Value of red blood cell distribution width in prediction of diastolic dysfunction in cirrhotic cardiomyopathy

BACKGROUND Clinical diagnosis of cirrhotic cardiomyopathy(CCM) often encounters challenges of lack of timeliness and disease severity, with the commonly positive indicator usually associated with advanced heart failure.AIM To explore suitable biomarkers for early CCM prediction.METHODS A total of 505 eligible patients were enrolled in this study and divided into four groups according to Child-Pugh classification: Group Ⅰ, Class A without CCM(105 cases);Group Ⅱ, Class A with CCM(175 cases);Group Ⅲ, Class B with CCM(139 cases);and Group Ⅳ, Class C with CCM(86 cases). Logistic regression and receiver operating characteristic(ROC) curve analyses were performed to determine whether red blood cell distribution width(RDW) was an independent risk factor for CCM risk. The relationships between RDW and Child-Pugh scores, Model for End-Stage Liver Disease(MELD) scores, and N-terminal pro-brain natriuretic peptide(NT-proBNP) were analyzed by Pearson correlation analysis.RESULTS A constant RDW increase was evident from Group Ⅰ to Group Ⅳ(12.54 ± 0.85, 13.29 ± 1.19, 14.30 ± 1.96, and 16.25 ± 2.13, respectively). Pearson correlation analysis showed that RDW was positively correlated with Child-Pugh scores(r = 0.642, P < 0.001), MELD scores(r = 0.592, P < 0.001), and NT-proBNP(r = 0.715, P < 0.001). Furthermore, between Group Ⅰ and Group Ⅱ, RDW was the only significant index(odds ratio: 2.175, 95% confidence interval [CI]: 1.549-3.054, P < 0.001), and it reached statistical significance when examined by ROC curve analysis(area under the curve: 0.686, 95%CI: 0.624-0.748, P < 0.001).CONCLUSION RDW can serve as an effective and accessible clinical indicator for the prediction of diastolic dysfunction in CCM, in which a numerical value of more than 13.05% may indicate an increasing CCM risk.

N-乙酰半胱氨酸对丙酮醛诱导的人肾小管上皮细胞损伤的保护作用及机制研究

目的探讨N-乙酰半胱氨酸(NAC)对丙酮醛引起人肾小管上皮细胞(HK-2细胞)损伤的保护作用及其可能机制。方法 HK-2细胞分为6组:对照组、丙酮醛组、丙酮醛+不同浓度NAC(1、2、4及8 mmol/L)处理组。采用CCK-8检测细胞活力,DAPI染色观察细胞核形态,罗丹明123染色及流式细胞仪检测细胞线粒体膜电位,Western blot检测抗凋亡蛋白Bcl-2、促凋亡蛋白Bax、Cleaved Caspase-3以及磷酸化ERK1/2(pERK1/2)蛋白表达水平。结果与对照组比较,HK-2细胞经400μmol/L丙酮醛处理后,细胞活力、线粒体膜电位及Bcl-2蛋白表达水平降低,凋亡细胞数增多,Bax、Cleaved Caspase-3及p-ERK1/2蛋白表达水平则升高。而经不同浓度的NAC干预后,可以逆转丙酮醛对HK-2细胞的上述作用。结论 NAC对丙酮醛诱导的HK-2细胞损伤具有保护作用,其机制可能与其抗凋亡及抑制ERK1/2信号通路有关。

Surgical treatment of a patient with peliosis hepatis: A case report

This report describes a case of a space-occupying lesion in the right liver in a 38-year-old man who was found to have peliosis hepatis. Clinical data of this patient were presented, including medical history, laboratory test and imaging results, and postoperative pathological findings (hematoxylin and eosin staining). Review of his medical history showed that the patient had been bitten by a dog three years earlier. B-mode ultrasonography revealed an uneven echo mass in the right hemiliver, and magnetic resonance imaging scans also showed a mass in the anterior segment of the right liver. Upon surgical removal, the mass was found to be 4.0 cm × 3.8 cm × 3.8 cm in size and located in segment Ⅵ. The mass had a dark and soft appearance, with an irregular edge on intraoperative ultrasonography. Postoperative pathological findings revealed many small capsules filled with blood cells. The patient was diagnosed with peliosis hepatis based on his medical history of having been bitten by a dog, presence of mild anemia, and lack of characteristic symptoms, including fever of unknown origin, abdominal pain, and hepatosplenomegaly, combined with intraoperative and postoperative pathologic findings. The operation was successful, and after being treated with anti-infection agents, the patient had a good recovery.

In situ preparation of well-dispersed CuO nanocatalysts in heavy oil for catalytic aquathermolysis

We developed an in situ synthesis strategy for preparing well-dispersed CuO nanoparticles as aquathermolysis catalyst for viscosity reduction in Shengli heavy oil(China). A Cu(OH)_2-contained microemulsion was employed as a carrier to disperse the precursor Cu(OH)_2 to the heavy oil phase. Under aquathermolysis condition(240 ℃, 2.5 MPa of N_2), the Cu(OH)_2 precursors would first be converted in situ to well-crystallized and size-homogeneous CuO nanoparticles naturally, catalyzed by which the viscosity of Shengli heavy oil could be reduced as much as 94.6%; simultaneously, 22.4% of asphaltenes were converted to light components. The agglomeration of the in situ prepared monoclinic CuO nanoparticles could be negligible throughout the catalytic reaction. Based on the characterization results of ~1 H NMR, elemental analysis and GC-MS of oil samples before and after catalytic aquathermolysis, the mechanism for viscosity reduction of heavy oil in the catalytic system was investigated.

Diagnosis and Treatment of Cholangiocarcinoma: A Consensus from Surgical Specialists of China

Cholangiocarcinoma refers to malignant tumors that develop in epithelial lining of biliary system, and it is divided into two categories according to tumor location, intrahepatic cholangiocarcinoma （ICC） and extrahepatic cholangiocarcinoma （ECC）. ICC occurs from the epithelial cells of the intrahepatic bile duct, its branches and interlobular biliary tree; and ECC is divided into hilar cholangiocarcinoma and distal cholangiocarcinoma by the circumscription at the confluence of cystic duct and the common hepatic duct.

Simultaneous recovery of dual pathways for ammonia metabolism do not improve further detoxification of ammonia in HepG2 cells

BACKGROUND:Key enzyme deficiency in the dual-pathway of ammonia metabolism leads to low detoxification capacity of HepG2 cells.Previously,we established a HepG2/AFhGS cell line with overexpression of human glutamine synthetase(hGS) in pathway 1 and a HepG2/(hArgI+hOTC)4 cell line with overexpression of human arginase I(hArgI) and human ornithine transcarbamylase(hOTC) in pathway 2.The present study aimed to investigate whether simultaneous recovery of the two pathways contributes to the further improvement of ammonia detoxification in HepG2 cells.METHODS:We adopted a recombinant retrovirus carrying the hGS gene to infect HepG2/(hArgI+hOTC)4 cells and selected a new recombinant HepG2 cell line.The capacities of ammonia tolerance and detoxification in cells were detected by biochemical methods.Cell cycle PCR chip was used to assess the changes of gene expression.RESULTS:Introducing hGS into HepG2/(hArgI+hOTC)4 cells did not lead to hGS overexpression,but inhibited hArgI expression.The levels of synthetic glutamine and urea in HepG2/(hArgI+hOTC+AFhGS)1 cells were significantly lower than those in HepG2/(hArgI+hOTC)4 cells when cultured in the medium with 10 and 15 mmol/L glutamate(Glu) and with 60 and 180 mmol/L NH 4 Cl,respectively.In addition,the comparison of different cell growth showed that HepG2/AFhGS cells significantly lagged behind the other cells by the 5th and 7th day,indicating that introduction of hGS impedes HepG2 cell proliferation.Analysis of the mechanism suggested that the decreased expression of BCL2 played an important role.CONCLUSIONS:This study demonstrated that the recovery of two ammonia metabolic pathways in HepG2 cells is not helpful in increasing ammonia metabolism.The reinforcement of the pathway of urea metabolism is more important and valuable in improving the ammonia metabolism capacity in HepG2 cells.

Hepatic abscess caused by esophageal foreign body misdiagnosed as cystadenocarcinoma by magnetic resonance imaging:A case report

BACKGROUND Foreign bodies stuck in the throat and esophagus can be discharged through the digestive tract.Esophageal-lodged foreign bodies can cause secondary injury or detrimental response,with hepatic abscess being one such,albeit rare,outcome.Review and discussion of the few case reports on such instances will help to improve the overall understanding of such conditions and aid in differential diagnosis to improve patient outcome.CASE SUMMARY A 51-year-old female patient with pre-existing diabetes visited our hospital following a 15-d experience of chills and fever.Both plain and enhanced magnetic resonance imaging and color Doppler ultrasound examination of the liver and gallbladder revealed a space-occupying lesion in the caudate lobe of the liver(7.8 cm×6.0 cm×5.0 cm).Initially,a malignant tumor was suspected,but differential diagnosis was unable to exclude the possibility of hepatic abscess.Conservative anti-infection therapy produced a less than ideal outcome.Additional examination by hepatobiliary imaging with computed tomography suggested a foreign body present in the upper abdomen and hepatic abscess,and subsequent endoscopy revealed a sinus tract in the anterior wall of the duodenal bulb.Therefore,surgery was performed to remove the object(fishbone)and drain the abscess.After a 2-wk uneventful recovery,the patient was discharged.The final diagnosis was foreign body-induced hepatic abscess of the caudate lobe.CONCLUSION Differential diagnosis is important for hepatic masses,and systematic examination and physician awareness can aid in diagnosing and curing such rare conditions.

The correlation of the quantitative ultrasonography parameters with the liver cancer cell proliferation activity and intralesional angiogenesis

Objective:To study the correlation of the quantitative ultrasonography parameters with liver cancer cell proliferation activity and intralesional angiogenesis.Methods: A total of 46 patients with liver cancer who received surgical resection in Hancheng People's Hospital between June 2014 and March 2017 as well as 28 patients who received partial hepatectomy for abdominal trauma during the same period were selected, the patients with liver cancer received ultrasonography, and the quantitative parameters were calculated;the liver cancer tissue and adjacent tissue of patients with liver cancer as well as the normal liver tissue of patients with abdominal trauma were collected to determine the expression of proliferation genes, tumor suppressor genes and angiogenesis genes.Results:The IMAX of liver cancer tissue was significantly higher than that of adjacent tissue while the TTP, WT and mTT were significantly shorter than those of adjacent tissue;RNF180, Merlin, PICK1 and PTEN protein expression in liver cancer tissue and adjacent tissue were significantly lower than those in normal liver tissue, negatively correlated with the IMAX of liver cancer tissue, and positively correlated with the TTP, WT and mTT of liver cancer tissue;EphB4, SALL4, Cripto-1, VEGF, PDGF, EGFR and Ang-2 protein expression in liver cancer tissue and adjacent tissue were significantly higher than those in normal liver tissue, positively correlated with the IMAX of liver cancer tissue, and negatively correlated with the TTP, WT and mTT of liver cancer tissue. Conclusion: The changes in the quantitative parameters of liver cancer ultrasonography are valuable for evaluating the cell proliferation and angiogenesis.