Noninvasive assessment of liver fibrosis with combined serum aminotransferase/platelet ratio index and hyaluronic acid in patients with chronic hepatitis B

AIM:To construct a noninvasive assessment model consisting of routine laboratory data to predict significant fibrosis and cirrhosis in patients with chronic hepatitis B (CHB). METHODS: A total of 137 consecutive patients with CHB who underwent percutaneous liver biopsy were retrospectively analyzed. These patients were divided into two groups according to their aminotransferase (ALT) level. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), the likelihood ratio (LR) of aminotransferase/platelet ratio index (APRI)≥1.5 or <1.5 in combination with different hyaluronic acid (HA) cut-off points were calculated for the presence of moderate to severe fibrosis/cirrhosis (fibrosis stages 2 and 4) and no to mild fibrosis/cirrhosis (fibrosis stages 0 and 1). RESULTS: The APRI correlated with fibrosis stage in CHB patients. The APRI≥1.5 in combination with a cut-off HA cut-off point >300 ng/mL could detect moderate to severe fibrosis (stages 2-4) in CHB patients. The PPV was 93.7%, the specificity was 98.9%. The APRI <1.5 in combination with different HA cut-off points could not detect no to mild fibrosis in CHB patients. CONCLUSION: The APRI≥ 1.5 in combination with a HA cut-off point >300ng/mL can detect moderate to severe fibrosis (stages 2-4) in CHB patients.

Blood F_2-isoprostanes are significantly associated with abnormalities of lipid status in rats with steatosis

AIM: To investigate oxidative stress and lipid peroxi-dation in hepatic steatosis and the underlying implica-tions in pathological mechanisms of non-alcoholic fatty liver disease (NAFLD). METHODS: F_2-isoprostanes (iPF2α-) in blood and liver samples from steatotic (n = 9) and control (n = 7) rats were measured as in vivo marker of lipid peroxida-tion by a mass spectrometric approach. The lipid pro-fi le and endogenous antioxidant status (SOD and CAT) in the rats were also analyzed. RESULTS: Signifi cantly higher levels of iPF2α-(mean 3.47 vs 2.40 pmol/mg tissue, P = 0.004) and lower activities of SOD (mean 1.26 U vs 1.40 U, P < 0.001) and CAT (mean 1026.36 U/mg vs 1149.68 U/mg pro-tein, without signifi cance) were observed in the livers of steatotic rats. Plasma total iPF2α-was signifi cantly correlated with the abnormalities of blood lipids as well as alanine aminotransferase (ALT) levels in the rats with simple steatosis, whereas no similar tendencies were observed in the control rats. CONCLUSION: Enhancement of hepatic oxidative imbalance occurring at the steatotic stage of NAFLD suggests a possibility that manifestation of the local ⅢⅢⅢoxidative damage precedes that of systemic oxidative imbalance. Predominant metabolic features of the in-creased lipid peroxidation further suggest a close asso-ciation of the oxidative imbalance and the dyslipidemia with functional deterioration of the steatotic liver. The fi ndings need to be further evaluated, especially in hu-man studies.

Current status of Mycoplasma pneumoniae infection in China

Mycoplasma pneumoniae(M.pneumoniae)is one of the most important pathogens for community-acquired pneumonia worldwide,especially in children and adolescents[1,2].M.pneumoniae is easily transmitted through droplets or direct contact in densely populated,enclosed,or poorly ventilated environments.The incubation period is 1-3 weeks,and it is contagious from the incubation period to a few weeks after clinical symptom relief.M.pneumoniae infection can occur in any season,and there are differences in the epidemic seasons among regions in China[3].The most suitable culture temperature for M.pneumoniae is between 35℃C and 37 C,and therefore,hot weather may make it survive longer in the environment and spread further.Infection is more common in autumn and winter in northern China,while it is more prevalent in summer and autumn in southern China.

Morphological Evidence of Telocytes in Mice Aorta

Background： Telocytes （TCs） are a novel type of interstitial cells, which have been recently described in a large variety of cavitary and noncavitary organs. TCs have small cell bodies, and remarkably thin, long, and moniliform prolongations called telopodes （Tps）. Until now, TCs have been found in various loose connective tissues surrounding the arterioles, venules, and capillaries, but as a histological cellular component, whether TCs exist in large arteries remains unexplored. Methods： TCs were identified by transmission electron microscope in the aortic arch of male C57BL/6 mice. Results： TCs in aortic arch had small cell bodies （length： 6.06-13.02 μm： width： 1.05-4.25 μm） with characteristics of specific long （7.74-39.05 μm）, thin, and moniliform Tps; TCs distributed in the whole connective tissue layer of tunica adventitia： TCs in the innermost layer of tunica adventitia, located at the juncture between media and adventitia, with their long axes oriented parallel to the outer elastic membrane： and TCs in outer layers oftunica adventitia, were embedded among transverse and longitudinal oriented collagen fibers,forming a highly complex three-dimensional meshwork. Moreover, desmosomes were observed, serving as pathways connecting neighboring Tps. In addition, vesicles shed from the surface of TCs into the extracellular matrix, participating in some biological processes. Conclusions： TCs in aorta arch are a newly recognized complement distinct from other interstitial cells in large arteries, such as fibroblasts. And further biologically functional correlations need to be elucidated.