The outbreak of novel coronavirus disease 2019(COVID-19)has resulted in global emergence.With the expansion of related research,in addition to respiratory symptoms,digestive system involvement such as nausea,vomiting,...The outbreak of novel coronavirus disease 2019(COVID-19)has resulted in global emergence.With the expansion of related research,in addition to respiratory symptoms,digestive system involvement such as nausea,vomiting,and diarrhea have also been reported with COVID-19.Besides,abnormal liver function is also frequent in biochemical tests of COVID-19 patients,which is correlated with the severity and mortality of the disease course.The etiology of liver injury in patients with COVID-19 might include viral immunologic injury,drug-induced liver injury,the systemic inflammatory response,hypoxic hepatitis,and the exacerbation of preexisting liver disease.Although liver injuries in COVID-19 are often transient and reversible,health workers need to pay attention to preexisting liver disease,monitor liver function,strengthen supportive treatment,and reduce the chance of drug-induced liver injury.This article reviews the epidemiological characteristics,etiology,management,and preventive strategies for liver injury in patients with COVID-19.展开更多
The novel coronavirus disease 2019(COVID-19)pandemic,caused by severe acute respiratory syndrome coronavirus 2,has become a global challenge of unprecedented nature since December 2019.Although most patients with COVI...The novel coronavirus disease 2019(COVID-19)pandemic,caused by severe acute respiratory syndrome coronavirus 2,has become a global challenge of unprecedented nature since December 2019.Although most patients with COVID-19 exhibit mild clinical manifestations and upper respiratory tract involvement,in approximately 5%-10%of patients,the disease is severe and involves multiple organs,leading to multi-organ dysfunction and failure.The liver and gastrointestinal tract are also frequently involved in COVID-19.In the context of liver involvement in patients with COVID-19,many key aspects need to be addressed in both native and transplanted organs.This review focuses on the clinical presentations and laboratory abnormalities of liver function tests in patients with COVID-19 with no prior liver disease,patients with pre-existing liver diseases and liver transplant recipients.A brief overview of the history of COVID-19 and etiopathogenesis of the liver injury will also be described as a prelude to better understanding the above aspects.展开更多
Background: Preventing anterior cruciate ligament(ACL) injuries is very important for athletes, and dynamic knee valgus is considered a risk factor for non-contact ACL injury. However, little is known about whether...Background: Preventing anterior cruciate ligament(ACL) injuries is very important for athletes, and dynamic knee valgus is considered a risk factor for non-contact ACL injury. However, little is known about whether the functions of the hip abductor and rear-foot increase dynamic knee valgus. A two-dimensional(2D) video-based screening test focused on hip abductor and rear-foot functions among factors involved in dynamic knee valgus. The present study determined associations between hip and rear-foot dynamic alignment and dynamic knee valgus.Methods: This cross-sectional study recruited 130 female basketball players(258 legs) from nine high-school teams. The players performed single-leg squats and single-leg drop landings to provide knee-in(KID) and hip-out(HOD) distances on 2D video images. Hip and rear-foot dynamic alignment was evaluated using a dynamic Trendelenburg test(DTT) and a dynamic heel-floor test(HFT).Results: The Chi-square test revealed no significant difference in the prevalence of DTT-positivity between single-leg squats(28.7%) and singleleg drop landings(23.3%). The prevalence of HFT-positivity was significantly greater during landings(51.4%) than during single-leg squats(31.0%, p 〈 0.01). The KID values for both single-leg squats and single-leg drop landings were greater in the DTT-positive than in the DTTnegative group(15.1 5.4 cm and 20.2 7.5 cm, p 〈 0.001). The HOD values were similarly greater in the DTT-positive group(15.2 1.9 cm and 17.6 2.8 cm, p 〈 0.001). The KID values for both single-leg squats and single-leg drop landings were greater in the HFT-positive than in the HFT-negative group(12.2 5.1 cm, p 〈 0.01; 14.7 7.2 cm, p 〈 0.001), whereas HOD values for these tasks did not significantly differ between the two groups.Conclusion: Dynamic hip mal-alignment might be associated with both greater KID and HOD, whereas rear-foot eversion is associated only with greater KID. Hip abductor and rear-foot dysfunction are important factors for dynamic knee valgus and thus evaluating DTT and HFT will help to prevent dynamic knee valgus.展开更多
BACKGROUND Abnormal liver chemistries are common findings in patients with Coronavirus Disease 2019(COVID-19).However,the association of these abnormalities with the severity of COVID-19 and clinical outcomes is poorl...BACKGROUND Abnormal liver chemistries are common findings in patients with Coronavirus Disease 2019(COVID-19).However,the association of these abnormalities with the severity of COVID-19 and clinical outcomes is poorly understood AIM We aimed to assess the prevalence of elevated liver chemistries in hospitalized patients with COVID-19 and compare the serum liver chemistries to predict the severity and in-hospital mortality.METHODS This retrospective,observational study included 3380 patients with COVID-19 who were hospitalized in the Johns Hopkins Health System(Baltimore,MD,United States).Demographic data,clinical characteristics,laboratory findings,treatment measures,and outcome data were collected.Cox regression modeling was used to explore variables associated with abnormal liver chemistries on admission with disease severity and prognosis RESULTS A total of 2698(70.4%)had abnormal alanine aminotransferase(ALT)at the time of admission.Other more prevalent abnormal liver chemistries were aspartate aminotransferase(AST)(44.4%),alkaline phosphatase(ALP)(16.1%),and total bilirubin(T-Bil)(5.9%).Factors associated with liver injury were older age,Asian ethnicity,other race,being overweight,and obesity.Higher ALT,AST,T-Bil,and ALP levels were more commonly associated with disease severity.Multivariable adjusted Cox regression analysis revealed that abnormal AST and T-Bil were associated with the highest mortality risk than other liver injury indicators during hospitalization.Abnormal AST,T-Bil,and ALP were associated with a need for vasopressor drugs,whereas higher levels of AST,T-Bil,and a decreased albumin levels were associated with mechanical ventilation CONCLUSION Abnormal liver chemistries are common at the time of hospital admission in COVID-19 patients and can be closely related to the patient’s severity and prognosis.Elevated liver chemistries,specifically ALT,AST,ALP,and T-Bil levels,can be used to stratify risk and predict the need for advanced therapies in these patients.展开更多
Coronavirus disease 2019(COVID-19)disease affects multiple organs,including anomalies in liver function.In this review we summarize the knowledge about liver injury found during severe acute respiratory syndrome coron...Coronavirus disease 2019(COVID-19)disease affects multiple organs,including anomalies in liver function.In this review we summarize the knowledge about liver injury found during severe acute respiratory syndrome coronavirus 2(SARSCoV-2)infection with special attention paid to possible mechanisms of liver damage and abnormalities in liver function tests allowing for the evaluation of the severity of liver disease.Abnormalities in liver function observed in COVID-19 disease are associated with the age and sex of patients,severity of liver injury,presence of comorbidity and pre-treatment.The method of antiviral treatment can also impact on liver function,which manifests as increasing values in liver function tests.Therefore,analysis of variations in liver function tests is necessary in evaluating the progression of liver injury to severe disease.展开更多
BACKGROUND Release of cardiac biomarkers is common after strenuous endurance exercise,but data on intermittent exercise are scarce.It has not been investigated whether cardiac troponin elevation is influenced dependin...BACKGROUND Release of cardiac biomarkers is common after strenuous endurance exercise,but data on intermittent exercise are scarce.It has not been investigated whether cardiac troponin elevation is influenced depending on the type of exercise that an athlete is adapted to perform.We hypothesized that intermittent but not continuous exercise induces cardiac troponin elevation in professional athletes adapted to high-intensity intermittent exercise.AIM To examine how training specificity impacts high-sensitivity cardiac troponin T(hs-cTnT)release.METHODS Nine professional floorball players participated in the study,which comprised two different exercise tests:a continuous incremental cycle ergometer test and a Yo-Yo Intermittent Recovery 2(Yo-Yo IR2)test.Serial assessment of hs-cTnT was performed after the cycle ergometer test and the Yo-Yo IR2 test(baseline,0,2,6,and 24 h).RESULTS No hs-cTnT elevation above the myocardial damage cutoff(≥14 ng/L)was shown after the cycle ergometer test,whereas hs-cTnT levels rose over the cutoff in three of nine participants after the Yo-Yo IR2 test.The hs-cTnT levels peaked at 6 h after both tests,but were significantly higher after the Yo-Yo IR2 test compared to the cycle ergometer test(median hs-cTnT concentration 10.6 ng/L vs 7.8 ng/L,P=0.038).All levels returned to baseline within 24 h.CONCLUSION In professional athletes adapted to high-intensity intermittent exercise,hs-cTnT was significantly elevated after intermittent but not continuous exercise.This principle of specificity training should be considered when designing future studies to avoid misinterpretation of hs-cTnT elevation.展开更多
The study of α4β2 nicotinic receptors has provided new indications in the treatment of pain. Efforts have been made to explore new α4β2 nicotinic receptor agonists, including TC-2559, as antinociceptive drugs. In ...The study of α4β2 nicotinic receptors has provided new indications in the treatment of pain. Efforts have been made to explore new α4β2 nicotinic receptor agonists, including TC-2559, as antinociceptive drugs. In this study, we discovered a set of novel epibatidine analogs with strong binding affinities to the α4β2 nicotinic receptors. Among these compounds, C-159, C-163, and C-9515 attenuated formalin-induced nociceptive responses in mice; C-9515 caused the most potent analgesic effect, which was blocked by mecamylamine, a non-selective nicotinic receptor antagonist. Furthermore, C-9515 potently inhibited chronic constriction injury(CCI)-induced neuropathic pain in rats, which was sensitive to DHβE, a selective α4β2 subtype antagonist,indicating that its analgesic effect was mediated by the activation of the α4β2 nicotinic receptors. In conclusion, the epibatidine analog C-9515 was found to be a potent α4β2 nicotinic receptor agonist with potent analgesic function, which demonstrated potential for the further exploration of its druggability.展开更多
Objective To explore whether acupuncture can improve sleep disturbance,cognitive impairment and emotional disorders caused by sleep deprivation,and its association with the attenuation of oxidative stress injury in pr...Objective To explore whether acupuncture can improve sleep disturbance,cognitive impairment and emotional disorders caused by sleep deprivation,and its association with the attenuation of oxidative stress injury in prefrontal cortex.Methods Fifty-two male Sprague-Dawley rats were randomly divided into a control group(n=10),a model group(n=14),a manual acupuncture(MA)group(n=14),and a sham-MA group(n=14).All the groups were established as sleep deprivation models via the modified multiple platform method,except for the control group.Rats in both the MA group and the sham-MA group received corresponding intervention,respectively.After modeling and intervention,the four groups received three behavioral tests,namely sleep monitoring,by comprehensive lab animal monitoring system(CLAMS),Morris water maze(MWM)test and open-field test(OFT),followed by oxygen free radical level test and Western blot(WB)detection for the expression levels of Bax and Bcl-2.Results The MA group derived more sleep time within 24 h than either the model group or the sham-MA group(both P<0.05).On MWM orientation navigation test day 1,there were no significant differences in escape latency among the control,MA and sham-MA groups(P>0.05),and the escape latency was significantly shorter in these three groups than that in the model group(all P<0.05).On test day 4,the escape latency was markedly shorter in the MA group than that in either the model group or the sham-MA group(both P<0.05);meanwhile,the MA group showed significantly better performance compared with these two groups in space probe test(both P<0.05).In OFT,compared with the control group,there was a significant decline in the horizontal movement score in the other three groups(all P<0.05),and the decrease was more significant in the model group and the sham-MA group than that in the MA group(both P<0.05).The superoxide dismutase(SOD)content was markedly higher and the malondialdehyde(MDA)content was markedly lower in the MA group than those in the model group and the sham-MA group(all P<0.05).Compared with the model group and the sham-MA group,the expression of Bax was significantly lower and the expression of Bcl-2 was significantly higher in the MA group(all P<0.05).Conclusion MA therapy can lengthen the sleep time in sleep-deprived rats and improve learning and memory impairments induced by sleep deprivation,and the underlying mechanism may be associated with the enhancement of antioxidant capacity in the prefrontal cortex and the inhibition of hippocampal neuronal apoptosis.展开更多
基金Supported by the National Key Research and Development Program,No.2017YFC0908903National Natural Science Foundation of China,No.81873565 and No.81900507Hospital Funded Clinical Research,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,No.17CSK04.
文摘The outbreak of novel coronavirus disease 2019(COVID-19)has resulted in global emergence.With the expansion of related research,in addition to respiratory symptoms,digestive system involvement such as nausea,vomiting,and diarrhea have also been reported with COVID-19.Besides,abnormal liver function is also frequent in biochemical tests of COVID-19 patients,which is correlated with the severity and mortality of the disease course.The etiology of liver injury in patients with COVID-19 might include viral immunologic injury,drug-induced liver injury,the systemic inflammatory response,hypoxic hepatitis,and the exacerbation of preexisting liver disease.Although liver injuries in COVID-19 are often transient and reversible,health workers need to pay attention to preexisting liver disease,monitor liver function,strengthen supportive treatment,and reduce the chance of drug-induced liver injury.This article reviews the epidemiological characteristics,etiology,management,and preventive strategies for liver injury in patients with COVID-19.
文摘The novel coronavirus disease 2019(COVID-19)pandemic,caused by severe acute respiratory syndrome coronavirus 2,has become a global challenge of unprecedented nature since December 2019.Although most patients with COVID-19 exhibit mild clinical manifestations and upper respiratory tract involvement,in approximately 5%-10%of patients,the disease is severe and involves multiple organs,leading to multi-organ dysfunction and failure.The liver and gastrointestinal tract are also frequently involved in COVID-19.In the context of liver involvement in patients with COVID-19,many key aspects need to be addressed in both native and transplanted organs.This review focuses on the clinical presentations and laboratory abnormalities of liver function tests in patients with COVID-19 with no prior liver disease,patients with pre-existing liver diseases and liver transplant recipients.A brief overview of the history of COVID-19 and etiopathogenesis of the liver injury will also be described as a prelude to better understanding the above aspects.
文摘Background: Preventing anterior cruciate ligament(ACL) injuries is very important for athletes, and dynamic knee valgus is considered a risk factor for non-contact ACL injury. However, little is known about whether the functions of the hip abductor and rear-foot increase dynamic knee valgus. A two-dimensional(2D) video-based screening test focused on hip abductor and rear-foot functions among factors involved in dynamic knee valgus. The present study determined associations between hip and rear-foot dynamic alignment and dynamic knee valgus.Methods: This cross-sectional study recruited 130 female basketball players(258 legs) from nine high-school teams. The players performed single-leg squats and single-leg drop landings to provide knee-in(KID) and hip-out(HOD) distances on 2D video images. Hip and rear-foot dynamic alignment was evaluated using a dynamic Trendelenburg test(DTT) and a dynamic heel-floor test(HFT).Results: The Chi-square test revealed no significant difference in the prevalence of DTT-positivity between single-leg squats(28.7%) and singleleg drop landings(23.3%). The prevalence of HFT-positivity was significantly greater during landings(51.4%) than during single-leg squats(31.0%, p 〈 0.01). The KID values for both single-leg squats and single-leg drop landings were greater in the DTT-positive than in the DTTnegative group(15.1 5.4 cm and 20.2 7.5 cm, p 〈 0.001). The HOD values were similarly greater in the DTT-positive group(15.2 1.9 cm and 17.6 2.8 cm, p 〈 0.001). The KID values for both single-leg squats and single-leg drop landings were greater in the HFT-positive than in the HFT-negative group(12.2 5.1 cm, p 〈 0.01; 14.7 7.2 cm, p 〈 0.001), whereas HOD values for these tasks did not significantly differ between the two groups.Conclusion: Dynamic hip mal-alignment might be associated with both greater KID and HOD, whereas rear-foot eversion is associated only with greater KID. Hip abductor and rear-foot dysfunction are important factors for dynamic knee valgus and thus evaluating DTT and HFT will help to prevent dynamic knee valgus.
文摘BACKGROUND Abnormal liver chemistries are common findings in patients with Coronavirus Disease 2019(COVID-19).However,the association of these abnormalities with the severity of COVID-19 and clinical outcomes is poorly understood AIM We aimed to assess the prevalence of elevated liver chemistries in hospitalized patients with COVID-19 and compare the serum liver chemistries to predict the severity and in-hospital mortality.METHODS This retrospective,observational study included 3380 patients with COVID-19 who were hospitalized in the Johns Hopkins Health System(Baltimore,MD,United States).Demographic data,clinical characteristics,laboratory findings,treatment measures,and outcome data were collected.Cox regression modeling was used to explore variables associated with abnormal liver chemistries on admission with disease severity and prognosis RESULTS A total of 2698(70.4%)had abnormal alanine aminotransferase(ALT)at the time of admission.Other more prevalent abnormal liver chemistries were aspartate aminotransferase(AST)(44.4%),alkaline phosphatase(ALP)(16.1%),and total bilirubin(T-Bil)(5.9%).Factors associated with liver injury were older age,Asian ethnicity,other race,being overweight,and obesity.Higher ALT,AST,T-Bil,and ALP levels were more commonly associated with disease severity.Multivariable adjusted Cox regression analysis revealed that abnormal AST and T-Bil were associated with the highest mortality risk than other liver injury indicators during hospitalization.Abnormal AST,T-Bil,and ALP were associated with a need for vasopressor drugs,whereas higher levels of AST,T-Bil,and a decreased albumin levels were associated with mechanical ventilation CONCLUSION Abnormal liver chemistries are common at the time of hospital admission in COVID-19 patients and can be closely related to the patient’s severity and prognosis.Elevated liver chemistries,specifically ALT,AST,ALP,and T-Bil levels,can be used to stratify risk and predict the need for advanced therapies in these patients.
文摘Coronavirus disease 2019(COVID-19)disease affects multiple organs,including anomalies in liver function.In this review we summarize the knowledge about liver injury found during severe acute respiratory syndrome coronavirus 2(SARSCoV-2)infection with special attention paid to possible mechanisms of liver damage and abnormalities in liver function tests allowing for the evaluation of the severity of liver disease.Abnormalities in liver function observed in COVID-19 disease are associated with the age and sex of patients,severity of liver injury,presence of comorbidity and pre-treatment.The method of antiviral treatment can also impact on liver function,which manifests as increasing values in liver function tests.Therefore,analysis of variations in liver function tests is necessary in evaluating the progression of liver injury to severe disease.
文摘BACKGROUND Release of cardiac biomarkers is common after strenuous endurance exercise,but data on intermittent exercise are scarce.It has not been investigated whether cardiac troponin elevation is influenced depending on the type of exercise that an athlete is adapted to perform.We hypothesized that intermittent but not continuous exercise induces cardiac troponin elevation in professional athletes adapted to high-intensity intermittent exercise.AIM To examine how training specificity impacts high-sensitivity cardiac troponin T(hs-cTnT)release.METHODS Nine professional floorball players participated in the study,which comprised two different exercise tests:a continuous incremental cycle ergometer test and a Yo-Yo Intermittent Recovery 2(Yo-Yo IR2)test.Serial assessment of hs-cTnT was performed after the cycle ergometer test and the Yo-Yo IR2 test(baseline,0,2,6,and 24 h).RESULTS No hs-cTnT elevation above the myocardial damage cutoff(≥14 ng/L)was shown after the cycle ergometer test,whereas hs-cTnT levels rose over the cutoff in three of nine participants after the Yo-Yo IR2 test.The hs-cTnT levels peaked at 6 h after both tests,but were significantly higher after the Yo-Yo IR2 test compared to the cycle ergometer test(median hs-cTnT concentration 10.6 ng/L vs 7.8 ng/L,P=0.038).All levels returned to baseline within 24 h.CONCLUSION In professional athletes adapted to high-intensity intermittent exercise,hs-cTnT was significantly elevated after intermittent but not continuous exercise.This principle of specificity training should be considered when designing future studies to avoid misinterpretation of hs-cTnT elevation.
基金supported by the National Natural Science Foundation of China(31471027,81400895 to Yun Wang and Weiwei Li)
文摘The study of α4β2 nicotinic receptors has provided new indications in the treatment of pain. Efforts have been made to explore new α4β2 nicotinic receptor agonists, including TC-2559, as antinociceptive drugs. In this study, we discovered a set of novel epibatidine analogs with strong binding affinities to the α4β2 nicotinic receptors. Among these compounds, C-159, C-163, and C-9515 attenuated formalin-induced nociceptive responses in mice; C-9515 caused the most potent analgesic effect, which was blocked by mecamylamine, a non-selective nicotinic receptor antagonist. Furthermore, C-9515 potently inhibited chronic constriction injury(CCI)-induced neuropathic pain in rats, which was sensitive to DHβE, a selective α4β2 subtype antagonist,indicating that its analgesic effect was mediated by the activation of the α4β2 nicotinic receptors. In conclusion, the epibatidine analog C-9515 was found to be a potent α4β2 nicotinic receptor agonist with potent analgesic function, which demonstrated potential for the further exploration of its druggability.
文摘Objective To explore whether acupuncture can improve sleep disturbance,cognitive impairment and emotional disorders caused by sleep deprivation,and its association with the attenuation of oxidative stress injury in prefrontal cortex.Methods Fifty-two male Sprague-Dawley rats were randomly divided into a control group(n=10),a model group(n=14),a manual acupuncture(MA)group(n=14),and a sham-MA group(n=14).All the groups were established as sleep deprivation models via the modified multiple platform method,except for the control group.Rats in both the MA group and the sham-MA group received corresponding intervention,respectively.After modeling and intervention,the four groups received three behavioral tests,namely sleep monitoring,by comprehensive lab animal monitoring system(CLAMS),Morris water maze(MWM)test and open-field test(OFT),followed by oxygen free radical level test and Western blot(WB)detection for the expression levels of Bax and Bcl-2.Results The MA group derived more sleep time within 24 h than either the model group or the sham-MA group(both P<0.05).On MWM orientation navigation test day 1,there were no significant differences in escape latency among the control,MA and sham-MA groups(P>0.05),and the escape latency was significantly shorter in these three groups than that in the model group(all P<0.05).On test day 4,the escape latency was markedly shorter in the MA group than that in either the model group or the sham-MA group(both P<0.05);meanwhile,the MA group showed significantly better performance compared with these two groups in space probe test(both P<0.05).In OFT,compared with the control group,there was a significant decline in the horizontal movement score in the other three groups(all P<0.05),and the decrease was more significant in the model group and the sham-MA group than that in the MA group(both P<0.05).The superoxide dismutase(SOD)content was markedly higher and the malondialdehyde(MDA)content was markedly lower in the MA group than those in the model group and the sham-MA group(all P<0.05).Compared with the model group and the sham-MA group,the expression of Bax was significantly lower and the expression of Bcl-2 was significantly higher in the MA group(all P<0.05).Conclusion MA therapy can lengthen the sleep time in sleep-deprived rats and improve learning and memory impairments induced by sleep deprivation,and the underlying mechanism may be associated with the enhancement of antioxidant capacity in the prefrontal cortex and the inhibition of hippocampal neuronal apoptosis.