BACKGROUND Since non-alcoholic fatty liver disease(NAFLD)is associated with abnormal liver function tests,treatment recommendations aim to reduce the level of known markers of liver inflammation,such as alanine transa...BACKGROUND Since non-alcoholic fatty liver disease(NAFLD)is associated with abnormal liver function tests,treatment recommendations aim to reduce the level of known markers of liver inflammation,such as alanine transaminase(ALT),aspartate transaminase(AST)and gamma-glutamyl transferase(GGT).Essential phospholipids(EPLs)have been shown to reduce levels of these liver enzymes and improve ultrasonographic features.While non-invasive diagnostic tests have been developed to stage inflammation,these tests were not specifically designed to evaluate patients with NAFLD.This highlights the need to describe the liver enzyme profile across the different levels of NAFLD severity for improved grading and staging of NAFLD.AIM To describe liver enzyme profiles across NAFLD severity to inform a diagnostic staging algorithm and identify who may benefit from EPLs.METHODS This post-hoc analysis of the observational MANPOWER study included 2843 adult patients with newly diagnosed NAFLD.The primary endpoint was assessment of baseline liver enzyme profiles.Secondary endpoints were effectiveness of Essentiale®(an EPL)on liver enzyme levels and ultrasonography findings across three definitions of NAFLD:(1)Statistical distribution of liver enzyme levels;(2)MANPOWER cut-offs;and(3)Presence of physiciandiagnosed non-alcoholic steatohepatitis.The best performing algorithm was used to describe the risk factors and profiles associated with increased liver enzyme levels.RESULTS Of the 2843 patients included in this post-hoc analysis,most were female(62.2%),with a mean age of 48.4 years(SD 8.59 years).Overall,mean levels of ALT,AST and GGT increased with NAFLD severity for all three subgroups,with the rate of chronic comorbidities correlated with NAFLD severity.Across each subgroup of interest,Essentiale significantly reduced average liver enzyme levels and improved ultrasonography features,including diffuse liver hyperechogenicity and heterogeneous liver structure(P<0.05),with greater benefit associated with increased severity.Compared with all algorithms tested,the algorithm based on the statistical distribution of liver enzymes displayed the highest accuracy,sensitivity and specificity for the grading and staging of NAFLD and could form the basis of a diagnostic algorithm.CONCLUSION Liver enzyme profiles may identify NAFLD severity and allow monitoring of therapeutic response.Essentiale may improve liver enzyme levels and ultrasonography features.An algorithm could aid in the diagnosis/staging of NAFLD.展开更多
BACKGROUND Essential phospholipids(EPL)are used for the supportive treatment of nonalcoholic fatty liver disease(NAFLD),but data are mostly from small-scale studies.AIM To evaluate the efficacy of EPL treatment in adu...BACKGROUND Essential phospholipids(EPL)are used for the supportive treatment of nonalcoholic fatty liver disease(NAFLD),but data are mostly from small-scale studies.AIM To evaluate the efficacy of EPL treatment in adult patients with NAFLD and type 2 diabetes and/or obesity.METHODS The MEDLINE,PubMed,Embase,and Cochrane databases were searched up to March 2019 for clinical trials and comparative observational studies.Eligible studies were those published in English or Chinese that enrolled adult patients(≥18 years)with NAFLD and type 2 diabetes mellitus and/or obesity receiving EPL as monotherapy or as add-on therapy to existing therapy,and that included at least one of the efficacy outcomes of interest.A variety of studies were identified;thus,direct,indirect and cohort meta-analyses were performed.Mean difference(MD)and 95%confidence interval(CI)were calculated for continuous variables,and relative risk with 95%CI for disease response and recovery.A random-effects model was used to address between-study heterogeneity.RESULTS Ten studies met the inclusion criteria(n=22-324).EPL treatment duration ranged from 4 to 72 wk.In the direct meta-analysis(four randomized controlled trials),compared with antidiabetic therapy alone,EPL plus antidiabetic therapy was associated with a significantly greater reduction in[alanine aminotransferase(ALT);MD:11.28 U/L(95%CI:-17.33,-5.23),P=0.0003],triglyceride[MD:-49.33 mg/dL(95%CI:-66.43,-32.23),P<0.0001]and total cholesterol levels[MD:-29.74 mg/dL(95%CI:-38.02,-21.45),P<0.0001].There was also a significant increase in the rate of overall improvement[relative risk 1.50(95%CI:1.26-1.79),P<0.0001],and risk of no disease(P=0.0091),and a reduction in moderate disease(P=0.0187);there were no significant differences in severe disease,mild disease,or significant improvement.In the cohort meta-analysis of three non-randomized clinical trials,the MD in ALT levels was-16.71 U/L(95%CI:-24.94,-8.49)and 23%of patients had improved disease.In the cohort meta-analysis of five randomized trials,MD in ALT levels was–28.53 U/L(95%CI:-35.42,-21.65),and 87%(95%CI:81%,93%)and 58%(95%CI:46%,70%)of patients showed clinical improvement and significant clinical improvement.CONCLUSION This analysis provides evidence for a benefit of EPL in patients with NAFLD and diabetes and/or obesity.Further large-scale trials are warranted.展开更多
With the widespread use of digital cameras, imaging software, photo-sharing sites, social networks, and other related technolo- gies. media production and consumption patterns have become much more nmltifaceted and co...With the widespread use of digital cameras, imaging software, photo-sharing sites, social networks, and other related technolo- gies. media production and consumption patterns have become much more nmltifaceted and complex than they used to be. Us- er-generated content in particular has grown tremendously. As a resuh, quality of experience （QoE） and related quality assess- ment （QA） methods must also be looked at from a different an- gle. This paper contrasts some of the traditional quality assess- ment approaches with newer approaches designed for user-gen- erated content. It also describes some sample applications we have developed.展开更多
Isolation and culture of ADSCs in vitro,detection of cell surface markers.Detection of alkaline phosphatase(ALP)and mineralized nodules after cell osteogenic induction.Oil red 0 staining after induction of adipogenesi...Isolation and culture of ADSCs in vitro,detection of cell surface markers.Detection of alkaline phosphatase(ALP)and mineralized nodules after cell osteogenic induction.Oil red 0 staining after induction of adipogenesis.Cells were induced to differentiate into SCs,and MTT detected cell viability;Scanning electron microscopy and immunocytochemical staining observed the expression of S100.展开更多
文摘BACKGROUND Since non-alcoholic fatty liver disease(NAFLD)is associated with abnormal liver function tests,treatment recommendations aim to reduce the level of known markers of liver inflammation,such as alanine transaminase(ALT),aspartate transaminase(AST)and gamma-glutamyl transferase(GGT).Essential phospholipids(EPLs)have been shown to reduce levels of these liver enzymes and improve ultrasonographic features.While non-invasive diagnostic tests have been developed to stage inflammation,these tests were not specifically designed to evaluate patients with NAFLD.This highlights the need to describe the liver enzyme profile across the different levels of NAFLD severity for improved grading and staging of NAFLD.AIM To describe liver enzyme profiles across NAFLD severity to inform a diagnostic staging algorithm and identify who may benefit from EPLs.METHODS This post-hoc analysis of the observational MANPOWER study included 2843 adult patients with newly diagnosed NAFLD.The primary endpoint was assessment of baseline liver enzyme profiles.Secondary endpoints were effectiveness of Essentiale®(an EPL)on liver enzyme levels and ultrasonography findings across three definitions of NAFLD:(1)Statistical distribution of liver enzyme levels;(2)MANPOWER cut-offs;and(3)Presence of physiciandiagnosed non-alcoholic steatohepatitis.The best performing algorithm was used to describe the risk factors and profiles associated with increased liver enzyme levels.RESULTS Of the 2843 patients included in this post-hoc analysis,most were female(62.2%),with a mean age of 48.4 years(SD 8.59 years).Overall,mean levels of ALT,AST and GGT increased with NAFLD severity for all three subgroups,with the rate of chronic comorbidities correlated with NAFLD severity.Across each subgroup of interest,Essentiale significantly reduced average liver enzyme levels and improved ultrasonography features,including diffuse liver hyperechogenicity and heterogeneous liver structure(P<0.05),with greater benefit associated with increased severity.Compared with all algorithms tested,the algorithm based on the statistical distribution of liver enzymes displayed the highest accuracy,sensitivity and specificity for the grading and staging of NAFLD and could form the basis of a diagnostic algorithm.CONCLUSION Liver enzyme profiles may identify NAFLD severity and allow monitoring of therapeutic response.Essentiale may improve liver enzyme levels and ultrasonography features.An algorithm could aid in the diagnosis/staging of NAFLD.
文摘BACKGROUND Essential phospholipids(EPL)are used for the supportive treatment of nonalcoholic fatty liver disease(NAFLD),but data are mostly from small-scale studies.AIM To evaluate the efficacy of EPL treatment in adult patients with NAFLD and type 2 diabetes and/or obesity.METHODS The MEDLINE,PubMed,Embase,and Cochrane databases were searched up to March 2019 for clinical trials and comparative observational studies.Eligible studies were those published in English or Chinese that enrolled adult patients(≥18 years)with NAFLD and type 2 diabetes mellitus and/or obesity receiving EPL as monotherapy or as add-on therapy to existing therapy,and that included at least one of the efficacy outcomes of interest.A variety of studies were identified;thus,direct,indirect and cohort meta-analyses were performed.Mean difference(MD)and 95%confidence interval(CI)were calculated for continuous variables,and relative risk with 95%CI for disease response and recovery.A random-effects model was used to address between-study heterogeneity.RESULTS Ten studies met the inclusion criteria(n=22-324).EPL treatment duration ranged from 4 to 72 wk.In the direct meta-analysis(four randomized controlled trials),compared with antidiabetic therapy alone,EPL plus antidiabetic therapy was associated with a significantly greater reduction in[alanine aminotransferase(ALT);MD:11.28 U/L(95%CI:-17.33,-5.23),P=0.0003],triglyceride[MD:-49.33 mg/dL(95%CI:-66.43,-32.23),P<0.0001]and total cholesterol levels[MD:-29.74 mg/dL(95%CI:-38.02,-21.45),P<0.0001].There was also a significant increase in the rate of overall improvement[relative risk 1.50(95%CI:1.26-1.79),P<0.0001],and risk of no disease(P=0.0091),and a reduction in moderate disease(P=0.0187);there were no significant differences in severe disease,mild disease,or significant improvement.In the cohort meta-analysis of three non-randomized clinical trials,the MD in ALT levels was-16.71 U/L(95%CI:-24.94,-8.49)and 23%of patients had improved disease.In the cohort meta-analysis of five randomized trials,MD in ALT levels was–28.53 U/L(95%CI:-35.42,-21.65),and 87%(95%CI:81%,93%)and 58%(95%CI:46%,70%)of patients showed clinical improvement and significant clinical improvement.CONCLUSION This analysis provides evidence for a benefit of EPL in patients with NAFLD and diabetes and/or obesity.Further large-scale trials are warranted.
基金supported by the Advanced Digital Sciences Center (ADSC) under a grant from the Agency for Science,Technology and Research of Singapore (A*STAR)
文摘With the widespread use of digital cameras, imaging software, photo-sharing sites, social networks, and other related technolo- gies. media production and consumption patterns have become much more nmltifaceted and complex than they used to be. Us- er-generated content in particular has grown tremendously. As a resuh, quality of experience （QoE） and related quality assess- ment （QA） methods must also be looked at from a different an- gle. This paper contrasts some of the traditional quality assess- ment approaches with newer approaches designed for user-gen- erated content. It also describes some sample applications we have developed.
文摘Isolation and culture of ADSCs in vitro,detection of cell surface markers.Detection of alkaline phosphatase(ALP)and mineralized nodules after cell osteogenic induction.Oil red 0 staining after induction of adipogenesis.Cells were induced to differentiate into SCs,and MTT detected cell viability;Scanning electron microscopy and immunocytochemical staining observed the expression of S100.
