AIM: To evaluate the hepatic dysfunction in leptospirosis is usually mild and resolved eventually. However,sequential follow-up of liver biochemical data remained lacking..METHODS: The biochemistry data and clinical s...AIM: To evaluate the hepatic dysfunction in leptospirosis is usually mild and resolved eventually. However,sequential follow-up of liver biochemical data remained lacking..METHODS: The biochemistry data and clinical symptoms of 11 sporadic patients were collected and analyzed, focusing on the impacts of leptospirosis upon liver biochemistry tests.RESULTS: The results disclosed that of the 11 cases, 5 or 45% died. The liver biochemistry data in the beginning of the disease course were only mildly elevated.Nevertheless, late exaggerated aspartate transaminase (AST)elevations were noted in three cases who finally died when compared with the typical course. Besides, significant higher AST/alanine transaminase (ALT) ratios (AARs) of the peak levels for transaminase were also noted in the cases who eventually succumbed. The mean±SD of AARs for the survival group and dead group were 5.65±2.27 (n = 5)and 1.86±0.64 (n = 6) respectively (P= 0.006). The ratios of the cases who finally died were all more than 3.0.Conversely, the survival group's ratios were less than 3.0.CONCLUSION: Serial follow-up of transaminase might provide evidence to predict some rare evolutions in leptospirosis. If AST elevated progressively without a concomitant change of ALT, it might indicate an acute disease course with ensuing death. Additionally, AAR is another prognostic parameter for leptospirosis. Once the value was higher than 3.0, a grave prognosis is inevitable.展开更多
BACKGROUND: There are 8 well-documented genotypes of hepatitis B virus (HBV) at this time point. Genotyping can be accomplished based on a partial sequence of hepatitis B virus (HBV) genome such as the pre-S or S gene...BACKGROUND: There are 8 well-documented genotypes of hepatitis B virus (HBV) at this time point. Genotyping can be accomplished based on a partial sequence of hepatitis B virus (HBV) genome such as the pre-S or S gene. Several methods have been developed and used for HBV genotyping including direct sequencing, restriction fragment length polymorphism, line probe assay and enzyme-linked immunoassay. Recently, a novel, rapid and cost-effective genotyping method based on PCR amplification assay using type-specific primers that can identify all six major genotypes has been developed. This study was undertaken to characterise HBV genotypes and investigate the association between the prevalence of different genotypes and the severity of HBV-induced liver diseases. METHODS: Serum samples from carriers of HBV and patients with HBV-related liver diseases from Zhejiang Province were screened for viral serological markers using commercially available radioimmunoassay (RIA) and enzyme linked immunosorbent assay (ELISA) kits. Serum HBV DNA load was determined by real-time detection PCR. A type-specific primer based the nested-PCR method was employed in the HBV genotyping. The genotype results obtained were confirmed by direct sequencing of nested PCR amplicons of the pre-S region. Ten samples of each genotype (B and C) were sequenced. RESULTS: The survey on a cohort of 125 HBV carriers in and around Hangzhou City, Zhejiang Province showed the existence of HBV genotypes A (0.8%), B (48%), C (40.8%), D (0.8%), mixed B and C (9.6%) and an absence of E and F genotypes. Distribution of HBV genotypes in patients with liver diseases revealed a statistically insignificant higher prevalence of genotype B in mild chronic hepatitis (CH). Among the three genotypes B, C and mixed B/C infections 11 (73.3%), 3 (20%) and 1 (6.7%), (P< 0.05), respectively in subjects with moderate CH, genotype B was significantly predominant. The infection patterns for genotypes B, C and B/C mixed in (i) liver cirrhosis (LC) 4 (23.5%), 10 (58.8%) and3 (17.7%) and (ii) hepatocellular carcinoma (HCC) 2 (28.6%), 5(71.4%) and 0 (0.0%) respectively revealed a marked association of C genotype with liver disease; however, the association was statistically insignificant (P >0.05). Differences in positive rate of HBeAg for the three genotypes B, 16(30.8%), C, 27(51.9%), and mixed B/C, 9(17.3%) were significant (P < 0. 05 ) , with genotype C showing predominance. CONCLUSIONS : These findings show an interesting distribution of HBV A-D genotypes in Zhejiang Province. Furthermore, our results indicate a novel and markedly high prevalence of mixed B/C genotype infections in subjects with severe CH and LC, and a possible association of mixed B/C infections with the severity of liver diseases in this region of China's Mainland.展开更多
BACKGROUND:Fatty liver is a common chronic liver disease worldwide.It is associated with an increasing morbidity in China in recent years.The aim of this study was to analyze the effect of drinking alcohol on the hemo...BACKGROUND:Fatty liver is a common chronic liver disease worldwide.It is associated with an increasing morbidity in China in recent years.The aim of this study was to analyze the effect of drinking alcohol on the hemoglobin and biochemical values of patients with fatty liver.METHODS:We investigated the clinical and laboratory data of 669 patients with fatty liver.Of the 669 patients,166 consumed alcohol more than 60 g per week for at least 2 years,and 503 did not have a history of long-term alcohol consumption.We further analyzed the relationship between alcohol consumption and clinical characteristics of these patients.RESULTS:The values of aspartate transaminase (AST),gammaglutamyl transpeptidase (GGT),and hemoglobin in the long-term consumption group were significantly higher than those in the non long-term consumption group (P<0.05).In the patients without long-term alcohol consumption,the values of GGT and hemoglobin in patients with light alcohol consumption were significantly higher than those in non alcohol consumers (P<0.05).CONCLUSION:Alcohol consumption is associated with significantly increased values of AST,GGT,and hemoglobin in patients with fatty liver,suggesting their potential roles in hepatic steatosis.展开更多
BACKGROUND: Paraoxonase 1(PON1) is an ester hydro- lase in serum and in the liver. Studies have suggested that PON1 measurement to the current battery of tests may im- prove the evaluation of chronic liver diseases. T...BACKGROUND: Paraoxonase 1(PON1) is an ester hydro- lase in serum and in the liver. Studies have suggested that PON1 measurement to the current battery of tests may im- prove the evaluation of chronic liver diseases. The aim of this study was to investigate the clinical significance of mo- nitoring the level of serum PON1 activity in liver transplan- tation patients. METHODS: A series of biochemical indexes were moni- tored in preoperative, operative and postoperative serum samples of 17 liver-transplanted patients. The change of se- rum PON1 level and its relations with other biochemical in- dexes were analyzed. RESULTS: PON1 was distributed normally in the healthy population and its reference value ranged from 45.5 to 265.8 U/mL. The PON1 level of all patients was lower than that of control group significantly (P<0.001); the level be- gan to elevate continuously 5 minutes after opening of the portal vein and was higher than that 90 minutes after open- ing of the portal vein ( P <0.05). Two days after operation it was still higher than the normal. The levels of serum ALT and AST elevated more significantly after opening of the portal vein than before operation and they were higher than the normal values till 2 days after the operation. CONCLUSIONS: The level of PON1 in serum may be taken as one of the effective indexes to assess whether the implant is alive and to monitor liver function of the patient together with other tests.展开更多
Objective The beneficial effects of silymarin have been extensively studied in the context of inflammation and cancer treatment, yet much less is known about its therapeutic effect on diabetes. The present study was a...Objective The beneficial effects of silymarin have been extensively studied in the context of inflammation and cancer treatment, yet much less is known about its therapeutic effect on diabetes. The present study was aimed to investigate the cytoprotective activity of silymarin against diabetes-induced cardiomyocyte apoptosis. Methods Rats were randomly divided into： control group, untreated diabetes group and diabetes group treated with silymarin （120 mg/ks·d） for 10 d. Rats were sacrificed, and the cardiac muscle specimens and blood samples were collected. The immunoreactivity of caspase-3 and Bcl-2 in the cardiomyocytes was measured. Total proteins, glucose, insulin, creatinine, AST, ALT, cholesterol, and triglycerides levels were estimated. Results Unlike the treated diabetes group, cardiomyocyte apoptosis increased in the untreated rats, as evidenced by enhanced caspase-3 and declined Bcl-2 activities. The levels of glucose, creatinine, AST, ALT, cholesterol, and triglycerides declined in the treated rats. The declined levels of insulin were enhanced again after treatment of diabetic rats with silymarin, reflecting a restoration of the pancreatic β-cells activity. Conclusion The findings of this study are of great importance, which confirmed for the first time that treatment of diabetic subjects with silymarin may protect cardiomyocytes against apoptosis and promote survival-restoration of the pancreatic β-cells.展开更多
BACKGROUND As of June 1,2020,over 370000 coronavirus disease 2019(COVID-19)deaths have been reported to the World Health Organization.However,the risk factors for patients with moderate-to-severe or severe-to-critical...BACKGROUND As of June 1,2020,over 370000 coronavirus disease 2019(COVID-19)deaths have been reported to the World Health Organization.However,the risk factors for patients with moderate-to-severe or severe-to-critical COVID-19 remain unclear.AIM To explore the characteristics and predictive markers of severely and critically ill patients with COVID-19.METHODS A retrospective study was conducted at the B11 Zhongfaxincheng campus and E1-3 Guanggu campus of Tongji Hospital affiliated with Huazhong University of Science and Technology in Wuhan.Patients with COVID-19 admitted from 1st February 2020 to 8th March 2020 were enrolled and categorized into 3 groups:The moderate group,severe group and critically ill group.Epidemiological data,demographic data,clinical symptoms and outcomes,complications,laboratory tests and radiographic examinations were collected retrospectively from the hospital information system and then compared between groups.RESULTS A total of 126 patients were enrolled.There were 59 in the moderate group,49 in the severe group,and 18 in the critically ill group.Multivariate logistic regression analysis showed that age[odd ratio(OR)=1.055,95%(confidence interval)CI:1.099-1.104],elevated neutrophil-to-lymphocyte ratios(OR=4.019,95%CI:1.045-15.467)and elevated high-sensitivity cardiac troponin I(OR=10.126,95%CI:1.088-94.247)were high-risk factors.CONCLUSION The following indicators can help clinicians identify patients with severe COVID-19 at an early stage:age,an elevated neutrophil-to-lymphocyte ratio and high sensitivity cardiac troponin I.展开更多
Fever and cough are the most common clinical symptoms of coronavirus disease 2019(COVID-19),but complications(such as pneumonia,respiratory distress syndrome,and multiorgan failure)can occur in people with additional ...Fever and cough are the most common clinical symptoms of coronavirus disease 2019(COVID-19),but complications(such as pneumonia,respiratory distress syndrome,and multiorgan failure)can occur in people with additional comorbidities.COVID-19 may be a new cause of liver disease,as liver profile disturbance is one of the most common findings among patients.The molecular mechanism underlying this phenomenon,however,is still unknown.In this paper,we review the most current research on the patterns of change in liver profile among patients with COVID-19,the possible explanation for these findings,and the relation to pre-existing liver disease in these patients.展开更多
AIMTo investigate the diagnostic ability of a non-invasive biological marker to predict liver fibrosis in hepatitis C genotype 4 patients with high accuracy. METHODSA cohort of 332 patients infected with hepatitis C g...AIMTo investigate the diagnostic ability of a non-invasive biological marker to predict liver fibrosis in hepatitis C genotype 4 patients with high accuracy. METHODSA cohort of 332 patients infected with hepatitis C genotype 4 was included in this cross-sectional study. Fasting plasma glucose, insulin, C-peptide, and angiotensin-converting enzyme serum levels were measured. Insulin resistance was mathematically calculated using the homeostasis model of insulin resistance (HOMA-IR). RESULTSFibrosis stages were distributed based on Metavir score as follows: F0 = 43, F1 = 136, F2 = 64, F3 = 45 and F4 = 44. Statistical analysis relied upon reclassification of fibrosis stages into mild fibrosis (F0-F) = 179, moderate fibrosis (F2) = 64, and advanced fibrosis (F3-F4) = 89. Univariate analysis indicated that age, log aspartate amino transaminase, log HOMA-IR and log platelet count were independent predictors of liver fibrosis stage (P CONCLUSIONOur predictive model is easily available and reproducible, and predicted liver fibrosis with acceptable accuracy.展开更多
The effects of sublethal levels of nuracron,dimethylphosphate-3-hydroxy-N-methyl-cis-crotonamide(0,0.625× 10-6,1.25×10-6,2.5×10-6,5.0×10-6 and 10.0×10-6) on biochemical changes(aspartate trans...The effects of sublethal levels of nuracron,dimethylphosphate-3-hydroxy-N-methyl-cis-crotonamide(0,0.625× 10-6,1.25×10-6,2.5×10-6,5.0×10-6 and 10.0×10-6) on biochemical changes(aspartate transaminase,AST,E.C.2.6.1.1;alanine transaminase,ALT;2.6.2.2;alkaline phosphatase,ALP,EC 3.1.3.1) in the organs(kidney,liver,gill) and muscle tissues of hybrid catfi sh Heterobranchus bidorsalis,♂× Clarias gariepinus,♀ [mean weight,(277.76±53.11) g SD;mean total length,(35.69±2.80) cm,SD] were studied after a 23 d exposure in a renewal bioassay under laboratory conditions.Generally,nuracron inhibited AST,ALT and ALP activities in all the exposure concentrations,with ALT activity being mostly affected.The most elicited enzyme was ALP in the kidney [(4 052.67±1610.45) IU/L],followed by AST in the muscle [(908.44±218.34) IU/L] and ALT in the liver [(160.29±73.68) IU/L].The ALP activity was 30.24 and 6.53 times greater than that of ALT and AST.The highest inhibition for AST(43.65%),ALT(47.88%) and ALP(57.98%) occurred at 10×10-6,0.625×10-6 and 2.5×10-6,respectively.The activities of the enzymes in all the organs did not show any direct relationship with the exposure concentrations of the toxicant.ALT activity in the muscle generally suffered the most compared with the other enzymes.The activities of enzymes in the liver were generally inhibited,with elevation at 5.0×10-6 for all the enzymes.The lower concentrations of nuracron(0.625 ×10-6～2.5×10-6) caused elevation in the activities of ALP,but the reverse was the case with the higher concentrations;these of AST and ALT were haphazard.The relative activities of the various enzymes in the organs showed that the order for AST was liver>muscle>kidney>gill;that for ALT:liver>kidney,muscle>gill and that for ALP:kidney>gill>liver and muscle.However,for AST and ALT the activities in the organs of the exposed fi sh peaked at 5.0×10-6 nuracron.The alteration in the activities of the enzymes indicated that the extract interfered with the Kreb's cycle intermediaries and the transamination process,and therefore could elicit negative consequences on the physiology of the fi sh,a non-target species in the aquatic environment.展开更多
Aim:We aimed to further investigate the role of hepcortespenlisimut-L(Hepko-V5 or V5),a new oral immunotherapy developed by us,for hepatocellular carcinoma(HCC)indication.Methods:The interim data from ongoing PhaseⅢp...Aim:We aimed to further investigate the role of hepcortespenlisimut-L(Hepko-V5 or V5),a new oral immunotherapy developed by us,for hepatocellular carcinoma(HCC)indication.Methods:The interim data from ongoing PhaseⅢplacebo-controlled,randomized trial were evaluated on the initial group of patients in advanced stage of HCC with emphasis on liver function and tumor marker alpha-fetoprotein levels.Additionally,an in vitro study was undertaken to elucidate the mechanism of action of V5 by measuring with flow cytometry the expression of cytokines such as IL-2,INF-γ,and TNF-αand cell activation markers CD69 and Ki67 on CD4-and CD8-positive lymphocytes isolated from peripheral blood of healthy volunteers.Results:As early as one month after treatment initiation,there was a clear improvement in alanine transaminase,aspartate transaminase,alkaline phosphatase,and bilirubin levels among HCC patients who received daily dose of V5,but not in the placebo group.Additionally,alpha-fetoprotein(AFP)levels among V5 recipients decreased,while in the ;placebo group they rose.Clinical results are in line with in vitro observations indicating immune activation,as evidenced by many-fold enhancement of CD69,Ki67,and INF-γexpression and at the same time marked anti-inflammatory effect resulting in 10-fold decrease in TNF-αoutput and lack of influence on IL-2 production.Conclusion:Hepcortespenlisimut-L,a tableted oral formulation derived from heat-inactivated pooled blood of patients with HCC and viral hepatitis shows beneficial clinical effect,as demonstrated by improvement in liver function and reduction of tumor marker AFP levels.These correlate with in vitro observations showing potent activation of the immune response and pronounced oral tolerance effect.展开更多
基金Supported by the Chang Gung Medical Research Project fund, No. CMRPG 33014
文摘AIM: To evaluate the hepatic dysfunction in leptospirosis is usually mild and resolved eventually. However,sequential follow-up of liver biochemical data remained lacking..METHODS: The biochemistry data and clinical symptoms of 11 sporadic patients were collected and analyzed, focusing on the impacts of leptospirosis upon liver biochemistry tests.RESULTS: The results disclosed that of the 11 cases, 5 or 45% died. The liver biochemistry data in the beginning of the disease course were only mildly elevated.Nevertheless, late exaggerated aspartate transaminase (AST)elevations were noted in three cases who finally died when compared with the typical course. Besides, significant higher AST/alanine transaminase (ALT) ratios (AARs) of the peak levels for transaminase were also noted in the cases who eventually succumbed. The mean±SD of AARs for the survival group and dead group were 5.65±2.27 (n = 5)and 1.86±0.64 (n = 6) respectively (P= 0.006). The ratios of the cases who finally died were all more than 3.0.Conversely, the survival group's ratios were less than 3.0.CONCLUSION: Serial follow-up of transaminase might provide evidence to predict some rare evolutions in leptospirosis. If AST elevated progressively without a concomitant change of ALT, it might indicate an acute disease course with ensuing death. Additionally, AAR is another prognostic parameter for leptospirosis. Once the value was higher than 3.0, a grave prognosis is inevitable.
文摘BACKGROUND: There are 8 well-documented genotypes of hepatitis B virus (HBV) at this time point. Genotyping can be accomplished based on a partial sequence of hepatitis B virus (HBV) genome such as the pre-S or S gene. Several methods have been developed and used for HBV genotyping including direct sequencing, restriction fragment length polymorphism, line probe assay and enzyme-linked immunoassay. Recently, a novel, rapid and cost-effective genotyping method based on PCR amplification assay using type-specific primers that can identify all six major genotypes has been developed. This study was undertaken to characterise HBV genotypes and investigate the association between the prevalence of different genotypes and the severity of HBV-induced liver diseases. METHODS: Serum samples from carriers of HBV and patients with HBV-related liver diseases from Zhejiang Province were screened for viral serological markers using commercially available radioimmunoassay (RIA) and enzyme linked immunosorbent assay (ELISA) kits. Serum HBV DNA load was determined by real-time detection PCR. A type-specific primer based the nested-PCR method was employed in the HBV genotyping. The genotype results obtained were confirmed by direct sequencing of nested PCR amplicons of the pre-S region. Ten samples of each genotype (B and C) were sequenced. RESULTS: The survey on a cohort of 125 HBV carriers in and around Hangzhou City, Zhejiang Province showed the existence of HBV genotypes A (0.8%), B (48%), C (40.8%), D (0.8%), mixed B and C (9.6%) and an absence of E and F genotypes. Distribution of HBV genotypes in patients with liver diseases revealed a statistically insignificant higher prevalence of genotype B in mild chronic hepatitis (CH). Among the three genotypes B, C and mixed B/C infections 11 (73.3%), 3 (20%) and 1 (6.7%), (P< 0.05), respectively in subjects with moderate CH, genotype B was significantly predominant. The infection patterns for genotypes B, C and B/C mixed in (i) liver cirrhosis (LC) 4 (23.5%), 10 (58.8%) and3 (17.7%) and (ii) hepatocellular carcinoma (HCC) 2 (28.6%), 5(71.4%) and 0 (0.0%) respectively revealed a marked association of C genotype with liver disease; however, the association was statistically insignificant (P >0.05). Differences in positive rate of HBeAg for the three genotypes B, 16(30.8%), C, 27(51.9%), and mixed B/C, 9(17.3%) were significant (P < 0. 05 ) , with genotype C showing predominance. CONCLUSIONS : These findings show an interesting distribution of HBV A-D genotypes in Zhejiang Province. Furthermore, our results indicate a novel and markedly high prevalence of mixed B/C genotype infections in subjects with severe CH and LC, and a possible association of mixed B/C infections with the severity of liver diseases in this region of China's Mainland.
文摘BACKGROUND:Fatty liver is a common chronic liver disease worldwide.It is associated with an increasing morbidity in China in recent years.The aim of this study was to analyze the effect of drinking alcohol on the hemoglobin and biochemical values of patients with fatty liver.METHODS:We investigated the clinical and laboratory data of 669 patients with fatty liver.Of the 669 patients,166 consumed alcohol more than 60 g per week for at least 2 years,and 503 did not have a history of long-term alcohol consumption.We further analyzed the relationship between alcohol consumption and clinical characteristics of these patients.RESULTS:The values of aspartate transaminase (AST),gammaglutamyl transpeptidase (GGT),and hemoglobin in the long-term consumption group were significantly higher than those in the non long-term consumption group (P<0.05).In the patients without long-term alcohol consumption,the values of GGT and hemoglobin in patients with light alcohol consumption were significantly higher than those in non alcohol consumers (P<0.05).CONCLUSION:Alcohol consumption is associated with significantly increased values of AST,GGT,and hemoglobin in patients with fatty liver,suggesting their potential roles in hepatic steatosis.
文摘BACKGROUND: Paraoxonase 1(PON1) is an ester hydro- lase in serum and in the liver. Studies have suggested that PON1 measurement to the current battery of tests may im- prove the evaluation of chronic liver diseases. The aim of this study was to investigate the clinical significance of mo- nitoring the level of serum PON1 activity in liver transplan- tation patients. METHODS: A series of biochemical indexes were moni- tored in preoperative, operative and postoperative serum samples of 17 liver-transplanted patients. The change of se- rum PON1 level and its relations with other biochemical in- dexes were analyzed. RESULTS: PON1 was distributed normally in the healthy population and its reference value ranged from 45.5 to 265.8 U/mL. The PON1 level of all patients was lower than that of control group significantly (P<0.001); the level be- gan to elevate continuously 5 minutes after opening of the portal vein and was higher than that 90 minutes after open- ing of the portal vein ( P <0.05). Two days after operation it was still higher than the normal. The levels of serum ALT and AST elevated more significantly after opening of the portal vein than before operation and they were higher than the normal values till 2 days after the operation. CONCLUSIONS: The level of PON1 in serum may be taken as one of the effective indexes to assess whether the implant is alive and to monitor liver function of the patient together with other tests.
文摘Objective The beneficial effects of silymarin have been extensively studied in the context of inflammation and cancer treatment, yet much less is known about its therapeutic effect on diabetes. The present study was aimed to investigate the cytoprotective activity of silymarin against diabetes-induced cardiomyocyte apoptosis. Methods Rats were randomly divided into： control group, untreated diabetes group and diabetes group treated with silymarin （120 mg/ks·d） for 10 d. Rats were sacrificed, and the cardiac muscle specimens and blood samples were collected. The immunoreactivity of caspase-3 and Bcl-2 in the cardiomyocytes was measured. Total proteins, glucose, insulin, creatinine, AST, ALT, cholesterol, and triglycerides levels were estimated. Results Unlike the treated diabetes group, cardiomyocyte apoptosis increased in the untreated rats, as evidenced by enhanced caspase-3 and declined Bcl-2 activities. The levels of glucose, creatinine, AST, ALT, cholesterol, and triglycerides declined in the treated rats. The declined levels of insulin were enhanced again after treatment of diabetic rats with silymarin, reflecting a restoration of the pancreatic β-cells activity. Conclusion The findings of this study are of great importance, which confirmed for the first time that treatment of diabetic subjects with silymarin may protect cardiomyocytes against apoptosis and promote survival-restoration of the pancreatic β-cells.
基金Supported by Disciplines Construction Project of Peking Union Medical College,No.201920202102.
文摘BACKGROUND As of June 1,2020,over 370000 coronavirus disease 2019(COVID-19)deaths have been reported to the World Health Organization.However,the risk factors for patients with moderate-to-severe or severe-to-critical COVID-19 remain unclear.AIM To explore the characteristics and predictive markers of severely and critically ill patients with COVID-19.METHODS A retrospective study was conducted at the B11 Zhongfaxincheng campus and E1-3 Guanggu campus of Tongji Hospital affiliated with Huazhong University of Science and Technology in Wuhan.Patients with COVID-19 admitted from 1st February 2020 to 8th March 2020 were enrolled and categorized into 3 groups:The moderate group,severe group and critically ill group.Epidemiological data,demographic data,clinical symptoms and outcomes,complications,laboratory tests and radiographic examinations were collected retrospectively from the hospital information system and then compared between groups.RESULTS A total of 126 patients were enrolled.There were 59 in the moderate group,49 in the severe group,and 18 in the critically ill group.Multivariate logistic regression analysis showed that age[odd ratio(OR)=1.055,95%(confidence interval)CI:1.099-1.104],elevated neutrophil-to-lymphocyte ratios(OR=4.019,95%CI:1.045-15.467)and elevated high-sensitivity cardiac troponin I(OR=10.126,95%CI:1.088-94.247)were high-risk factors.CONCLUSION The following indicators can help clinicians identify patients with severe COVID-19 at an early stage:age,an elevated neutrophil-to-lymphocyte ratio and high sensitivity cardiac troponin I.
文摘Fever and cough are the most common clinical symptoms of coronavirus disease 2019(COVID-19),but complications(such as pneumonia,respiratory distress syndrome,and multiorgan failure)can occur in people with additional comorbidities.COVID-19 may be a new cause of liver disease,as liver profile disturbance is one of the most common findings among patients.The molecular mechanism underlying this phenomenon,however,is still unknown.In this paper,we review the most current research on the patterns of change in liver profile among patients with COVID-19,the possible explanation for these findings,and the relation to pre-existing liver disease in these patients.
基金Supported by The Governmental Foundation Scientific and Technology Development Foundation(STDF),Egypt,Project ID:1538
文摘AIMTo investigate the diagnostic ability of a non-invasive biological marker to predict liver fibrosis in hepatitis C genotype 4 patients with high accuracy. METHODSA cohort of 332 patients infected with hepatitis C genotype 4 was included in this cross-sectional study. Fasting plasma glucose, insulin, C-peptide, and angiotensin-converting enzyme serum levels were measured. Insulin resistance was mathematically calculated using the homeostasis model of insulin resistance (HOMA-IR). RESULTSFibrosis stages were distributed based on Metavir score as follows: F0 = 43, F1 = 136, F2 = 64, F3 = 45 and F4 = 44. Statistical analysis relied upon reclassification of fibrosis stages into mild fibrosis (F0-F) = 179, moderate fibrosis (F2) = 64, and advanced fibrosis (F3-F4) = 89. Univariate analysis indicated that age, log aspartate amino transaminase, log HOMA-IR and log platelet count were independent predictors of liver fibrosis stage (P CONCLUSIONOur predictive model is easily available and reproducible, and predicted liver fibrosis with acceptable accuracy.
文摘The effects of sublethal levels of nuracron,dimethylphosphate-3-hydroxy-N-methyl-cis-crotonamide(0,0.625× 10-6,1.25×10-6,2.5×10-6,5.0×10-6 and 10.0×10-6) on biochemical changes(aspartate transaminase,AST,E.C.2.6.1.1;alanine transaminase,ALT;2.6.2.2;alkaline phosphatase,ALP,EC 3.1.3.1) in the organs(kidney,liver,gill) and muscle tissues of hybrid catfi sh Heterobranchus bidorsalis,♂× Clarias gariepinus,♀ [mean weight,(277.76±53.11) g SD;mean total length,(35.69±2.80) cm,SD] were studied after a 23 d exposure in a renewal bioassay under laboratory conditions.Generally,nuracron inhibited AST,ALT and ALP activities in all the exposure concentrations,with ALT activity being mostly affected.The most elicited enzyme was ALP in the kidney [(4 052.67±1610.45) IU/L],followed by AST in the muscle [(908.44±218.34) IU/L] and ALT in the liver [(160.29±73.68) IU/L].The ALP activity was 30.24 and 6.53 times greater than that of ALT and AST.The highest inhibition for AST(43.65%),ALT(47.88%) and ALP(57.98%) occurred at 10×10-6,0.625×10-6 and 2.5×10-6,respectively.The activities of the enzymes in all the organs did not show any direct relationship with the exposure concentrations of the toxicant.ALT activity in the muscle generally suffered the most compared with the other enzymes.The activities of enzymes in the liver were generally inhibited,with elevation at 5.0×10-6 for all the enzymes.The lower concentrations of nuracron(0.625 ×10-6～2.5×10-6) caused elevation in the activities of ALP,but the reverse was the case with the higher concentrations;these of AST and ALT were haphazard.The relative activities of the various enzymes in the organs showed that the order for AST was liver>muscle>kidney>gill;that for ALT:liver>kidney,muscle>gill and that for ALP:kidney>gill>liver and muscle.However,for AST and ALT the activities in the organs of the exposed fi sh peaked at 5.0×10-6 nuracron.The alteration in the activities of the enzymes indicated that the extract interfered with the Kreb's cycle intermediaries and the transamination process,and therefore could elicit negative consequences on the physiology of the fi sh,a non-target species in the aquatic environment.
基金This study would never have had a chance to succeed if we did not receive the financial contribution from our former patient with terminal HCC,Dr.Steve Kramer-now in complete remission since 2014-and his spouse Jane Kramer,who as our genuine friends generously supported our effort over many years.Additional support was provided by several other patients who contributed extra in addition to regular payment for Hepko-V5.They were not involved in clinical study design,collection,analysis and interpretation of data.
文摘Aim:We aimed to further investigate the role of hepcortespenlisimut-L(Hepko-V5 or V5),a new oral immunotherapy developed by us,for hepatocellular carcinoma(HCC)indication.Methods:The interim data from ongoing PhaseⅢplacebo-controlled,randomized trial were evaluated on the initial group of patients in advanced stage of HCC with emphasis on liver function and tumor marker alpha-fetoprotein levels.Additionally,an in vitro study was undertaken to elucidate the mechanism of action of V5 by measuring with flow cytometry the expression of cytokines such as IL-2,INF-γ,and TNF-αand cell activation markers CD69 and Ki67 on CD4-and CD8-positive lymphocytes isolated from peripheral blood of healthy volunteers.Results:As early as one month after treatment initiation,there was a clear improvement in alanine transaminase,aspartate transaminase,alkaline phosphatase,and bilirubin levels among HCC patients who received daily dose of V5,but not in the placebo group.Additionally,alpha-fetoprotein(AFP)levels among V5 recipients decreased,while in the ;placebo group they rose.Clinical results are in line with in vitro observations indicating immune activation,as evidenced by many-fold enhancement of CD69,Ki67,and INF-γexpression and at the same time marked anti-inflammatory effect resulting in 10-fold decrease in TNF-αoutput and lack of influence on IL-2 production.Conclusion:Hepcortespenlisimut-L,a tableted oral formulation derived from heat-inactivated pooled blood of patients with HCC and viral hepatitis shows beneficial clinical effect,as demonstrated by improvement in liver function and reduction of tumor marker AFP levels.These correlate with in vitro observations showing potent activation of the immune response and pronounced oral tolerance effect.
