treat-ment with 10 mL of HPE administered intravenously once or twice per week significantly improved liver function.The observed improvements in fatty liver and liver function suggest the utility of this approach for the management of patients with CLD.CONCLUSION This case series highlights the potential of innovative treatments for patients with CLD that could improve the quality of life of the patients.
基金supported by the Budgeted Fund of Shanghai University of Traditional Chinese Medicine(Natural Science)(No.2021LK037)the Open Project of Qinghai Province Key Laboratory of Tibetan Medicine Pharmacology and Safety Evaluation(No.2021-ZY-03).
文摘Objective Rheumatoid arthritis(RA)is a systemic autoimmune disease that affects the small joints of the whole body and degrades the patients’quality of life.Zhengqing Fengtongning(ZF)is a traditional Chinese medicine preparation used to treat RA.ZF may cause liver injury.In this study,we aimed to develop a prediction model for abnormal liver function caused by ZF.Methods This retrospective study collected data from multiple centers from January 2018 to April 2023.Abnormal liver function was set as the target variable according to the alanine transaminase(ALT)level.Features were screened through univariate analysis and sequential forward selection for modeling.Ten machine learning and deep learning models were compared to find the model that most effectively predicted liver function from the available data.Results This study included 1,913 eligible patients.The LightGBM model exhibited the best performance(accuracy=0.96)out of the 10 learning models.The predictive metrics of the LightGBM model were as follows:precision=0.99,recall rate=0.97,F1_score=0.98,area under the curve(AUC)=0.98,sensitivity=0.97 and specificity=0.85 for predicting ALT<40 U/L;precision=0.60,recall rate=0.83,F1_score=0.70,AUC=0.98,sensitivity=0.83 and specificity=0.97 for predicting 40≤ALT<80 U/L;and precision=0.83,recall rate=0.63,F1_score=0.71,AUC=0.97,sensitivity=0.63 and specificity=1.00 for predicting ALT≥80 U/L.ZF-induced abnormal liver function was found to be associated with high total cholesterol and triglyceride levels,the combination of TNF-αinhibitors,JAK inhibitors,methotrexate+nonsteroidal anti-inflammatory drugs,leflunomide,smoking,older age,and females in middle-age(45-65 years old).Conclusion This study developed a model for predicting ZF-induced abnormal liver function,which may help improve the safety of integrated administration of ZF and Western medicine.
基金Supported by WBE Liver Foundation,No.WBE20220182022 Young and Middle-aged Talents Incubation Project(Youth Innovation)of Beijing Youan Hospital,Capital Medical University,No.BJYAYY-YN-2022-092023 Young and Middle-aged Talents Incubation Project(Youth Innovation)of Beijing Youan Hospital,Capital Medical University,No.BJYAYYYN2023-14.
文摘BACKGROUND Autoimmune liver diseases,including primary biliary cholangitis(PBC),autoi-mmune hepatitis(AIH),and their overlap syndrome(OS),involve immune-mediated liver injury,with OS occurring in 1.2%-25%of PBC patients.OS carries a higher risk of cirrhosis,hepatocellular carcinoma,and reduced survival.While its pathogenesis remains unclear,gut microbiota dysbiosis and serum metabolite alterations may play key roles.This study uses 16S rRNA sequencing and liquid chromatography-mass spec-trometry(LC-MS)metabolomics to compare gut microbiota and serum metabolites among PBC,AIH,and OS patients,and explores their associations with liver function.AIM To differentiate OS from PBC and AIH based on gut microbiota,serum metabolites,and liver function.METHODS Gut microbiota profiles were analyzed using 16S rRNA sequencing,while untargeted serum metabolomics was conducted via LC-MS.Comparative analyses were performed to identify differences in microbial composition and serum metabolite levels among PBC,AIH,and OS groups.Correlation analyses and network visualization tech-niques were applied to elucidate the interactions among liver function parameters,gut microbiota,and serum metabolites in OS patients.RESULTS Compared to patients with PBC or AIH,OS patients demonstrated significantly reduced microbial diversity and richness.Notable taxonomic shifts included decreased abundances of Firmicutes,Bacteroidetes,and Actinobacteria,alongside increased levels of Proteobacteria and Verrucomicrobia.Distinct serum metabolites,such as pentadecanoic acid and aminoimidazole carboxamide ribonucleotide,were identified in OS patients.Correlation analysis revealed that aspartate aminotransferase(AST)levels were negatively associated with the bacterial genus Fusicatenibacter and the metabolite L-Tyrosine.A microbial-metabolite network diagram further confirmed a strong association between Fusicatenibacter and L-Tyrosine in OS patients.CONCLUSION OS patients show decreased gut microbiota diversity and unique serum metabolites.Multi-omics linked AST,Fusicatenibacter,and L-Tyrosine,revealing OS mechanisms and diagnostic potential.
文摘This editorial comment is on the article by Xu et al.It offers an in-depth analysis of liver function assessment tools and their prognostic roles in non-malignant liver diseases,with a focus on the albumin-bilirubin(ALBI)score.ALBI’s components,grading system,and clinical relevance across various liver conditions are reviewed and compared with traditional models such as the Child-Pugh and model for end-stage liver disease scores.We included recent studies evaluating ALBI’s role in estimating liver function,suggesting it may help differentiate patients who appear similar under other staging systems,and assist in guiding clinical decisions.Although ALBI is primarily used as an indicator of hepatic reservoir in hepatocellular carcinoma,it has been demonstrated a positive correlation with overall survival,tumor recurrence,and post-hepatectomy liver failure in patients undergoing potentially curative treatments such as liver resection,liver transplantation,and local ablation.Moreover,several studies suggest that ALBI can also predict survival outcomes,treatment-related toxicity,and liver-related complications in patients receiving trans-arterial chemoembolization,radioembolization,external-beam radiotherapy,or systemic therapies.Its growing use in nonmalignant liver diseases,including primary biliary cholangitis,cirrhosis,acute and chronic liver failure,and viral hepatitis highlights the need for large,prospective studies.Further studies are warranted to validate the integration of ALBI into routine clinical practice and to clarify its role in guiding prognosis and treatment planning.
基金supported by the CAMS Innovation Fund for Medical Sciences(2024-12M-C&T-B-045).
文摘BACKGROUND:Preoperative liver function in children with congenital heart disease is often compromised to varying degrees because of the unique pathophysiology.We aimed to investigate the relationships between liver function indicators at hospital admission and mortality in children receiving venoarterial extracorporeal membrane oxygenation(VA-ECMO)support following cardiac surgery.METHODS:We retrospectively analysed the clinical data of pediatric patients who received postcardiotomy VA-ECMO support at Fuwai Hospital between January 2010 and June 2020.Univariable and multivariable-adjusted Cox proportional hazard models were constructed to evaluate the risk factors associated with 30-day and 180-day mortality.The cut-off values for the liver function variables measured at hospital admission were categorized into high and low groups and then compared using Kaplan-Meier survival curves and log-rank tests.RESULTS:Our study included 96 pediatric patients who received VA-ECMO support after cardiotomy.Among the patients receiving VA-ECMO,the 30-day and 180-day mortality rates were 37.5% and 52.1%,respectively.The level of aspartate aminotransferase(AST)at admission was associated with 30-day mortality(hazard ratios[HRs]=1.852,95%CI 1.010-3.398,P=0.046).The AST and alkaline phosphatase(ALP)levels were predictors of 180-day mortality,with adjusted HRs of 1.799(95%CI 1.074-3.014;P=0.025)and 1.384(95%CI 1.050-1.825;P=0.021),respectively.The cut-off value for AST to predict mortality at 30 d was 77 U/L,and that for ALP to predict mortality at 180 d was 269 U/L.CONCLUSION:Liver function indicators,including AST and ALP,at hospital admission are associated with mortality risk in children with congenital heart disease receiving VA-ECMO after cardiac surgery.
基金Supported by the National Key Specialty Major Scientific Research Project of the Hunan Provincial Health Commission,No.Z2023158.
文摘BACKGROUND Diabetes mellitus(DM)and metabolic-associated fatty liver disease(MAFLD)are common metabolic disorders,and their coexistence can exacerbate the progression of either disease.Human umbilical cord mesenchymal stem cell(hUCMSC)therapy has shown promising potential in the treatment of several metabolic diseases.AIM To investigate how hUC-MSCs affect liver metabolism in diabetic rats with MAFLD and assess their therapeutic potential and underlying mechanisms.METHODS A streptozotocin-induced rat model of DM with MAFLD was established,and hUC-MSCs were administered via tail vein injection.Changes in body weight,fasting blood glucose(FBG),and serum triglyceride(TG),alanine aminotransferase,aspartate aminotransferase levels,and pathological changes of liver were evaluated.Receiver operating characteristic analysis was used to assess the diagnostic value of differential metabolites and their ability to predict the therapeutic effects of hUC-MSCs.Spearman correlation was employed to analyze the relationships between liver metabolites and key biochemical markers.RESULTS hUC-MSC treatment significantly reduced FBG and TG levels in diabetic rats with MAFLD and improved histological steatosis and injury in the liver.Metabolomic analysis indicated that hUC-MSCs significantly ameliorated liver metabolic disturbances via their regulatory effect on several key metabolic pathways related to carbohydrate,amino acid,and lipid metabolism.Receiver operating characteristic curve analysis revealed that 70 differential metabolites had good diagnostic value for DM with MAFLD and could effectively predict the therapeutic effect of hUC-MSCs.Moreover,Spearman correlation analysis confirmed that significant correlations existed between differential liver metabolites and the concentrations of biochemical markers(FBG,TG,alanine aminotransferase,aspartate aminotransferase).CONCLUSION hUC-MSCs alleviate liver metabolic disturbances in diabetic rats with MAFLD,thereby mitigating the pathological state of DM and slowing the progression of MAFLD.
基金Supported by Guangdong Provincial Hospital of Chinese Medicine Science and Technology Research Special Project,No.YN2023WSSQ01State Key Laboratory of Traditional Chinese Medicine Syndrome.
文摘BACKGROUND Research has shown that several factors can influence postoperative abnormal liver function;however,most studies on this issue have focused specifically on hepatic and cardiac surgeries,leaving limited research on contributing factors in other types of surgeries.AIM To identify the risk factors for early postoperative abnormal liver function in multiple surgery types and construct a risk prediction model.METHODS This retrospective cohort study involved 3720 surgical patients from 5 surgical departments at Guangdong Provincial Hospital of Traditional Chinese Medicine.Patients were divided into abnormal(n=108)and normal(n=3612)groups based on liver function post-surgery.Univariate analysis and LASSO regression screened variables,followed by logistic regression to identify risk factors.A prediction model was constructed based on the variables selected via logistic re-gression.The goodness-of-fit of the model was evaluated using the Hosm-er–Lemeshow test,while discriminatory ability was measured by the area under the receiver operating characteristic curve.Calibration curves were plotted to visualize the consistency between predicted probabilities and observed outcomes.RESULTS The key factors contributing to abnormal liver function after surgery include elevated aspartate aminotransferase and alanine aminotransferase levels and reduced platelet counts pre-surgery,as well as the sevoflurane use during the procedure,among others.CONCLUSION The above factors collectively represent notable risk factors for postoperative liver function injury,and the prediction model developed based on these factors demonstrates strong predictive efficacy.
文摘BACKGROUND Insulin resistance is a cardiometabolic risk factor characterized by elevated insulin levels.It is associated with fatty liver disease and elevated liver function tests(LFT)in cross-sectional studies,but data from cohort studies are scarce.AIM To investigate the association between insulin and pathological LFT,liver disease,and cirrhosis in a populationbased retrospective cohort study.METHODS Anthropometric and cardiometabolic factors of 857 men and 1228 women from prospective cohort studies were used.LFT were obtained at two time points 8 years to 24 years after baseline.Liver disease diagnoses were obtained from nationwide registries.The association between insulin levels and the development of elevated LFT or liver disease and cirrhosis was analyzed.RESULTS Total follow-up was 54054 person-years for women and 27556 person-years for men.Insulin levels were positively correlated with elevated LFT during follow-up,whereas physical activity and coffee consumption were negatively correlated.Individuals with both insulin levels in the upper tertile and alcohol consumption above MASLD thresholds had an increased risk for both liver disease,adjusted hazard ratio(aHR)of 4.3(95%CI:1.6-14.6)and cirrhosis(aHR=4.8,95%CI:1.6-14.6).CONCLUSION This population-based study provides evidence that high insulin levels are a risk factor for development of elevated liver enzymes and clinically manifest liver disease.The results support the concept of metabolic dysfunction associated liver disease.
文摘BACKGROUND The treatment of patients with liver cancer after surgery with the artificial liver support system combined with traditional Chinese medicine(TCM)for strengthening the body and removing blood stasis is a new idea.AIM To analyze the post-surgical effect of the artificial liver support system with TCM in patients with liver cancer.METHODS Ninety-eight patients with liver cancer who underwent surgical treatment at the Fifth People’s Hospital of Huai’an from January 2023-2024 were selected and divided into two groups(49 patients each)via random lottery method.Both groups underwent surgery.The control group received artificial liver support,and the observation group was additionally treated with TCM for strengthening the body and removing blood stasis.Gastrointestinal recovery,liver function,tumor marker levels,immune function,and safety were compared between both groups.RESULTS There were significant differences in the levels of indicators related to gastrointestinal recovery between the groups(P<0.05).After treatment,the levels of alanine aminotransferase,aspartate aminotransferase,total bilirubin,and gamma-glutamyl transpeptidase in the observation group were lower,whereas the albumin level was higher(P<0.05).After treatment,tumor marker levels in the observation group were relatively lower(P<0.05).After treatment,compared to the control group,the CD4+level in the observation group was higher and the CD8+level was lower(P<0.05).There was no significant difference in the incidence of adverse reactions between both groups(P>0.05).CONCLUSION Combining the artificial liver support system with TCM significantly improves liver and gastrointestinal functions,enhances immune responses,and reduces tumor marker levels with high safety,suggesting that it could be a promising approach for optimizing postoperative care and improving patient outcomes,potentially reducing complications and enhancing quality of life.
文摘Objective:To study the clinical value of combined detection of blood lipids,blood glucose,and liver function in non-alcoholic fatty liver disease.Methods:105 patients with non-alcoholic fatty liver disease treated in our hospital from May 2022 to July 2024 were selected as the research subjects.All patients underwent a B-ultrasound examination.According to the severity of the disease,they were divided into group A(mild,n=35),group B(moderate,n=44),and group C(severe,n=26).Another 30 healthy residents who came to the hospital for physical examination during the same period were selected as group D.The differences in blood lipids,blood glucose,and liver function indicators between groups were compared.Results:The triglyceride(TG),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL)levels in groups A,B,and C were higher than those in group D,while the high-density lipoprotein cholesterol(HDL)level was lower(P<0.05).The fasting plasma glucose(FPG)levels in groups B and C were higher than those in group D(P<0.05).The TG,LDL,and FPG levels in groups B and C were higher than those in group A(P<0.05).The TC level in group C was higher than that in group A,while the HDL level was lower(P<0.05).The TC and FPG levels in group C were higher than those in group B(P<0.05).The total bilirubin(TBil),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)levels in groups A,B,and C were higher than those in group D(P<0.05).The TBil and ALT levels in groups B and C were higher than those in group A(P<0.05).The AST level in group C was higher than that in group A(P<0.05).The AST and ALT levels in group C were higher than those in group B(P<0.05).Conclusion:Patients with non-alcoholic fatty liver disease have disordered glucose and lipid metabolism.Blood lipids,blood glucose,and liver function are closely related to the severity of the disease.Strengthening exercise and dietary intervention early on can help control the progression of simple fatty liver disease and reduce the risk of severe liver diseases such as steatohepatitis and cirrhosis.
基金supported by the National Natural Science Foundation of China(No.42177408)Guangdong(China)Innovative and Entrepreneurial Research Team Program(No.2016ZT06N258)。
文摘Studies have shown that per-and polyfluoroalkyl substances(PFASs)may be hepatotoxic in animals or humans.However,data on clinical epidemiology are very limited.In this study,21PFASs were determined in patients with liver diseases,with the highest median concentrations detected in the serum sample(26.7 ng/mL),followed by blood(10.7 ng/mL)and urine(5.02 ng/mL).Higher total PFAS concentrations were found in hepatocellular carcinoma(HCC)patients compared to non-HCC patients,with significant discrepancies in serum and blood samples.Besides,significant correlations were also found among PFAS concentrations and age,gender,body mass index(BMI),and liver function biomarkers levels.For example,PFAS concentrations are significantly higher in males than in females;Several serum PFASs concentrations increase with age and BMI,while the serum perfluorohexane sulfonic acid(PFHxS)concentrations are negatively correlated with age.In addition,multiple regression models adjusted for age,gender and BMI found that increased serum perfluorobutane sulfonic acid(PFBS),perfluoroheptane sulfonic acid(PFHpS)and perfluorohexylphosphonic acid(PFHxPA)conentrations are correlated with elevated alkaline phosphatase(ALP),aspartate aminotransferase(AST),and alpha-fetoprotein(AFP)(p<0.05).Our results provide epidemiological support for the future study on the potential clinical hepatotoxicity of PFAS.
基金Supported by The Health System Research Project of Ningxia Hui Autonomous Region of China,No.2022-NWKY-061.
文摘BACKGROUND Hepatitis B cirrhosis(HBC)is a chronic disease characterized by irreversible diffuse liver damage and aggravated by intestinal microbial imbalance and metabolic dysfunction.Although the relationship between certain single probiotics and HBC has been explored,the impact of the complex ready-to-eat Lactobacillus paracasei N1115(LP N1115)supplement on patients with HBC has not been determined.AIM To compare the changes in the microbiota,inflammatory factor levels,and liver function before and after probiotic treatment in HBC patients.METHODS This study included 160 HBC patients diagnosed at the General Hospital of Ningxia Medical University between October 2018 and December 2020.Patients were randomly divided into an intervention group that received LP N1115 supplementation and routine treatment and a control group that received routine treatment only.Fecal samples were collected at the onset and conclusion of the 12-wk intervention period.The structure of the intestinal microbiota and the levels of serological indicators,such as liver function and inflammatory factors,were assessed.RESULTS Following LP N1115 intervention,the intestinal microbial diversity significantly increased in the intervention group(P<0.05),and the structure of the intestinal microbiota was characterized by an increase in the proportions of probiotic microbes and a reduction in harmful bacteria.Additionally,the intervention group demonstrated notable improvements in liver function indices and significantly lower levels of inflammatory factors(P<0.05).CONCLUSION LP N1115 is a promising treatment for ameliorating intestinal microbial imbalance in HBC patients by modulating the structure of the intestinal microbiota,improving liver function,and reducing inflammatory factor levels.
文摘BACKGROUND This study was designed to investigate the clinical efficacy and safety of Gamma Knife®combined with transarterial chemoembolization(TACE)and immunotherapy in the treatment of primary liver cancer.AIM To investigate the clinical efficacy and safety of Gamma Knife®combined with TACE and immune-targeted therapy in the treatment of primary liver cancer.METHODS Clinical data from 51 patients with primary liver cancer admitted to our hospital between May 2018 and October 2022 were retrospectively collected.All patients underwent Gamma Knife®treatment combined with TACE and immunotherapy.The clinical efficacy,changes in liver function,overall survival(OS),and progression-free survival(PFS)of patients with different treatment responses were evaluated,and adverse reactions were recorded.RESULTS The last follow-up for this study was conducted on October 31,2023.Clinical evaluation of the 51 patients with primary liver cancer revealed a partial response(PR)in 27 patients,accounting for 52.94%(27/51);stable disease(SD)in 16 patients,accounting for 31.37%(16/51);and progressive disease(PD)in 8 patients,accounting for 15.69%(8/51).The objective response rate was 52.94%,and the disease control rate was 84.31%.Alanine aminotransferase,aspartate aminotransferase,lactate dehydrogenase,and alpha-fetoprotein isoform levels decreased after treatment compared with pretreatment(all P=0.000).The median OS was 26 months[95%confidence interval(95%CI):19.946-32.054]in the PR group and 19 months(95%CI:14.156-23.125)in the SD+PD group,with a statistically significant difference(P=0.015).The median PFS was 20 months(95%CI:18.441-34.559)in the PR group and 12 months(95%CI:8.745-13.425)in the SD+PD group,with a statistically significant difference(P=0.002).Common adverse reactions during treatment included nausea and vomiting(39.22%),thrombocytopenia(27.45%),and leukopenia(25.49%),with no treatment-related deaths reported.CONCLUSION Gamma Knife®combined with TACE and immune-targeted therapy is safe and effective in the treatment of primary liver cancer and has a good effect on improving the clinical benefit rate and liver function of patients.
文摘Epidemiological data are scarce regarding the association of exposure to mixtures of per-and polyfluoroalkyl substances(PFASs)with liver injury in the general population.In the current study,therefore,we examined data from the National Health and Nutrition Examination Survey(2009–2018).The PFAS exposure levels were defined by the serum concentrations of PFASs with over 70%detection in samples,namely perfluorooctanoic acid,perfluorononanoic acid,perfluorohexane sulfonic acid,perfluorodecanoic acid,and perfluorooctane sulfonic acid(PFOS).We evaluated liver injury from two aspects:first,the degree of liver inflammation was determined based on levels of the serum alanine aminotransferase,aspartate aminotransferase,glutamyltransferase,and total bilirubin;second,the degree of liver fibrosis was determined based on the fibrosis-4 index.We assessed the associations of individual or total PFAS exposure with these liver injury outcomes using multivariable linear and logistic regression models,restricted cubic splines,and weighted quantile sum regression.Among the samples of 7484 American adults,the median concentration of PFOS was the highest,followed by perfluorooctanoic acid and perfluorohexane sulfonic acid.Using multivariable linear regression,we observed positive correlations between all PFAS exposure and liver enzyme levels,such as alanine aminotransferase,aspartate aminotransferase,and total bilirubin.Additionally,the weighted quantile sum model indicated an overall positive association between exposure to the five PFASs and liver injury risk.For liver function biomarkers and liver fibrosis,perfluorononanoic acid and PFOS were the most heavily weighted chemicals,respectively.Our findings provide new epidemiological evidence indicating potential associations between PFAS exposure and adverse effects on liver injury biomarkers,highlighting the potentially harmful effects of PFAS exposure on human liver health.
文摘BACKGROUND Hepatectomy is the first choice for treating liver cancer.However,inflammatory factors,released in response to pain stimulation,may suppress perioperative immune function and affect the prognosis of patients undergoing hepatectomies.AIM To determine the short-term efficacy of microwave ablation in the treatment of liver cancer and its effect on immune function.METHODS Clinical data from patients with liver cancer admitted to Suzhou Ninth People’s Hospital from January 2020 to December 2023 were retrospectively analyzed.Thirty-five patients underwent laparoscopic hepatectomy for liver cancer(liver cancer resection group)and 35 patients underwent medical image-guided microwave ablation(liver cancer ablation group).The short-term efficacy,complications,liver function,and immune function indices before and after treatment were compared between the two groups.RESULTS One month after treatment,19 patients experienced complete remission(CR),8 patients experienced partial remission(PR),6 patients experienced stable disease(SD),and 2 patients experienced disease progression(PD)in the liver cancer resection group.In the liver cancer ablation group,21 patients experienced CR,9 patients experienced PR,3 patients experienced SD,and 2 patients experienced PD.No significant differences in efficacy and complications were detected between the liver cancer ablation and liver cancer resection groups(P>0.05).After treatment,total bilirubin(41.24±7.35 vs 49.18±8.64μmol/L,P<0.001),alanine aminotransferase(30.85±6.23 vs 42.32±7.56 U/L,P<0.001),CD4+(43.95±5.72 vs 35.27±5.56,P<0.001),CD8+(20.38±3.91 vs 22.75±4.62,P<0.001),and CD4+/CD8+(2.16±0.39 vs 1.55±0.32,P<0.001)were significantly different between the liver cancer ablation and liver cancer resection groups.CONCLUSION The short-term efficacy and safety of microwave ablation and laparoscopic surgery for the treatment of liver cancer are similar,but liver function recovers quickly after microwave ablation,and microwave ablation may enhance immune function.
基金Supported by Natural Science Foundation of Guangdong Province,No.2023A1515012464 and No.2022A1515011716Basic and Applied Basic Research Foundation of Guangdong Province,No.2022A1515110666。
文摘BACKGROUND Liver condition is a crucial prognostic factor for patients with hepatocellular carcinoma(HCC),but a convenient and comprehensive method to assess liver condition is lacking.Liver stiffness(LS)measured by two-dimensional shear wave elastography may help in assessing liver fibrosis and liver condition.Chronic hepatitis B(CHB)is an important risk factor for HCC progression,but LS was found to be less reliable in assessing liver fibrosis following hepatitis viral eradication.We hypothesize that the status of hepatitis virus infection would affect the accuracy of LS in assessing the liver condition.AIM To test the feasibility and impact factors of using LS to assess liver condition in patients with HCC and CHB.METHODS A total of 284 patients were retrospectively recruited and classified into two groups on the basis of serum CHB virus hepatitis B virus(HBV)-DNA levels[HBV-DNA≥100.00 IU/mL as Pos group(n=200)and<100.00 IU/mL as Neg group(n=84)].Correlation analyses and receiver operating characteristic analyses were conducted to evaluate the relationship between LS and liver condition.RESULTS A significant correlation was found between LS and most of the parameters considered to have the ability to evaluate liver condition(P<0.05).When alanine aminotransferase(ALT)concentrations were normal(≤40 U/L),LS was correlated with liver condition indices(P<0.05),but the optimal cutoff of LS to identify a Child-Pugh score of 5 was higher in the Neg group(9.30 kPa)than the Pos group(7.40 kPa).When ALT levels were elevated(>40 U/L),the correlations between LS and liver condition indices were not significant(P>0.05).CONCLUSION LS was significantly correlated with most liver condition indices in patients with CHB and HCC.However,these correlations varied according to differences in HBV-DNA and transaminase concentrations.
基金supported by grants from National Natural Science Foundation of China(No.82272064)Jiangsu Provincial Science and Technique Program(No.BK20221461)Zhongda Hospital Affiliated to Southeast University,Jiangsu Province High-level Hospital Paring Assistance Construction(No.zdlyg08).
文摘Objective Cachexia occurs in approximately half of hepatocellular carcinoma(HCC)patients as the disease progresses and is correlated with a poor prognosis.Therefore,early identification of HCC patients at risk of developing cachexia and their prognosis is crucial.This study investigated the functional liver imaging score(FLIS)derived from gadoxetic acid-enhanced magnetic resonance imaging(MRI)to identify cachexia in HCC patients and their prognosis.Methods Pretreatment clinical and MRI data from 339 HCC patients who underwent gadoxetic acid-enhanced MRI scans were retrospectively collected.Patient weights were recorded for 6 months following the MRI scan to diagnose cachexia.The FLIS was calculated as the sum of the enhancement quality score,the excretion quality score,and the portal vein sign quality score.A Cox proportional hazards model was used to determine the significant factors affecting overall survival(OS).Multivariable logistic regression was then conducted to identify variables predicting cachexia in HCC patients,which were subsequently used to predict OS.Results Cox regression analysis revealed a significant association between cachexia and worse OS.Both FLIS(0–4 vs.5–6 points)(OR,9.20;95%CI:4.68–18.10;P<0.001)andα-fetoprotein>100 ng/mL(OR,4.08;95%CI:2.13–7.83;P<0.001)emerged as significant predictors of cachexia in patients with HCC.Furthermore,FLIS(0–4 vs.5–6 points)(HR,1.73;95%CI:1.19–2.51;P=0.004)was significantly associated with OS.Patients in the FLIS 0–4 points group had shorter OS than those in the FLIS 5–6 points group[20 months(95%CI,14.7–25.3)vs.43 months(95%CI,27.7–58.3);P=0.001].Conclusion Cachexia was associated with worse OS.The functional liver imaging score emerged as a significant predictor of cachexia in HCC patients and their prognosis.
文摘Objective:To explore the effect of transarterial chemoembolization(TACE)+CT-guided microwave ablation(MWA)on treating patients with primary liver cancer.Methods:78 primary liver cancer cases were enrolled and divided into groups according to their assigned surgical plans.The control group was treated with TACE alone,and the observation group was treated with TACE+CT-guided MWA.The efficacy of the treatment and the liver function indicators and follow-up results of the patients of the two groups were compared.Results:The efficacy of the treatment received by the observation group was higher than that of the control group.Besides,the patients in the observation group exhibited better improvement in liver function indicators after 3 months of treatment.Furthermore,the survival rates of 1 and 2 years after surgery of the observation group were all higher than those of the control group(P<0.05).Conclusion:TACE combined with CT-guided MWA is more effective in treating primary liver cancer compared to TACE alone.Besides,it resulted in better improvement of liver function and long-term survival rate.Therefore,this treatment regime should be popularized.
基金Supported by the Science and Technology Innovation Team Project of Colleges and Universities in Gansu Province(2016C-09)National Natural Science Foundation of Gansu Province(17JR5RA158)+3 种基金Talent Innovation and Venture Project of Lanzhou City(2016-RC-85)Project of Research Center of Investigation Theory and Practice in Northwest Ethnic RegionsCharacteristic Subject Project of Evidence Science of Gansu ProvinceScience and Technology Project of Lanzhou City(2015-3-80)
文摘To study the effects of noise pollution on the functions of the liver and kidney of rats, a total of 40 male SPF Wistar rats were randomly divided into a control group and three experimental groups. The rats in the experimental groups were respectively stimulated with 38, 55 and 70 dB noise for 15 days, and the levels of blood components were determined by an automatic biochemical analyzer. The results showed that in compari-son with the control group, the level of the blood glucose in the experimental groups increased by 23.53%, 52.94% and 88.24%, respectively, and the differences were statistically significant （P〈0.01）. The levels of triglyceride in the blood rose by 20.83%, 38.54% and 79.68%, respectively, and the differences were also statistically significant （P〈0.01）. The level of globulin in the blood increased by 16.49%, 21.13% and 51.78%, and the level of albumin in the blood rose by 9.51 %, 12.67% and 17.89%, respectively. The level of total bilirubin in the blood increased by 27.04%, 41.63% and 73.67%, respectively, and the differences were statistically significant （P〈0.01）. The level of creatinine in the blood rose by 9.72%, 10.21% and 20.99%, respectively. The level of amylase in the blood reduced by 6.6%, 13.05% and 23.89%, respectively. The level of creatine kinase in the blood decreased by 19.81%, 27.37% and 36.81 %, respectively, and the level of urea in the blood reduced by 11.19%, 12.77% and 19.26%, respectively. The results revealed that noise pollution could significantly affect the levels of blood components and the functions of the liver and kidney of rats.
