Estimating liver weight of adults by body weight and gender

AIM： To estimate the standard liver weight for assessing adequacies of graft size in live donor liver transplantation and remnant liver in major hepatectomy for cancer. METHODS： In this study, anthropometric data of body weight and body height were tested for a correlation with liver weight in 159 live liver donors who underwent donor right hepatectomy including the middle hepatic vein. Liver weights were calculated from the right lobe graft weight obtained at the back table, divided by the proportion of the right lobe on the computed tomography. RESULTS： The subjects, all Chinese, had a mean age of 35.8 ± 10.5 years, and a female to male ratio of 118：41. The mean volume of the right lobe was 710.14 ±131.46 mL and occupied 64.55%±4.47% of the whole liver on computed tomography. Right lobe weighed 598.90±117.39 g and the estimated liver weight was 927.54 ± 168.78 g. When body weight and body height were subjected to multiple stepwise linear regression analysis, body height was found to be insignificant. Females of the same body weight had a slightly lower liver weight. A formula based on body weight and gender was derived： Estimated standard liver weight （g）=218＋BW （kg）× 12.3＋gender×51 （R^2 = 0.48） （female=0, male= 1）. Based on the anthropometric data of these 159 subjects, liver weights were calculated using previously published formulae derived from studies on Caucasian, .lapanese, Korean, and Chinese. All formulae overestimated liver weights compared to this formula. The Japanese formula overestimated the estimated standard liver weight （ESLW） for adults less than 60 kg.CONCLUSION： A formula applicable to Chinese males and females is available. A formula for individual races appears necessary.

Standard liver weight model in adult deceased donors with fatty liver: A prospective cohort study

BACKGROUND Standard liver weight(SLW)is frequently used in deceased donor liver transplantation to avoid size mismatches with the recipient.However,some deceased donors(DDs)have fatty liver(FL).A few studies have reported that FL could impact liver size.To the best of our knowledge,there are no relevant SLW models for predicting liver size.AIM To demonstrate the relationship between FL and total liver weight(TLW)in detail and present a related SLW formula.METHODS We prospectively enrolled 212 adult DDs from West China Hospital of Sichuan University from June 2019 to February 2021,recorded their basic information,such as sex,age,body height(BH)and body weight(BW),and performed abdominal ultrasound(US)and pathological biopsy(PB).The chi-square test and kappa consistency score were used to assess the consistency in terms of FL diagnosed by US relative to PB.Simple linear regression analysis was used to explore the variables related to TLW.Multiple linear regression analysis was used to formulate SLW models,and the root mean standard error and interclass correlation coefficient were used to test the fitting efficiency and accuracy of the model,respectively.Furthermore,the optimal formula was compared with previous formulas.RESULTS Approximately 28.8%of DDs had FL.US had a high diagnostic ability(sensitivity and specificity were 86.2%and 92.9%,respectively;kappa value was 0.70,P<0.001)for livers with more than a 5%fatty change.Simple linear regression analysis showed that sex(R2,0.226;P<0.001),BH(R2,0.241;P<0.001),BW(R2,0.441;P<0.001),BMI(R2,0.224;P<0.001),BSA(R2,0.454;P<0.001)and FL(R2,0.130;P<0.001)significantly impacted TLW.In addition,multiple linear regression analysis showed that there was no significant difference in liver weight between the DDs with no steatosis and those with steatosis within 5%.Furthermore,in the context of hepatic steatosis,TLW increased positively(nonlinear);compared with the TLW of the non-FL group,the TLW of the groups with hepatic steatosis within 5%,between 5%and 20%and more than 20%increased by 0 g,90 g,and 340 g,respectively.A novel formula,namely,-348.6+(110.7 x Sex[0=Female,1=Male])+958.0 x BSA+(179.8 x FLUS[0=No,1=Yes]),where FL was diagnosed by US,was more convenient and accurate than any other formula for predicting SLW.CONCLUSION FL is positively correlated with TLW.The novel formula deduced using sex,BSA and FLUS is the optimal formula for predicting SLW in adult DDs.

Mapping novel genetic loci associated with female liver weight variations using Collaborative Cross mice

Background: Liver weight is a complex trait, controlled by polygenic factors and differs within populations. Dissecting the genetic architecture underlying these variations will facilitate the search for key role candidate genes involved directly in the hepatomegaly process and indirectly involved in related diseases etiology.Methods: Liver weight of 506 mice generated from 39 different Collaborative Cross(CC) lines with both sexes at age 20 weeks old was determined using an electronic balance. Genomic DNA of the CC lines was genotyped with high-density single nucleotide polymorphic markers.Results: Statistical analysis revealed a significant(P < 0.05) variation of liver weight between the CC lines, with broad sense heritability(H^2) of 0.32 and genetic coefficient of variation(CV_G) of 0.28. Subsequently, quantitative trait locus(QTL) mapping was performed, and results showed a significant QTL only for females on chromosome 8 at genomic interval 88.61-93.38 Mb(4.77 Mb). Three suggestive QTL were mapped at chromosomes 4, 12 and 13. The four QTL were designated as LWL1-LWL4 referring to liver weight loci 1-4 on chromosomes 8, 4, 12 and 13,respectively.Conclusion: To our knowledge, this report presents, for the first time, the utilization of the CC for mapping QTL associated with baseline liver weight in mice. Our findings demonstrate that liver weight is a complex trait controlled by multiple genetic factors that differ significantly between sexes.

Physical activity support or weight loss counseling for nonalcoholic fatty liver disease?

AIM: To determine the clinical effectiveness of intense psychological support to physical activity (PA) in nonalcoholic fatty liver disease (NAFLD), compared with cognitive-behavioral treatment (CBT).

Diffusion weighted magnetic resonance imaging of liver: Principles, clinical applications and recent updates

Diffusion-weighted imaging(DWI), a functional imaging technique exploiting the Brownian motion of water molecules, is increasingly shown to have value in various oncological and non-oncological applications. Factors such as the ease of acquisition and ability to obtain functional information in the absence of intravenous contrast, especially in patients with abnormal renal function, have contributed to the growing interest in exploring clinical applications of DWI. In the liver, DWI demonstrates a gamut of clinical applications ranging from detecting focal liver lesions to monitoring response in patients undergoing serial follow-up after loco-regional and systemic therapies. DWI is also being applied in the evaluation of diffuse liver diseases such as non-alcoholic fatty liver disease, hepatic fibrosis and cirrhosis. In this review, we intend to review the basic principles, technique, current clinical applications and future trends of DW-MRI in the liver.

Diffusion weighted imaging in the liver

Diffusion weighted magnetic resonance imaging (DWI) is an imaging technique which provides tissue contrast by the measurement of diffusion properties of water molecules within tissues. Diffusion is expressed in an apparent diffusion coefficient (ADC), which reflects the diffusion properties unique to each type of tissue. DWI has been originally used in neuroradiology. More recently, DWI has increasingly been used in addition to conventional unenhanced and enhanced magnetic resonance imaging (MRI) in other parts of the body. The reason for this delay was a number of technical problems inherent to the technique, making DWI very sensitive to artifacts, which had to be overcome. With assessment of ADC values, DWI proved to be helpful in characterization of focal liver lesions. However, DWI should always be used in conjunction to conventional MRI since there is considerable overlap between ADC values of benign and malignant lesions. DWI is useful in the detection of hepatocellular carcinoma in the cirrhotic liver and detection of liver metastases in oncological patients. In addition, DWI is a promising tool in the prediction of tumor responsiveness to chemotherapy and the follow-up of oncological patients after treatment, as DWI may be capable of detecting recurrent disease earlier than conventional imaging.This review focuses on the most common applications of DWI in the liver.

Liver intravoxel incoherent motion diffusion-weighted imaging for the assessment of hepatic steatosis and fibrosis in children

AIM To evaluate the correlation between intravoxel incoherent motion(IVIM) diffusion-weighted imaging(DWI) parameters and the degree of hepatic steatosis and fibrosis in children.METHODS This retrospective study was approved by the institutional review board. The children(≤ 18 years) who underwent liver IVIM DWI with 8 b-values under the suspicion of hepatic steatosis or fibrosis from February 2013 to November 2016 were included. Subjects were divided into normal, fatty liver(FAT), and fibrotic liver(FIB) groups. The slow diffusion coefficient(D), fast diffusion coefficient(D*), perfusion fraction(f), and apparent diffusion coefficient(ADC) were measured. MR proton density fat fraction(PDFF), MR elastography(MRE), and IVIM values were compared.RESULTS A total of 123 children(median age of 12 years old, range: 6-18 years) were included, with 8 in the normal group, 93 in the FAT group, and 22 in the FIB group. The D* values were lower in the FIB group compared with those of the normal(P = 0.015) and FAT(P = 0.003) groups. The f values were lower in the FIB group compared with the FAT group(P = 0.001). In multivariate analyses, PDFF value was positively correlated with f value(β = 3.194, P < 0.001), and MRE value was negatively correlated with D* value(β =-7.031, P = 0.032). The D and ADC values were not influenced by PDFF or MRE value.CONCLUSION In liver IVIM DWI with multiple b-values in children, there was a positive correlation between hepatic fat and blood volume, and a negative correlation between hepatic stiffness and endovascular blood flow velocity, while diffusion-related parameters were not affected.

Diffusion-weighted MRI in a liver protocol: Its role in focal lesion detection

AIM: To evaluate the role of diffusion-weighted imaging (DWI) in the detection of focal liver lesions (FLLs), using a conventional magnetic resonance imaging (MRI) protocol. METHODS: Fifty-two patients (22 males, average age 55.6 years, range: 25-82 years), studied using a 1.5 Tesla magnetic resonance scanner, were retrospectively analyzed; detection of FLLs was evaluated by considering the number of lesions observed with the following sequences: (1) respiratory-triggered diffusion-weighted single-shot echo-planar (DW SS-EP) sequences; (2) fat-suppressed fast spin-echo (fs-FSE) T2 weighted sequences; (3) steady-state free precession (SSFP) images; and (4) dynamic triphasic gadolinium-enhanced images, acquired with three-dimensional fast spoiled gradient-echo (3D FSPGR). Two radiologists independently reviewed the images: they were blinded to their respective reports. DW SS-EP sequences were compared to fs-FSE, SSFP and dynamic gadolinium-enhanced acquisitions using a t -test. Pairs were compared for the detection of: (1) all FLLs; (2) benign FLLs; (3) malignant FLLs; (4) metastases; and (5) hepatocellular carcinoma (HCC). RESULTS: Interobserver agreement was very good (weighted = 0.926, CI = 0.880-0.971); on the consensus reading, 277 FLLs were detected. In the comparison with fs-FSE, DW SS-EP sequences had a significantly higher score in the detection of all FLLs, benign FLLs, malignant FLLs and metastases; no statistical difference was observed in the detection of hepatocellular carcinoma (HCCs). In the comparison with SSFP sequences, DW SS-EP had significantly higher scores (P < 0.05) in the detection of all lesions, benign lesions, malignant lesions, metastases and HCC. All FLLs were better detected by dynamic 3D FSGR enhanced acquisition, with P = 0.0023 for reader 1 and P = 0.0086 for reader 2 in the comparison with DW SS-EP sequences; with reference to benign FLLs, DW SS-EP showed lower values than 3D FSPGR enhanced acquisition (P < 0.05). No statistical differences were observed in the detection of malignant lesions and metastases; considering HCCs, a very slight difference was reported by reader 1 (P = 0.049), whereas no difference was found by reader 2 (P = 0.06). CONCLUSION: In lesion detection, DWI had higher scores than T2 sequences; considering malignant FLLs, no statistical difference was observed between DWI and dynamic gadolinium images.

Graft-to-recipient weight ratio lower to 0.7% is safe without portal pressure modulation in right-lobe living donor liver transplantation with favorable conditions

BACKGROUND: The low graft-to-recipient weight ratio(GRWR) in adult-to-adult living donor liver transplantation(LDLT) is one of the major risk factors affecting graft survival. The goal of this study was to evaluate whether the lower limit of the GRWR can be safely reduced without portal pressure modulation in right-lobe LDLT. METHODS: From 2005 to 2011, 317 consecutive patients from a single institute underwent LDLT with right-lobe grafts without portal pressure modulation. Of these, 23 had a GRWR of less than 0.7%(group A), 27 had a GRWR of ≥0.7%, 【0.8%(group B), and 267 had a GRWR of more than and equal to 0.8%(group C). Medical records, including recipient, donor, operation factors, laboratory findings and complications were reviewed retrospectively. RESULTS: The baseline demographics showed low model for end-stage liver disease score(mean 16.3±8.9) and high percentage of hepatocellular carcinoma(231 patients, 72.9%). Three groups by GRWR demonstrated similar characteristics except recipient body mass index and donor gender. For smallforsize syndrome, there were 3(13.0%) in group A, 1(3.7%) in group B, and 2 patients(0.7%) in group C(P【0.001). Hepatic artery thrombosis was more frequently observed in group A than in groups B and C(8.7% vs 3.7% vs 1.9%, P=0.047). However, among the three groups, graft survival rates at 1 year(100% vs 96.3% vs 93.6%) and 3 years(91.7% vs 73.2% vs 88.1%) were not different(P=0.539). In laboratory measurements,there was no group difference in total bilirubin and albumin. However, prothrombin time was longer in group A within postoperative 1 week and platelet count was lower in groups A and B within postoperative 1 month. CONCLUSION: A GRWR lower to 0.7% is safe and does not need to modulate portal pressure in adult-to-adult LDLT using the right-lobe in favorable conditions including low model for end-stage liver disease score.

Living donor liver transplantation with body-weight more or less than 10 kilograms

AIM: To compare the outcomes of pediatric patients weighing less than or more than 10 kg who underwent liver transplantation.METHODS: Data for 196 pediatric patients who underwent living donor liver transplantation between June 1994 and February 2011 were reviewed retrospectively.The information for each patient was anonymized and de-identified before analysis. The data included information regarding the pre-transplant conditions, intraoperative fluid replacement and outcomes for each patient. The 196 patients were divided into two groups: those with body weights of less than 10 kg were included in group 1(G1; n =101), while those with body weights of more than 10 kg were included in group 2(G2; n = 95). For each group, the patients' ages, body weights, heights,pediatric end stage liver disease scores, anesthesia times, and warm and cold ischemic times were analyzed. In addition, between-group comparisons were also made. Mann-Whitney U tests were used to compare all the variables except for complications and survival rates, which were analyzed using χ 2 tests and Kaplan-Meier tests, respectively.RESULTS: The general medical conditions of the G1patients were worse than those of the G2 patients, as shown by the higher pediatric end stage liver disease scores and poorer Z-scores. In addition, the preoperative Hb and serum albumin levels were all lower for the G1 patients than for the G2 patients. The G1 patients also had significantly more intraoperative blood loss than the G2 patients. In addition, the intraoperative fluid requirements for the G1 patients,including leukocyte poor red blood cell transfusions,5% albumin infusions and crystalloid infusions, were significantly higher than those for the G2 patients. The risk of intraoperative portal vein thrombosis was higher for the patients in G1 than for those in G2. However,the one-year survival rates(95.9% and 96.8% for G1 and G2, respectively) and three-year survival rates(94.9% and 94.6% for G1 and G2, respectively) for both groups were similar.CONCLUSION: Patients weighing less than 10 kg typically have poorer conditions, but their survival rates are comparable to those of children weighing more than 10 kg.

鳖甲煎丸对肝癌大鼠黏着斑激酶/雷帕霉素靶蛋白通路的影响

目的:探讨鳖甲煎丸对肝癌模型大鼠肝组织病理特征及FAK/mTORC1通路的影响。方法:HepG2(1×10^(7))细胞注射于大鼠右腋皮下,建立肝癌模型,分为模型组、5-氟尿嘧啶组、鳖甲煎丸低剂量组、鳖甲煎丸高剂量组,另设正常组。各药物组给予相应药物灌胃,持续给药4周,正常组、模型组给予等体积的0.9%氯化钠溶液。实验结束后,测定肝癌组织重量、肝癌组织体积、肝癌组织抑瘤率、肝癌FAK、mTORC1水平、肝癌VEGFR-2、VEGF、IL-4、IL-8、TNF-α蛋白水平。结果:与正常组比较,模型组肝癌组织重量、肝癌组织体积、肝癌组织抑瘤率、VEGFR-2、VEGF、IL-4、IL-8、TNF-α蛋白、肝癌FAK、mTORC1 mRNA和蛋白表达升高(均P<0.05)。与模型组比较,5-氟尿嘧啶组、鳖甲煎丸低剂量组、鳖甲煎丸高剂量组肝癌组织重量、肝癌组织体积、肝癌组织抑瘤率、VEGFR-2、VEGF、IL-4、IL-8、TNF-α蛋白、肝癌FAK、mTORC1 mRNA和蛋白表达降低(均P<0.05)。鳖甲煎丸高剂量组肝癌组织重量、肝癌组织体积、肝癌组织抑瘤率、VEGFR-2、VEGF、IL-4、IL-8、TNF-α蛋白、肝癌FAK、mTORC1 mRNA和蛋白表达低于鳖甲煎丸低剂量组(均P<0.05)。结论:鳖甲煎丸对大鼠肝癌具有明显抑制作用,能减轻大鼠肝癌所致的病理损伤,其机制可能与鳖甲煎丸抑制肝癌FAK、mTORC1表达,诱导肝癌细胞凋亡,降低炎症反应有关。

新诊断2型糖尿病合并非酒精性脂肪肝发生的影响因素分析

目的分析新诊断2型糖尿病(T2DM)合并非酒精性脂肪性肝病(NAFLD)发生的影响因素。方法收集2019至2020年在我院内分泌科住院的166例新诊断为T2DM患者作为研究对象,根据腹部B超检查结果,参照相关诊断标准将其分为T2DM合并NAFLD组(113例)和单纯T2DM组(53例)。收集所有患者的一般资料,包括性别、年龄、体重、体质指数(BMI)、收缩压(SBP)及舒张压(DBP);检测两组患者的生化指标,包括糖化血红蛋白(HbA1c)、空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)水平。采用多因素Logistic回归分析探讨T2DM合并NAFLD发生的影响因素。结果两组患者的年龄、SBP及DBP比较,差异无统计学意义(P>0.05);两组患者的性别比较,差异具有统计学意义(P<0.05);T2DM合并NAFLD组的体重、BMI大于单纯T2DM组,差异具有统计学意义(P<0.05)。两组患者的FBG、TC及HDL-C水平比较,差异无统计学意义(P>0.05);T2DM合并NAFLD组的HbA1c、LDL-C水平低于单纯T2DM组,差异具有统计学意义(P<0.05);T2DM组合并NAFLD组的TG水平高于单纯T2DM组(P<0.05)。多因素Logistic回归分析结果显示,性别、体重、HbA1c及TG是T2DM合并NAFLD发生的影响因素(P<0.05)。结论性别、体重、HbA1c及TG是新诊断T2DM合并NAFLD发生的影响因素,临床应针对女性、肥胖、低HbA1c及高TG水平患者开展筛查,进一步预防及干预T2NM合并NAFLD发生,并针对影响因素开展相关措施。

IVIM-DWI基于肝段水平对肝纤维化患者测量的可重复性及诊断效能

目的评估肝纤维化患者应用体素内不相干运动扩散加权成像(IVIM-DWI)测量的可重复性,并评估基于肝右叶肝段的IVIM-DWI相关参数对早期及中晚期肝纤维化的诊断效能。方法2020年6月~2022年9月期间招募早期肝纤维化及晚期肝纤维化患者,使用IVIM-DWI序列进行肝脏扫描。两名检查者基于肝右叶各段水平,应用单指数模型、双指数模型和拉伸指数模型测量相关参数数据。对获得的测量数据应用变异系数(CV)进行可重复性检验,剔除可重复性较低(CV>20%)的肝段参数后,用Logistic回归分析最终纳入的IVIM-DWI参数,计算诊断效能并描绘ROC曲线。结果59名早期肝纤维化和38名晚期肝纤维化患者被纳入研究。获得的数据中,D*(CV:29.25%~41.47%)和DDC(CV:22.44%~30.63%)的可重复性较差,而ADC(CV:5.29%~9.76%)、D(9.53%~13.22%)、f(CV:12.83%~16.95%)和α(CV:8.82%~15.52%)的可重复性较好。剔除可重复性较低的参数后,Logistic回归分析建立早期肝纤维化与晚期肝纤维化组的诊断模型并描绘ROC曲线,最终纳入模型的肝段水平参数为SⅦD及SⅧf,最终回归模型的曲线下面积(AUC)为0.857。结论基于肝段的高可重复性,IVIM-DWI对肝纤维化仍能获得较好的诊断效能,其中D、f参数以及肝右叶上段SⅦ、SⅧ在满足可重复性的前提下,可能是较稳定的肝纤维化分级诊断因素。

MRI-DWI联合超声声衰减成像诊断脂肪肝背景下<2 cm局灶结节性病变的价值

目的探讨磁共振成像-弥散加权成像(MRI-DMI)联合超声声衰减成像(ATI)诊断脂肪肝背景下<2 cm局灶结节性病变的价值。方法回顾性分析2022年6月至2023年6月河南大学淮河医院收治的68例脂肪肝合并<2 cm局灶结节性病变的临床资料,所有患者均接受MRI检查、病理学检查与ATI检查。根据脂肪肝病变程度不同将68例患者分为重度组(n=24)、中度组(n=27)、轻度组(n=17)。对比不同局灶节性病变患者的表观扩散系数(ADC)值、声衰减系数(AC)值与临床资料,对比不同脂肪肝病变程度患者的ADC值、AC值与临床资料,采用Pearson分析相关性,分析MRI-DWI联合AC值对脂肪肝合并<2 cm局灶结节性病变为恶性的诊断价值。结果病理学诊断结果显示,68例患者中,41例为良性结节,27例为恶性结节。良性结节组与恶性结节组低密度脂蛋白胆固醇(LDL-C)、年龄、三酰甘油(TG)、性别、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)对比差异无统计学意义(P>0.05)。轻度组、中度组、重度组TG、年龄、HDL-C、性别、TC、LDL-C比较差异无统计学意义(P>0.05)。恶性结节组不同b值下的ADC值低于良性结节组(P<0.05),恶性结节组AC值高于良性结节组(P<0.05)。重度组不同b值下的ADC值低于轻度组、中度组(P<0.05),中度组不同b值下的ADC值低于轻度组(P<0.05),重度组AC值高于轻度组、中度组(P<0.05),中度组AC值高于轻度组(P<0.05)。不同b值下的ADC值与脂肪肝病变程度均呈负相关(P<0.05),与TG、HDL-C、TC及LDL-C无关(P>0.05);AC值与脂肪肝病变程度呈正相关(P<0.05),与HDL-C呈负相关(P<0.05),与TG、TC及LDL-C无关(P>0.05)。MRI-DWI、AC值及二者联合诊断脂肪肝合并<2 cm局灶结节性病变为恶性的曲线下面积(AUC)值分别为0.775、0.773、0.909(P<0.05),且二者联合的AUC值更高(P<0.05)。结论MRI-DWI、ATI在鉴别诊断脂肪肝背景下<2 cm局灶结节性病变良恶性中具有重要价值,且二者联合具有更高的诊断价值。

Temporal Variations in Mortality after Liver Transplantation: Retrospective Investigation of Potential Risk Factors Using Propensity Score

Objective: We aim to detect over-time variations in mortality of liver transplant recipients stratified by the period of transplant. Since this is a retrospective investigation, bias reduction caused by possible confounding effects can be achieved by using propensity score weighting in a multivariate logistic regression model. Methods: Medical charts of all adult liver transplant recipients (n = 250) who were transplanted in three periods 2005-2009, 2010-2014 and 2015-2019 were retrospectively reviewed. The following recipient factors were analyzed: recipients and donors’ ages, sex, renal impairment, body mass index (BMI), presence of bacterial or viral infections, MELD (Model for end-stage diseases). Multivariate logistic model adjusted by Propensity Scores (PS) was used to identify the effect of the risk factors on mortality, and death within five years, in the targeted time frame. Patient outcomes are recorded as;(patient status = 1 if dead, or patient status = 0 if alive). Results: Meld score, recipient age, and renal impairments were shown to be predictors of mortality in transplanted patients. Multivariate regression model was used to identify the significance of the specified risk factors, followed by pairwise comparisons between periods. Pairwise comparisons between periods using logistic regression weighted by the inverse propensity score, correcting for the possible confounding effect of measured covariates showed that the death rate is significantly reduced in subsequent periods as compared to the initial period. Conclusions: The clinical implications of these findings are the ability to stratify patients at high risk of posttransplant death by planning more intensive and accurate management for them.

千金藤碱对CIA模型小鼠安全性评价

为评价千金藤碱对胶原诱导关节炎(CIA)模型小鼠体质量、肝脏与肾脏的影响,造模后对小鼠分别给药1.5 mg/kg阿达木单抗(阳性组)或2 mg/kg千金藤碱(给药组),监测体质量、肝脏质量及肾脏质量,H&E染色观察组织形态。实验结果表明,2 mg/kg的千金藤碱对CIA模型小鼠体质量无显著性影响,且对小鼠肝脏及肾脏无毒性。2 mg/kg千金藤碱对CIA小鼠体质量未产生影响,且未引起CIA小鼠肝脏、肾脏的病理变化,属于安全剂量。

肝脏磁共振扩散加权成像方法研究进展

扩散加权成像(diffusion weighted imaging,DWI)对肝脏局灶性病变表现出的强大诊断能力主要得益于其成像方法的发展。目前DWI对于肝脏弥漫性病变的评估仍存在缺陷,所以进一步探索并优化其成像方法具有重要意义。为此,本文对近年来肝脏DWI所涉及到的定量成像、图像质量提升和加速成像等方法进行综述。首先,本文阐述了目前肝脏DWI所面对的主要挑战;然后,综述了定量成像模型、脂肪抑制技术、并行成像、压缩感知技术和多层同步成像方法在肝脏DWI中的研究现状和问题的潜在解决方法,为现有成像方法的进一步优化和新方法的引入提供可行思路;最后,对肝脏DWI方法进行了总结与展望。

基于代谢组学分析香蜂草苷抗非酒精性脂肪肝病的作用机制

目的:基于非靶向代谢组学和生物信息学方法研究香蜂草苷抗非酒精性脂肪肝病(NAFLD)的作用机制。方法:将18只雄性SD大鼠随机分为正常对照组、模型组和香蜂草苷组(3 mg/kg),每组6只。使用高脂饲料喂养8周诱导建立NAFLD大鼠模型。香蜂草苷组每天灌胃给予香蜂草苷治疗8周,正常对照组和模型组灌胃给予等量生理盐水。采用苏木精—伊红(HE)染色和油红O染色观察各组大鼠肝组织病理学变化。使用超高效液相—质谱(UPLC-Xevo G2-XS QTof)检测大鼠肝匀浆代谢物,以P<0.05和变化倍数(|FC|)>2为标准筛选差异代谢物,进行代谢物分类富集分析;以总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、游离脂肪酸(FFA)和胰岛素抵抗(IR)等NAFLD相关指标为疾病表型,构建加权代谢共表达网络分析(WMCNA),筛选出与NAFLD相关的核心代谢物。取差异代谢物和核心代谢物交集进行生物标志物分析。结果:与模型组比较,香蜂草苷组大鼠体重降低,肝脏脂质沉积减少,肝脏病理损伤减轻。代谢组学结果表明,共筛选出差异代谢物126个,其中上调50个,下调76个(香蜂草苷组vs.模型组)。WMCNA筛选出核心代谢物189个,主要为磺酸及其衍生物、脂肪酸化合物。取差异代谢物和核心代谢物交集在Metaboanlyst在线数据库分析可得25个潜在生物标志物,其中脂酰类化合物Isopropylmalic acid(P<0.05,FC=-2.81)和脂肪酸生成相关化合物Alpha-Linoleoylcholine(P<0.05,FC=-1.39)、3-trans,5-cis-Octadienoyl-CoA(P<0.05,FC=-1.78)变化差异具有统计学意义。结论:香蜂草苷可能通过调节Isopropylmalic acid、Alpha-Linoleoylcholine和3-trans,5-cis-Octadienoyl-CoA的代谢水平,起到改善NAFLD的作用,为缓解脂质代谢紊乱提供前期实验基础。

IVIM-DWI及多层螺旋CT与肝细胞肝癌微血管侵犯的相关性分析

目的探究体素内不相干运动扩散加权成像(IVIM-DWI)多层螺旋CT(MSCT)与肝细胞肝癌(HCC)微血管侵犯(MVI)的相关性分析。方法选取2019年12月至2022年12月本院收治HCC患者100例临床资料开展回顾性分析。所有患者均经过病理检查、VIM-DWI检查与MSCT检查。100例患者经手术病理确诊为MVI阳性38例,MVI阴性62例。比较两组IVIM-DWI、MSCT定性、定量参数分析的差异,并通过ROC曲线分析IVIM-DWI定量参数、MSCT定量参数及联合数据对HCC存在MVI的诊断价值。结果MVI阳性组边缘毛糙、瘤周低信号、瘤周强化、存在晕征高于MVI阴性组(P<0.05),肿瘤包膜低于MVI阴性组(P<0.05)。两组D、F比较差异无统计学意义(P>0.05),但MVI阳性组ADC、D低于MVI阴性组(P<0.05)。MVI阳性组动脉期CT值低于MVI阴性组(P<0.05),延迟期CT值、门静脉期CT值、肿瘤大小高于MVI阴性组(P<0.05)。ROC曲线分析显示,ADC、D、D、f、延迟期CT值、门静脉期CT值、动脉期CT值、肿瘤大小诊断HCC存在MVI的AUC分别为0.775、0.856、0.609、0.565、0.708、0.728、0.643、0.705。MSCT参数、IVIM-DWI参数、联合数据诊断HCC存在MVI的AUC分别为0.809、0.832、0.920,均具有较好准确性。结论IVIM-DWI、MSCT定性、定量参数均与HCC患者MVI相关,而IVIMDWI、MSCT诊断MVI均具有一定价值,且联合诊断准确性更高。

基于RNA-seq技术挖掘影响鹅肝脏代谢的候选基因

目的:通过分析不同体质量皖西白鹅肝脏组织转录组表达谱,挖掘影响肝脏代谢的差异表达基因及相关代谢通路,探究不同体质量皖西白鹅肝脏组织对营养物质转化利用和代谢的影响。方法:根据平均日增重将皖西白鹅进行分组,分为高(H)、中(M)、低(L)组,对每组样本进行转录组测序分析,挖掘各组之间的差异表达基因,并随机筛选6个差异基因进行荧光定量PCR验证。利用GO和KEGG数据库对挖掘的差异表达基因进行功能注释分析。结果:分别从H vs M、H vs L和M vs L组中筛选差异表达基因334、256、380个;这些差异基因主要参与的信号通路包括氨基酸代谢、脂质代谢、碳水化合物代谢等。结论:基于转录组测序技术对不同体质量皖西白鹅肝脏组织进行研究分析,筛选调控体质量的差异表达基因(UGP2、SCD、PNPLA2、SLC7A3、CHAC1)。这些差异基因主要通过脂质代谢和氨基酸代谢等相关通路来调控肝脏组织的物质代谢和转化,初步探究了肝代谢对鹅体质量影响的分子机制,为后期改善鹅的生产提供理论依据。