Efficacy of Addiction Pharmacotherapy in Alcohol Use Disorder and Their Effects on Liver Health

Both alcohol-associated liver disease(ALD)and metabolic dysfunction-associated steatotic liver disease are leading contributors to chronic liver diseases.These conditions often coexist,exacerbating disease progression.Despite ALD being a leading cause of liver transplantation,many individuals with alcohol use disorder(AUD)do not receive treatment.In this review,we discussed the epidemiology of ALD in AUD,various treatment options for AUD,and their efficacy on liver health.Our critical analysis of current evidence underscores the need for integrated models involving multiple stakeholders to improve ALD management.

Effects of fish meal replacement with Chlorella meal on growth performance,pigmentation,and liver health of largemouth bass(Micropterus salmoides)

Chlorella meal is a potential protein source for aquafeeds.However,the physiological response of carnivorous fish fed Chlorella meal remains elusive.This study evaluated the effects of replacing dietary fish meal with Chlorella meal on growth performance,pigmentation,and liver health in largemouth bass.Five diets were formulated to replace dietary fish meal of 0%(C0,control),25%(C25),50%(C50),75%(C75),and 100%(C100)with Chlorella meal,respectively.Total 300 fish(17.6±0.03 g)were randomly assigned to 15 tanks(3 tanks/group).Fish were fed the experimental diet twice daily for 8 weeks.The increased dietary Chlorella meal quadratically influenced the final body weight(FBW),weight gain rate(WGR),specific growth rate(SGR),and feed intake(FI),which were significantly lower in the C100 group than in the other groups(P<0.05).The feed conversion ratio(FCR)increased linearly or quadratically with dietary Chlorella meal.Dietary Chlorella meal linearly or quadratically increased the lutein content of plasma,liver,and dorsal muscle of largemouth bass(P<0.05).Compared to the C0 group,all supplemented Chlorella meal groups significantly improved the yellowness(b*)of the dorsal body(1.5 to 2.0 fold),abdominal body(1.5 to 1.8 fold),and dorsal muscle(3.8 to 5.4 fold)of largemouth bass(P<0.05).In addition,compared to the C0 group,the liver vacuolation area of fish was significantly increased in the C75 and C100 groups(P<0.05).Transcriptional levels of apoptosis-related genes of b-cell lymphoma-2(bcl2),caspase-9-like(casp9),and caspase-3a(casp3)were markedly upregulated(0.9 to 1.6 fold)in the C100 group compared to the C0 group(P<0.05).Based on the quadratic regression analysis between FBW,WGR,or SGR and dietary Chlorella meal level,largemouth bass had the best growth when replacing 31.7%to 32.6%of fish meal with 15.03%to 15.43%dietary Chlorella meal.The present results indicated that dietary supplementation with Chlorella meal(11.85%to 47.45%)significantly enhanced the pigmentation;however,total replacement of fish meal(40%)with Chlorella meal(47.45%)caused growth retardation,apoptosis,and liver damage in largemouth bass.

Effects of paraprobiotics on bile acid metabolism and liver health in largemouth bass(Micropterus salmoides)fed a cottonseed protein concentrate-based diet

Cottonseed protein concentrate is a sustainable fishmeal alternative in aquafeed.A 10-week experiment was conducted to investigate the effects of a cottonseed protein concentrate-based diet with and without multi-strain yeast fractions(MsYF)on growth,bile acid metabolism,and health in largemouth bass.Four hundred fish(54.0±0.0 g)were casually distributed into 16 tanks(4 replicates/diet).Fish were fed with 4 iso-nitrogen and iso-energetic diets 3 times daily,including a fishmeal diet(FM),a soy protein concentrate-based diet(SPC;replacing 81%fishmeal protein),a cottonseed protein concentrate-based diet(CPC;replacing 81%fishmeal protein),and a CPC diet supplemented with 800 mg/kg MsYF(CPCY).Results showed that the survival of SPC was the lowest,i.e.,48%,with no apparent diet effect among other treatments;we omitted the SPC in additional analyses.Fish fed cottonseed protein concentrate-based diets showed lower growth than FM(P<0.05).Fish fed CPC showed the highest nuclear dense hepatic phenotypes ratio(50%),followed by CPCY(33%)and FM(17%).Further,dietary CPC increased hepatic total cholesterol and triglyceride levels with concurrently increased cholesterol syn-thesis but decreased triglyceride synthesis-associated transcription levels(P<0.05).Furthermore,di-etary CPC increased bile acid synthesis but decreased bile acid transport-associated transcription levels(P<0.05),and then induced an increment of plasma cholic acid and hepatic chenodeoxycholic acid content and the decrement of genus Romboustia(P<0.05).Regarding the effect of MsYF,fish fed CPCY reduced hepatic lipid accumulation and total plasma bile acid content(P<0.05)compared to CPC,suggesting an improvement in liver health.Also,dietary MsYF could reverse the microbiota community structure showing a similar gut microbial composition to FM.In conclusion,81%of fishmeal protein replaced by cottonseed protein concentrate suppressed growth and liver health,while dietary MsYF might mitigate the negative impact of a high cottonseed protein concentrate level diet on liver functions via gut microbiota regulation.

Non-alcoholic fatty liver disease is not associated with a lower health perception

AIM: To examine the association between non-alcoholic fatty liver disease (NAFLD) and general health perception.METHODS: This cross sectional and prospective follow-up study was performed on a cohort of a sub-sample of the first Israeli national health and nutrition examination survey, with no secondary liver disease or history of alcohol abuse. On the first survey, in 2003-2004, 349 participants were included. In 2009-2010 participants from the baseline survey were invited to participate in a follow-up survey. On both baseline and follow-up surveys the data collected included: self-reported general health perception, physical activity habits, frequency of physician’s visits, fatigue impact scale and abdominal ultrasound. Fatty liver was diagnosed by abdominal ultrasonography using standardized criteria and the ratio between the median brightness level of the liver and the right kidney was calculated to determine the Hepato-Renal Index.RESULTS: Out of 349 eligible participants in the first survey, 213 volunteers participated in the follow-up cohort and were included in the current analysis, NAFLD was diagnosed in 70/213 (32.9%). The prevalence of 'very good' self-reported health perception was lower among participants diagnosed with NAFLD compared to those without NAFLD. However, adjustment for BMI attenuated the association (OR = 0.73, 95%CI: 0.36-1.50, P = 0.392). Similar results were observed for the hepato-renal index; it was inversely associated with 'very good' health perception but adjustment for BMI attenuated the association. In a full model of multivariate analysis, that included all potential predictors for health perception, NAFLD was not associated with the self-reported general health perception (OR = 0.86, 95%CI: 0.40-1.86, P = 0.704). The odds for 'very good' self-reported general health perception (compared to 'else') increased among men (OR = 2.42, 95%CI: 1.26-4.66, P = 0.008) and those with higher performance of leisure time physical activity (OR = 1.01, 95%CI: 1.00-1.01, P < 0.001, per every minute/week) and decreased with increasing level of BMI (OR = 0.91, 95%CI: 0.84-0.99, P = 0.028, per every kg/m2) and older age (OR = 0.96, 95%CI: 0.93-0.99, P = 0.033, per one year). Current smoking was not associated with health perception (OR = 1.31, 95%CI: 0.54-3.16, P = 0.552). Newly diagnosed (naive) and previously diagnosed (at the first survey, not naive) NAFLD patients did not differ in their self-health perception. The presence of NAFLD at the first survey as compared to normal liver did not predict health perception deterioration at the 7 years follow-up. In terms of health-services utilization, subjects diagnosed with NAFLD had a similar number of physician’s visits (general physicians and specialty consultants) as in the normal liver group. Parameters in the fatigue impact scale were equivalent between the NAFLD and the normal liver groups.CONCLUSION: Fatty liver without clinically significant liver disease does not have independent impact on self-health perception.

Health-related quality of life in living liver donors after transplantation

BACKGROUND:Living donor liver transplantation (LDLT) has recently emerged as an effective therapeutic alternative for patients with end-stage liver disease.In the meantime,the health-related quality of life (HRQoL) of the donors is becoming better appreciated.Here we aimed to review the current literature and summarize the effects of liver donation on the long-term HRQoL of living donors.DATA SOURCES:A literature search of PubMed using 'donors','living donor liver transplantation','health-related quality of life',and 'donation' was performed,and all the information was collected.RESULTS:The varied postoperative outcomes of liver donors are attributive to the different evaluation instruments used.On the whole,donors experienced good long-term physical and mental well-being with a few complaining of compromised quality of life due to mild symptoms or psychiatric problems.The psychosocial dimension has received increasing attention with the vocational,interpersonal and financial impact of liver donation on donors mostly studied.CONCLUSIONS:Generally,donors have a good HRQoL after LDLT.Nevertheless,to achieve an ideal donor outcome,further work is necessary to minimize the negative effects as well as to incorporate recent progress in regenerative medicine.

Health-related quality of life after liver transplantation: the experience from a single Chinese center

BACKGROUND: Few studies have been performed to assess health-related quality of life (HRQOL) in liver transplantation (LT) patients in the mainland of China. This study aimed to investigate the HRQOL of post-LT patients in a single center. METHODS: HRQOL was evaluated by the SF-36 (Chinese version) questionnaire in 60 patients (LT group) who had received LT for benign end-stage liver disease (BELD). Fifty-five patients with BELD (BELD group) and 50 healthy volunteers from the general population (GP group) were also evaluated, and the results were compared among the three groups. RESULTS: There was a significant difference among the three groups in terms of the scores of eight domains in the SF-36 (P<0.01). Patients in the BELD group had lower scores in each domain of the SF-36 in comparison with those in the GP group (P<0.025). The LT group had mental health scores equivalent to those of the BELD group (P>0.025), but higher scores for the remaining seven domains (P<0.025). Compared with the GP group, the LT group scored equivalently for role physical, body pain, vitality, social function and role emotion (P>0.025), but had lower scores for the remaining three domains (P<0.025). Lower family income was found to be associated with reduced physical function and mental health scores (P<0.05). Better education was associated with increased mental health scores (P<0.05). CONCLUSIONS: LT patients generally have a good HRQOL although some respects of their HRQOL remains to be improved. Lower family income and poor education are important factors relating to the poor HRQOL of LT patients.

Low skeletal muscle mass is associated with non-alcoholic fatty liver disease in Korean adults： the Fifth Korea National Health and Nutrition Examination Survey

BACKGROUND： Sarcopenia and non-alcoholic fatty liver dis- ease （NAFLD） share similar pathophysiological mechanisms, and the relationship between sarcopenia and NAFLD has been recently investigated. The study investigated whether low skel- etal muscle mass is differentially associated with NAFLD by gender in Korean adults. METHODS： We conducted a cross-sectional analysis of the data from the Fifth Korea National Health and Nutrition Examination Survey. The skeletal muscle index （SMI） was obtained by the appendicular skeletal muscle mass divided by the weight. NAFLD was defined as a fatty liver index （FLI） 〉60 in the absence of other chronic liver disease. RESULTS： Among the included subjects, 18.3% （SE： 1.4%） in men and 7.0% （SE： 0.7%） in women were classified as having FLI-defined NAFLD. Most of the risk factors for FLI-defined NAFLD showed a significant negative correlation with the SMI in both genders. Multiple logistic regression analysis showed that low SMI was associated with FLI-defined NAFLD, inde- pendent of other metabolic and lifestyle parameters in both genders [males： odds ratio （OR）=1.35; 95% confidence inter- val （CI）： 1.17-1.54; females： OR=1.36; 95% CI： 1.18-1.55]. The magnitude of the association between FLI-defined NAFLD and low SMI was higher in middle aged to elderly males （OR-1.50; 95% CI： 1.22-1.84） than in males less than 45 years of age （OR=1.25; 95% CI： 1.02-1.52） and in premenopausal females （OR=l.50; 95% CI： 1.12-2.03） than in postmenopausal females （OR-1.36; 95% CI： 1.20-1.54）.CONCLUSIONS： Low SMI is associated with the risk of FLI- defined NAFLD independent of other well-known metabolic risk factors in both genders. This association may differ ac- cording to age group or menopausal status. Further studies are warranted to confirm this relationship.

Impact of Post Hepatitis C Chronic Liver Disease and Hepatocellular Carcinoma on Health Related Quality of Life

Background: Post hepatitis C virus chronic liver disease (CLD) is prevalent among the Egyptian population with a bad impact upon their quality of life (QOL). Hepatocellular carcinoma (HCC) is one of the long term and fatal complications of CLD and it also has its negative impact on patient’s quality of life. Aim: To assess impact of CLD and HCC on the quality of life of group of hospitalized elderly patients. Methodology: Ninety elderly patients were divided into three groups: 30 elderly with post hepatitis C virus CLD, 30 elderly with HCC and 30 others free of liver disease as control group (Cn), all were recruited from the in-patient ward and the outpatient clinic of the Geriatric Department, Ain-Shams University Hospital. After giving consent, comprehensive geriatric assessment was done with assessment of their quality of life by using the Short Form-36 health survey (SF-36). Investigations including liver enzymes, serum albumin, serum bilirubin and abdominal ultrasound were done. Results: All QOL domains were the highest among control group, followed by HCC group and the least among CLD group. The differences were statistically significant in most subscales and total score [Mean of Cn = 81.9 ± 12.4, Mean of CLD = 47.5 ± 21.9, Mean of HCC = 62.3 ± 16.1;P Cn/CLD ≤ 0.001, P Cn/HCC ≤ 0.001, P CLD/HCC = 0.004]. Albumin was the only biochemical marker correlated positively with total SF score and two subscales (PF and EF) [r = 0.408;P = 0.025]. Conclusion & Recommendation: Our study showed a decrease in the QOL of Egyptian post hepatitis C virus CLD and HCC patients compared with Egyptian population norms. The results showed that CLD were more affected than HCC patients. This had a particularly serious negative impact on their life. The findings indicate a need for updated counseling and educational materials designed to provide adequate information and consistent healthcare service to this patient setting.

Sex-influenced association of non-alcoholic fatty liver disease with colorectal adenomatous and hyperplastic polyps

AIM To investigate the relationship between non-alcoholic fatty liver disease(NAFLD) and colorectal adenomatous and hyperplastic polyps.METHODS A retrospective cross-sectional study was conducted on 3686 individuals undergoing health checkups(2430 males and 1256 females). All subjects underwent laboratory testing,abdominal ultrasonography,colonoscopy,and an interview to ascertain the baseline characteristics and general state of health. Multinomial logistic regression analysis was performed to examine the association between NAFLD and the prevalence of colorectal adenomatous and hyperplastic polyps.Furthermore,the relationship was analyzed in different sex groups. Subgroup analysis was performed based on number,size,and location of colorectal polyps.RESULTS The prevalence of colorectal polyps was 38.8% in males(16.2% for adenomatous polyps and 9.8% for hyperplastic polyps) and 19.3% in females(8.4% for adenomatous polyps and 3.9% for hyperplastic polyps). When adjusting for confounding variables,NAFLD was significantly associated with the prevalence of adenomatous polyps(OR = 1.28,95%CI: 1.05-1.51,P < 0.05) and hyperplastic polyps(OR = 1.35,95%CI: 1.01-1.82,P < 0.05). However,upon analyzing adenomatous and hyperplastic polyps in different sex groups,the significant association remained in males(OR = 1.53,95%CI: 1.18-2.00,P < 0.05; OR = 1.42,95%CI: 1.04-1.95,P < 0.05) but not in females(OR = 0.44,95%CI: 0.18-1.04,P > 0.05; OR = 1.18,95%CI: 0.50-2.78,P > 0.05). CONCLUSION NAFLD is specifically associated with an increased risk of colorectal adenomatous and hyperplastic polyps in men. However,NAFLD may not be a significant factor in the prevalence of colorectal polyps in women.

Posttraumatic stress disorder after liver transplantation

BACKGROUND: Liver transplantation can lead to the development of posttraumatic stress disorder (PTSD), but the risk factors associated with this progression are not well understood. To study this syndrome in adult liver transplant recipients, a cross-sectional investigation of 296 recipients at our hospital was carried out between January and June 2010. METHODS: Study participants completed two questionnaires [a PTSD self-rating scale (PTSD-SS) and a validated Chinese version of the Medical Outcomes Study Short Form-36 (SF-36)]. Clinical and demographic data were collected from the records of the Chinese Liver Transplant Registry and via questionnaires. RESULTS: The prevalence of full PTSD and partial PTSD (that met the criteria for 2 of the 3 symptom clusters) was 3.7% and 5.4%, respectively, for all transplant recipients. Significant differences between the recipients with no PTSD, partial PTSD, and full PTSD were found in all SF-36 domains except for physical functioning (P=0.466). In general, domain scores were the highest in the recipients who did not meet the criteria for PTSD and the lowest in the recipients who met the criteria for full PTSD. Greater severity of posttraumatic stress symptoms was correlated with poorer quality of life, especially in the bodily pain (P=0.004), social functioning (P=0.001), role-emotional (P=0.048), and mental health (P<0.001) domains. The model for end-stage liver disease (MELD) scores, complications, and educational status were identified by multiple regression analysis as risk factors for developing PTSD. CONCLUSIONS: PTSD occurred after liver transplantation and was significantly associated with decreased quality of life. Higher MELD scores and complications after transplantation were risk factors that contributed to PTSD, and higher education was a protective factor.

Risk factors for liver disease among adults of Mexican descent in the United States and Mexico

AIM To compare the prevalence of chronic liver disease(CLD) risk factors in a representative sample of MexicanAmericans born in the United States(US) or Mexico, to a sample of adults in Mexico.METHODS Data for Mexican-Americans in the US were obtained from the 1999-2014 National Health and Nutrition Examination Survey(NHANES), which includes persons of Mexican origin living in the US(n = 4274). The NHANES sample was restricted to Mexican-American participants who were 20 years and older, born in the US or Mexico, not pregnant or breastfeeding, and with medical insurance.The data in Mexico were obtained from the 2004-2013 Health Worker Cohort Study in Cuernavaca, Mexico(n =9485). The following known risk factors for liver disease/cancer were evaluated: elevated aminotransferase levels(elevated alanine aminotransferase was defined as > 40 IU/L for males and females; elevated aspartate aminotransferase was defined as > 40 IU/L for males and females), infection with hepatitis B or hepatitis C,metabolic syndrome, high total cholesterol, diabetes,obesity, abdominal obesity, and heavy alcohol use. The main independent variables for this study classified individuals by country of residence(i.e., Mexico vs the US) and place of birth(i.e., US-born vs Mexico-born).Regression analyses were used to investigate CLD risk factors.RESULTS After adjusting for socio-demographic characteristics,Mexican-American males were more likely to be obese,diabetic, heavy/binge drinkers or have abdominal obesity than males in Mexico. The adjusted multivariate results for females also indicate that Mexican-American females were significantly more likely to be obese, diabetic, be heavy/binge drinkers or have abdominal obesity than Mexican females. The prevalence ratios and prevalence differences mirror the multivariate analysis findings for the aforementioned risk factors, showing a greater risk among US-born as compared to Mexico-born MexicanAmericans. CONCLUSION In this study, Mexican-Americans in the US had more risk factors for CLD than their counterparts in Mexico.These findings can be used to design and implement more effective health promotion policies and programs to address the specific factors that put Mexicans at higher risk of developing CLD in both countries.

Non-invasive assessment of liver fibrosis:Betweenprediction/prevention of outcomes and cost-effectiveness

The assessment of the fibrotic evolution of chronic hepatitis has always been a challenge for the clinical hepatologist. Over the past decade, various noninvasive methods have been proposed to detect the presence of fibrosis, including the elastometric measure of stiffness, panels of clinical and biochemical parameters, and combinations of both methods. The aim of this review is to analyse the most recent data on non-invasive techniques for the evaluation of hepatic fibrosis with particular attention to costeffectiveness. We searched for relevant studies published in English using the Pub Med database from 2009 to the present. A large number of studies have suggested that elastography and serum markers are useful techniques for diagnosing severe fibrosis and cirrhosis and for excluding significant fibrosis in hepatitis C virus patients. In addition, hepatic stiffness may also help to prognosticate treatment response to antiviral therapy. It has also been shown that magnetic resonance elastography has a high accuracy for staging and differentiating liver fibrosis. Finally, studies have shown that non-invasive methods are becoming increasingly precise in either positively identifying or excluding liver fibrosis, thus reducing the need for liver biopsy. However, both serum markers and transient elastography still have "grey area" values of lower accuracy. In this case, liver biopsy is still required to properly assess liver fibrosis. Recently, the guidelines produced by the World Health Organization have suggested that the AST-to-platelet ratio index or FIB-4 test could be utilised for the evaluation of liver fibrosis rather than other, more expensive non-invasive tests, such as elastography or Fibro Test.

Improving cirrhosis care: The potential for telemedicine and mobile health technologies

Decompensated cirrhosis is a condition associated with significant morbidity and mortality. While there have been significant efforts to develop quality metrics that ensure high-value care of these patients, wide variations in clinical practice exist. In this opinion review, we discuss the quality gap in the care of patients with cirrhosis, including low levels of compliance with recommended cancer screening and other clinical outcome and patient-reported outcome measures. We posit that innovations in telemedicine and mobile health (mHealth) should play a key role in closing the quality gaps in liver disease management. We highlight interventions that have been performed to date in liver disease and heart failurefrom successful teleconsultation interventions in the care of veterans with cirrhosis to the use of telemonitoring to reduce hospital readmissions and decrease mortality rates in heart failure. Telemedicine and mHealth can effectively address unmet needs in the care of patients with cirrhosis by increasing preventative care, expanding outreach to rural communities, and increasing high-value care. We aim to highlight the benefits of investing in innovative solutions in telemedicine and mHealth to improve care for patients with cirrhosis and create downstream cost savings.

NLR’s Analogs with Young Blood Cells in Monitoring of Toxicity of Long-Term Preventing Immunosuppression in the Liver Transplant’s Recipients

The blood neutrophils to lymphocytes ratio (NLR) reflects the physiological homeostasis between lymphopoiesis and myelopoiesis, and its elevation serves as a harmful sign in many pathologies, partially, late rejection of allograft. The stem and young lymphoid cells have regenerative-trophic properties, which can affect the relevance of NLR, being opposed to immune properties, associated with bulk lymphocytes. In the present article, we have analyzed for the first time the applicability of NLR’s analogs with stem and immature blood cells for monitoring harmful long-term shifting from lymphopoiesis to myelopoiesis in transplant’s recipients received conventional immunosuppressive treatment. In opposition to conventional NLR, the ratio of subpopulation of CD31 cells committed to the liver tissue by alfa-fetoprotein (AFP), seems sensitive enough for such monitoring several years after transplantation of the liver from the dead.

反馈式健康教育结合精细化饮食护理对肝硬化患者营养状况的影响

目的探讨反馈式健康教育联合精细化饮食护理对肝硬化患者营养状况的改善作用。方法以2021年1月至2023年1月就诊于福建省立医院南院的92例肝硬化患者为研究对象,将患者按随机数字表法分为2组,其中,对照组(46例)予以常规健康教育,观察组(46例)基于对照组的干预方法给予反馈式健康教育结合精细化饮食护理。比较2组的肝功能、营养状况及生活质量。结果干预1个月和3个月后,观察组的丙氨酸氨基转移酶、总胆红素及天门冬氨酸氨基转移酶水平均低于同期对照组,血红蛋白、前白蛋白、白蛋白、总蛋白水平和生活质量综合评定问卷-74各项(躯体功能和社会功能等)评分均高于同期对照组(P均<0.05),且2组均较干预前更优(P均<0.05)。结论反馈式健康教育结合精细化饮食护理能改善肝硬化患者的肝功能和营养状况,并提高其生活质量。

氨基酸微量元素螯合物对草鱼肝脏和肠道健康的影响

为研究饲料中氨基酸微量元素螯合物(铁、锰、铜、锌)对草鱼(Ctenopharyngodon idellus)肝脏和肠道健康的影响。共设置6组等氮(30%)、等脂(4.7%)实验饲料,对照组(CON)为不添加铁、锰、铜、锌4种微量元素的基础饲料,在对照组配方基础上添加无机铁(50 mg/kg)、铜(2 mg/kg)、锰(10 mg/kg)、锌(40 mg/kg)制成IT100组,用氨基酸微量元素螯合物以25%(OT25组)、50%(OT50组)、75%(OT75组)和100%(OT100组)的比例替代IT100组中无机微量元素,投喂初始体质量(40.05±0.05) g的草鱼8周。研究显示,与对照组相比,饲料中添加无机微量元素和氨基酸微量元素螯合物显著提高了草鱼肝脏的谷胱甘肽过氧化物酶(GPx)、微量还原型谷胱甘肽(GSH)和总超氧化物歧化酶(SOD)活性,降低了丙二醛含量(P<0.05)。OT100组显著提高了过氧化氢酶(CAT)活性,且OT75组和OT100组GPx活性和GSH含量显著高于IT100组(P<0.05)。与对照组相比,各组草鱼的肝细胞形态和肝血窦丰度趋于正常。与对照组相比,除OT25组外,其余各组的肠道绒毛高度和杯状细胞数量显著提高,且OT75和OT100组显著高于IT100组。无机微量元素和氨基酸微量元素螯合物降低了草鱼肠道细胞因子白介素-6(il-6)和白介素-1β(il-1β)基因表达量,提高了肠道紧密连接蛋白闭锁小带蛋白-2(zo-2)和claudin12基因表达量。OT75组显著提高了zo-1和occludin基因表达量,且OT75组il-1β基因表达量显著低于IT100组。综上所述,无机微量元素和氨基酸微量元素螯合物均可显著改善草鱼肠道和肝脏健康,75%氨基酸微量元素螯合物的作用效果显著优于无机微量元素。

Geological and Geochemical Investigation of Low Grade Basement Rocks: Implication to Human Health in and around Asgeda Tsimbla, Western Tigray, Northern Ethiopia

The increase in the number of liver related disease patients from north western region of Ethiopia has been an environmental health issue of national concern. As the disease is restricted to a specific geographical terrain, particularly to Shire area, northwestern dry zone of the country, detail research studies are required to identify possible etiology and risk factors. The aim of the study is to determine the level of trace element and heavy metal concentrations and distributions in water and stream sediments of the area and identify the possible sources in relation to human health. During the study, geochemical sampling (20 water, 20 stream sediment and 6 rock samples) was carried out in March 2011. The collected samples were analyzed for their major and trace element contents using ICP-MS, ICP-OES, Ion Chromatography (IC), and XRF. Analytical data were organized and treated using Excel, SPSS, ArcGIS and Aquachem softwares. Analytical data results with respect to trace element contents in surface and ground waters are compared with the Maximum Acceptable Concentration or Maximum Allowable Concentration (MAC) of World Health Organization (WHO) and Ethiopian standards for drinking water. The comparison reveals that there are problematic elements that pass over the quality standards set for drinking water. One of these is: Bromine (Br), for which 100% all samples have value above 0.01 mg/l and up to 1.475 mg/l. Other problematic elements including aluminum (Al)—30%, fluorine (F)—20%, arsenic (As)—10%, and nitrate (NO3)—10% are examples of elements which have above WHO-MAC for drinking water. Selenium (Se) deficiency may be the other problematic element in the area for its deficiency is associated with liver damage and heart muscle disorder. The metal contaminations (i.e. heavy metals) were also evaluated by world geochemical background value in average shale and sediment quality guideline proposed by US EPA. The concentration of Co and Cr exceeded average shale value at most sample stations indicated that these stations ware in potential risk. Geochemical factors are mostly considered to explain the etiology of this liver related disease.

原发性肝癌病人健康素养管理移动护理辅助应用程序的构建及应用分析

目的:构建原发性肝癌(primary liver cancer, PLC)病人健康素养管理移动护理辅助应用程序,并对其使用效果进行验证分析。方法:构建由病人使用端、医护使用端及处理器组成的PLC病人健康素养管理移动护理辅助应用程序,将2021年2月-2022年10月于菏泽市立医院住院的100例PLC病人按随机数字表法分为干预组和对照组各50例。对照组采用常规护理管理,干预组在对照组基础上实施基于移动护理辅助应用程序的健康素养管理。采用慢性病病人健康素养调查量表及肝癌病人生活质量量表对两组病人干预前及干预1个月和3个月的健康素养和生活质量进行评估,验证程序的应用效果。结果:两组病人健康素养和生活质量的时间效应、组间效应及交互效应均有统计学意义(P<0.05),两组除干预前各项评分比较差异无统计学意义外,其余时间点各维度评分比较,干预组均高于对照组(P<0.05)。结论:构建PLC病人健康素养管理移动护理辅助应用程序是一种科学有效的医疗护理管理辅助手段,可有效提升病人健康素养水平,改善病人生活质量。

饲料中添加发酵豆粕对湘云鲫生长性能、肠道及肝脏健康的影响

为研究饲料中添加发酵豆粕对湘云鲫幼鱼生长性能、肠道及肝脏健康的影响,试验以豆粕含量26%、鱼粉含量20%的饲料作为基础鱼粉组(FM组)饲料,在FM组饲料的基础上添加12%发酵豆粕等蛋白替代10%豆粕和2%鱼粉制成发酵豆粕替代组(FSM组)饲料,对初始体重为(37.26±0.16)g的湘云鲫幼鱼进行为期56 d的养殖试验。结果显示:与FM组相比,FSM组增重率、特定生长率、尾均摄食量、饵料系数、肥满度、脏体比、肝体比、干物质沉积率、蛋白质沉积率及脂肪沉积率均无显著变化(P>0.05);肌肉粗蛋白质含量显著提高(P<0.05),粗灰分含量显著降低(P<0.05),全鱼粗蛋白质、粗脂肪、粗灰分以及肌肉粗脂肪含量没有显著变化(P>0.05)。在肠道健康方面,FSM组肠道绒毛数目和绒毛高度和FM组间无显著差异(P>0.05);与FM组相比,FSM组血浆D-乳酸含量显著降低了21.5%(P<0.05),血浆内毒素含量和二胺氧化酶活性在FSM组和FM组间无显著差异(P>0.05);FSM组肠道脂肪酶活性较FM组显著提高了10.2%(P<0.05),胰蛋白酶、淀粉酶和Na+-K+ATP酶活性在两组间差异不显著(P>0.05);与FM组相比,FSM组肠道总超氧化物歧化酶活性和丙二醛含量无显著差异(P>0.05)。在肝脏健康方面,发酵豆粕添加对湘云鲫肝脏结构无明显影响,两组均肝细胞索明显,排列较整齐,肝细胞结构完整;与FM组相比,FSM组血浆谷丙转氨酶活性和总胆固醇含量显著降低(P<0.05),其中谷丙转氨酶活性显著降低11.3%,总胆固醇含量降低23.1%,溶菌酶活性和免疫球蛋白M含量显著提高(P<0.05),两组间甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇含量以及谷草转氨酶活性均无显著差异(P>0.05)。

发酵菜籽粕对黄颡鱼表观消化率、肝脏及肠道健康的影响

为探究发酵菜籽粕对黄颡鱼的饲料表观消化率、肝脏及肠道健康的影响,实验以黄颡鱼(Tachysurus fulvidraco)为研究对象,共设置3组饲料,分别为对照组(Control)、未发酵菜籽粕组(URSM)和发酵菜籽粕组(FRSM),养殖实验共持续7周。研究结果表明,FRSM组的增重率(WGR)显著高于USRM组(P<0.05),而饲料系数(FCR)和肝体比(HSI)显著低于URSM组(P<0.05)。与未发酵菜籽粕原料相比,黄颡鱼对发酵菜籽粕原料的干物质、粗蛋白、粗脂肪和能量的表观消化率均增加。肝脏组织结构结果表明,URSM组黄颡鱼肝细胞空泡化的相对面积显著高于对照组和FRSM组(P<0.05)。肠道组织结构及紧密连接相关基因试验结果表明,3组间的黄颡鱼肠道绒毛宽度无显著性差异(P>0.05),而FRSM组黄颡鱼的绒毛长度和肠道zo-1和zo-2的mRNA表达水平显著高于URSM组(P<0.05)。炎症因子相关基因测定结果表明,与URSM组相比,FRSM组黄颡鱼肝脏tnf-α、tnf-β和il-1β的mRNA表达水平显著下调,肠道tnf-α和il-6的mRNA表达水平显著下调,而肠道il-10和tgf-β的mRNA表达水平显著上调。与对照组相比,饲料添加未发酵菜籽粕显著增加了黄颡鱼肝脏和肠道的MDA含量(P<0.05),降低了总抗氧化能力(P<0.05),引发肝脏和肠道氧化应激。而饲料添加发酵菜籽粕减轻了菜籽粕导致的黄颡鱼肝脏和肠道氧化损伤。凋亡相关基因检测结果发现,与对照组相比,饲料添加未发酵菜籽上调了黄颡鱼肝脏和肠道促凋亡基因bax、p53、caspase3、caspase9和mdm2的表达水平,但是下调了bcl2的mRNA表达(P<0.05)。而饲料添加发酵菜籽粕明显改善了未发酵菜籽粕导致的促凋亡现象。研究表明,菜籽粕经发酵后添加至饲料中,可以减轻未发酵菜籽粕导致的黄颡鱼肝脏和肠道炎症反应、氧化损伤及细胞凋亡,从而改善黄颡鱼肝脏和肠道健康。研究为深入探讨发酵菜籽粕对鱼类肝脏和肠道健康的改善作用提供了理论依据,对于发酵菜籽粕在鱼类生产中的应用具有重要意义。