葛黄颗粒对酒精性肝损伤大鼠醇、醛脱氢酶及细胞色素P4502E1活性的影响

目的观察葛黄颗粒对酒精性肝病大鼠醇脱氢酶(ADH)、醛脱氢酶(ALDH)及细胞色素P4502E1(CYP450 2E1)活性的影响。方法白酒灌胃加普通饲料饮食复制酒精性肝病大鼠,复制成功后,白酒灌胃继续,除模型组外,葛黄颗粒高、中、低剂量干预组同时分别给予不同浓度的葛黄颗粒灌胃,正常组一直采用相同剂量蒸馏水灌胃,13周后处死大鼠,行肝组织HE染色、血清丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、ADH、ALDH含量检测,Western blot检测肝CYP450 2E1蛋白表达。结果与正常组比较,模型组的肝脏指数、肝功能指标、ADH及CYP450 2E1均升高(P <0.01),而ALDH却降低(P <0.01);与模型组比较,不同剂量(高、中、低)葛黄颗粒干预组均可逆转以上检测指标,且存在一定的量效关系,即高、中剂量组逆转效果较好(P <0.01)。结论一定剂量葛黄颗粒可通过调节ADH等乙醇代谢酶活性延缓或逆转酒精性肝损伤的发生。

Effect of Ganduqing Granule on metabolic disorder and liver dysfunction in patients with chronic hepatitis B

Objective:This study investigated the potential mechanisms of Ganduqing Granule(GDQG)in improving the liver function in patients with chronic hepatitis B(CHB).Methods:Plasma samples from 30 healthy volunteers and 30 patients with CHB before and after the treatment with GDQG were measured for the alterations in liver function and metabolites,using the method of ultra-high-performance liquid chromatography coupled with time-of-flight mass spectrometry.Results:Patients with CHB developed severe liver dysfunction,which was associated with the higher plasma levels of 8 metabolites when compared with those of the normal control(P<0.05).Interestingly,after treatment with GDQG for 3 weeks,the 8 metabolites were significantly reduced(P<0.05).Among them,glycochenodeoxycholate-3-sulfate,glycochenodeoxycholic acid-3-glucuronide,taurochenodeoxycholic acid,and 7b-hydroxy-3-oxo-5b-cholanoic acid were associated with the metabolism of bile acids,while 3b,16a-dihydroxyandrostenone sulfate,lysophosphatidylcholine(C18:3),and lysophosphatidylethanolamine(C22:1)were related to the metabolism of lipids.2,6-Diamino-4-hydroxy-5-N-methylformamidopyrimidine was related to hepatic oxidative stress.Meanwhile,liver damage in patients was greatly reduced.Conclusion:Treatment with GDQG has improved liver function of patients with CHB through the possible mechanism of adjusting the metabolic disorders related to lipids,bile acids,and oxidative stress.

Minimally invasive surgery alone compared with intensity-modulated radiotherapy for primary stage I nasopharyngeal carcinoma

Background:The National Comprehensive Cancer Network guidelines recommend intensity-modulated radiotherapy(IMRT)as the primary curative treatment for newly diagnosed nasopharyngeal carcinoma(NPC),but the radiation-related complications and relatively high medical costs remain a consequential burden for the patients.Endoscopic nasopharyngectomy(ENPG)was successfully applied in recurrent NPC with radiation free and relatively low medical costs.In this study,we examined whether ENPG could be an effective treatment for localized stage I NPC.Methods:Ten newly diagnosed localized stage I NPC patients voluntarily received ENPG alone from June 2007 to September 2017 in Sun Yat-sen University Cancer Center.Simultaneously,the data of 329 stage I NPC patients treated with IMRT were collected and used as a reference cohort.The survival outcomes,quality of life(QOL),and medical costs between two groups were compared.Results:After a median follow-up of 59.0 months(95%CI 53.4-64.6),no death,locoregional recurrence,or distant metastasis was observed in the 10 patients treated with ENPG.The 5-year overall survival,local relapse-free survival,regional relapse-free survival,and distant metastasis-free survival among the ENPG-treated patients was similar to that among the IMRT-treated patients(100%vs.99.1%,100%vs.97.7%,100%vs.99.0%,100%vs.97.4%,respectively,P>0.05).In addition,compared with IMRT,ENPG was associated with decreased total medical costs($4090.42±1502.65 vs.$12620.88±4242.65,P<0.001)and improved QOL scores including dry mouth(3.3±10.5 vs.34.4±25.8,P<0.001)and sticky saliva(3.3±10.5 vs.32.6±23.3,P<0.001).Conclusions:ENPG alone was associated with promising long-term survival outcomes,low medical costs,and satisfactory QOL and might therefore be an alternative strategy for treating newly diagnosed localized stage I NPC patients who refused radiotherapy.However,the application of ENPG should be prudent,and prospective clinical tri-als were needed to further verify the results.

A curative-intent endoscopic surgery for postradiation nasopharyngeal necrosis in patients with nasopharyngeal carcinoma

Background:Postradiation nasopharyngeal necrosis(PRNN)is a severe complication after radiotherapy in patients with nasopharyngeal carcinoma(NPC),which can severely affect the quality of life and threaten the patient’s life.Only 13.4%-28.6%of patients can be cured by traditional repeated endoscopic debridement.Here,we introduced an innovative curative-intent endoscopic surgery for PRNN patients and evaluated its clinical efficacy.Methods:Clinical data of 72 PRNN patients who underwent radical endoscopic necrectomy,followed by reconstruc-tion using a posterior pedicle nasal septum and floor mucoperiosteum flap were analyzed to determine the efficacy of this surgery.The endpoints were complete re-epithelialization of the nasopharyngeal defect,relief of headache,and overall survival(OS).Results:All surgeries were successfully performed without any severe postoperative complications or death.The median value of numeric rating scales of pain decreased from 8 before surgery to 0 after surgery(P<0.001).Fifty-one patients(70.8%)achieved complete re-epithelialization of the nasopharyngeal defect.The number of cycles of radiotherapy(odds ratio[OR],7.254;95%confidence interval[CI]1.035-50.821;P=0.046),postoperative pathological result(OR,34.087;95%CI 3.168-366.746;P=0.004),and survival status of flap(OR,261.179;95%CI 17.176-3971.599;P<0.001)were independent risk factors of re-epithelialization of the nasopharyngeal defects.Postoperative patho-logical result(hazard ratio[HR],5.018;95%CI 1.970-12.782;P=0.001)was an independent prognostic factor for OS.The 2-year OS rate of the entire cohort was 77.9%.Conclusion:Curative-intent endoscopic necrectomy followed by construction using the posterior pedicle nasal septum and floor mucoperiosteum flap is a novel,safe,and effective treatment of PRNN in patients with NPC.