AIM: To evaluate the hepatic dysfunction in leptospirosis is usually mild and resolved eventually. However,sequential follow-up of liver biochemical data remained lacking..METHODS: The biochemistry data and clinical s...AIM: To evaluate the hepatic dysfunction in leptospirosis is usually mild and resolved eventually. However,sequential follow-up of liver biochemical data remained lacking..METHODS: The biochemistry data and clinical symptoms of 11 sporadic patients were collected and analyzed, focusing on the impacts of leptospirosis upon liver biochemistry tests.RESULTS: The results disclosed that of the 11 cases, 5 or 45% died. The liver biochemistry data in the beginning of the disease course were only mildly elevated.Nevertheless, late exaggerated aspartate transaminase (AST)elevations were noted in three cases who finally died when compared with the typical course. Besides, significant higher AST/alanine transaminase (ALT) ratios (AARs) of the peak levels for transaminase were also noted in the cases who eventually succumbed. The mean±SD of AARs for the survival group and dead group were 5.65±2.27 (n = 5)and 1.86±0.64 (n = 6) respectively (P= 0.006). The ratios of the cases who finally died were all more than 3.0.Conversely, the survival group's ratios were less than 3.0.CONCLUSION: Serial follow-up of transaminase might provide evidence to predict some rare evolutions in leptospirosis. If AST elevated progressively without a concomitant change of ALT, it might indicate an acute disease course with ensuing death. Additionally, AAR is another prognostic parameter for leptospirosis. Once the value was higher than 3.0, a grave prognosis is inevitable.展开更多
Objective The beneficial effects of silymarin have been extensively studied in the context of inflammation and cancer treatment, yet much less is known about its therapeutic effect on diabetes. The present study was a...Objective The beneficial effects of silymarin have been extensively studied in the context of inflammation and cancer treatment, yet much less is known about its therapeutic effect on diabetes. The present study was aimed to investigate the cytoprotective activity of silymarin against diabetes-induced cardiomyocyte apoptosis. Methods Rats were randomly divided into： control group, untreated diabetes group and diabetes group treated with silymarin （120 mg/ks·d） for 10 d. Rats were sacrificed, and the cardiac muscle specimens and blood samples were collected. The immunoreactivity of caspase-3 and Bcl-2 in the cardiomyocytes was measured. Total proteins, glucose, insulin, creatinine, AST, ALT, cholesterol, and triglycerides levels were estimated. Results Unlike the treated diabetes group, cardiomyocyte apoptosis increased in the untreated rats, as evidenced by enhanced caspase-3 and declined Bcl-2 activities. The levels of glucose, creatinine, AST, ALT, cholesterol, and triglycerides declined in the treated rats. The declined levels of insulin were enhanced again after treatment of diabetic rats with silymarin, reflecting a restoration of the pancreatic β-cells activity. Conclusion The findings of this study are of great importance, which confirmed for the first time that treatment of diabetic subjects with silymarin may protect cardiomyocytes against apoptosis and promote survival-restoration of the pancreatic β-cells.展开更多
目的探讨柔肝化纤颗粒联合核苷类抗病毒药物对乙型肝炎失代偿期肝硬化患者肝肾功能、门静脉系统血流动力学、血管活性、抗病毒指标及对天冬氨酸氨基转移酶-血小板比值指数(aspartate aminotransferase-platelet ratio index,APRI)的影...目的探讨柔肝化纤颗粒联合核苷类抗病毒药物对乙型肝炎失代偿期肝硬化患者肝肾功能、门静脉系统血流动力学、血管活性、抗病毒指标及对天冬氨酸氨基转移酶-血小板比值指数(aspartate aminotransferase-platelet ratio index,APRI)的影响。方法采用病例对照研究方法,收集2017年6月至2019年12月于唐山市传染病院和华北理工大学附属医院住院的乙型肝炎失代偿期肝硬化患者150例。应用计算机随机数字法分为对照组和观察组,每组各75例。对照组给予常规护肝和抗病毒治疗;观察组在对照组治疗的基础上加用柔肝化纤颗粒。观察两组患者的肝肾功能、门静脉系统血流动力学、血管活性、抗病毒指标及对APRI的变化。计量资料的两组间比较采用独立样本t检验,同组间治疗前后比较采用配对t检验,计数资料采用χ^(2)检验。结果两组患者性别、年龄、肝硬化病程、肝功能Child分级、治疗前各项指标基数资料比较差异均无统计学意义(均P>0.05)。治疗后两组患者丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、门静脉内径(diameter of portal vein,Dpv)、脾静脉内径(diameter of splenic vein,Dsv)、内皮素1、一氧化氮、胰高血糖素(glucagon,GLA)、APRI均较治疗前降低;组间比较,观察组ALT(51.60±15.97)U/L、AST(62.65±26.28)U/L、尿素氮(10.25±1.65)mmol/L、肌酐(78.54±14.09)μmol/L、Dpv(10.20±1.10)mm、Dsv(8.08±0.68)mm、内皮素1(31.93±6.35)ng/L、一氧化氮(41.38±8.06)μg/L、GLA(69.54±12.14)mg/L、APRI 3.14±1.35明显低于对照组[(97.49±30.87)U/L、(96.03±25.63)U/L、(17.49±2.55)mmol/L、(116.43±22.77)μmol/L、(13.42±1.26)mm、(10.44±0.83)mm、(44.34±11.88)ng/L、(63.47±15.50)μg/L、(107.11±25.29)mg/L、5.91±1.93],差异均有统计学意义(t值分别为11.43、7.87、20.64、12.26、16.62、18.99、7.98、10.96、11.60、10.23,均P<0.05)。治疗后两组患者白蛋白、门静脉血流速度(portal vein velocity,Vpv)、脾静脉血流速度(velocity of splenic vein blood flow,Vsv)均较治疗前升高,但对照组治疗前后Vsv比较差异无统计学意义(t=0.51,P=0.613);组间比较,观察组白蛋白(39.42±7.35)/L、Vpv(25.72±4.06)cm/s、Vsv(24.22±6.15)cm/s明显高于对照组[(34.66±7.95)g/L、(19.38±3.46)cm/s、(19.54±5.88)cm/s],差异均有统计学意义(t值分别为3.81、10.28、4.76,均P<0.05)。治疗后观察组总有效率[96.00%(72/75)与86.67%(65/75),χ^(2)=4.13,P=0.042]、HBV DNA转阴率[76.00%(57/75)与58.67%(44/75),χ^(2)=5.12,P=0.024]、HBeAg转阴率[50.67%(38/75)与30.67%(23/75),χ^(2)=6.22,P=0.013]、HBeAg/HBeAb血清转换[28.00%(21/75)与13.33%(10/75),χ^(2)=4.92,P=0.027]高于对照组,差异均有统计学意义;HBsAg转阴率[8.00%(6/75)与5.33%(4/75),χ^(2)=0.43,P=0.513]高于对照组,但差异无统计学意义(P>0.05)。结论柔肝化纤颗粒联合核苷类抗病毒药物对乙型肝炎失代偿期肝硬化患者疗效显著,改善肝肾功能、肝纤维化和门静脉系统血流动力学,增加血管活性功能,降低乙型肝炎病毒(hepatitis B virus,HBV)DNA载量、HBV复制,降低APRI、TLR-4、TGF-β1水平,提高机体免疫状态。展开更多
基金Supported by the Chang Gung Medical Research Project fund, No. CMRPG 33014
文摘AIM: To evaluate the hepatic dysfunction in leptospirosis is usually mild and resolved eventually. However,sequential follow-up of liver biochemical data remained lacking..METHODS: The biochemistry data and clinical symptoms of 11 sporadic patients were collected and analyzed, focusing on the impacts of leptospirosis upon liver biochemistry tests.RESULTS: The results disclosed that of the 11 cases, 5 or 45% died. The liver biochemistry data in the beginning of the disease course were only mildly elevated.Nevertheless, late exaggerated aspartate transaminase (AST)elevations were noted in three cases who finally died when compared with the typical course. Besides, significant higher AST/alanine transaminase (ALT) ratios (AARs) of the peak levels for transaminase were also noted in the cases who eventually succumbed. The mean±SD of AARs for the survival group and dead group were 5.65±2.27 (n = 5)and 1.86±0.64 (n = 6) respectively (P= 0.006). The ratios of the cases who finally died were all more than 3.0.Conversely, the survival group's ratios were less than 3.0.CONCLUSION: Serial follow-up of transaminase might provide evidence to predict some rare evolutions in leptospirosis. If AST elevated progressively without a concomitant change of ALT, it might indicate an acute disease course with ensuing death. Additionally, AAR is another prognostic parameter for leptospirosis. Once the value was higher than 3.0, a grave prognosis is inevitable.
文摘Objective The beneficial effects of silymarin have been extensively studied in the context of inflammation and cancer treatment, yet much less is known about its therapeutic effect on diabetes. The present study was aimed to investigate the cytoprotective activity of silymarin against diabetes-induced cardiomyocyte apoptosis. Methods Rats were randomly divided into： control group, untreated diabetes group and diabetes group treated with silymarin （120 mg/ks·d） for 10 d. Rats were sacrificed, and the cardiac muscle specimens and blood samples were collected. The immunoreactivity of caspase-3 and Bcl-2 in the cardiomyocytes was measured. Total proteins, glucose, insulin, creatinine, AST, ALT, cholesterol, and triglycerides levels were estimated. Results Unlike the treated diabetes group, cardiomyocyte apoptosis increased in the untreated rats, as evidenced by enhanced caspase-3 and declined Bcl-2 activities. The levels of glucose, creatinine, AST, ALT, cholesterol, and triglycerides declined in the treated rats. The declined levels of insulin were enhanced again after treatment of diabetic rats with silymarin, reflecting a restoration of the pancreatic β-cells activity. Conclusion The findings of this study are of great importance, which confirmed for the first time that treatment of diabetic subjects with silymarin may protect cardiomyocytes against apoptosis and promote survival-restoration of the pancreatic β-cells.
文摘目的探讨柔肝化纤颗粒联合核苷类抗病毒药物对乙型肝炎失代偿期肝硬化患者肝肾功能、门静脉系统血流动力学、血管活性、抗病毒指标及对天冬氨酸氨基转移酶-血小板比值指数(aspartate aminotransferase-platelet ratio index,APRI)的影响。方法采用病例对照研究方法,收集2017年6月至2019年12月于唐山市传染病院和华北理工大学附属医院住院的乙型肝炎失代偿期肝硬化患者150例。应用计算机随机数字法分为对照组和观察组,每组各75例。对照组给予常规护肝和抗病毒治疗;观察组在对照组治疗的基础上加用柔肝化纤颗粒。观察两组患者的肝肾功能、门静脉系统血流动力学、血管活性、抗病毒指标及对APRI的变化。计量资料的两组间比较采用独立样本t检验,同组间治疗前后比较采用配对t检验,计数资料采用χ^(2)检验。结果两组患者性别、年龄、肝硬化病程、肝功能Child分级、治疗前各项指标基数资料比较差异均无统计学意义(均P>0.05)。治疗后两组患者丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、门静脉内径(diameter of portal vein,Dpv)、脾静脉内径(diameter of splenic vein,Dsv)、内皮素1、一氧化氮、胰高血糖素(glucagon,GLA)、APRI均较治疗前降低;组间比较,观察组ALT(51.60±15.97)U/L、AST(62.65±26.28)U/L、尿素氮(10.25±1.65)mmol/L、肌酐(78.54±14.09)μmol/L、Dpv(10.20±1.10)mm、Dsv(8.08±0.68)mm、内皮素1(31.93±6.35)ng/L、一氧化氮(41.38±8.06)μg/L、GLA(69.54±12.14)mg/L、APRI 3.14±1.35明显低于对照组[(97.49±30.87)U/L、(96.03±25.63)U/L、(17.49±2.55)mmol/L、(116.43±22.77)μmol/L、(13.42±1.26)mm、(10.44±0.83)mm、(44.34±11.88)ng/L、(63.47±15.50)μg/L、(107.11±25.29)mg/L、5.91±1.93],差异均有统计学意义(t值分别为11.43、7.87、20.64、12.26、16.62、18.99、7.98、10.96、11.60、10.23,均P<0.05)。治疗后两组患者白蛋白、门静脉血流速度(portal vein velocity,Vpv)、脾静脉血流速度(velocity of splenic vein blood flow,Vsv)均较治疗前升高,但对照组治疗前后Vsv比较差异无统计学意义(t=0.51,P=0.613);组间比较,观察组白蛋白(39.42±7.35)/L、Vpv(25.72±4.06)cm/s、Vsv(24.22±6.15)cm/s明显高于对照组[(34.66±7.95)g/L、(19.38±3.46)cm/s、(19.54±5.88)cm/s],差异均有统计学意义(t值分别为3.81、10.28、4.76,均P<0.05)。治疗后观察组总有效率[96.00%(72/75)与86.67%(65/75),χ^(2)=4.13,P=0.042]、HBV DNA转阴率[76.00%(57/75)与58.67%(44/75),χ^(2)=5.12,P=0.024]、HBeAg转阴率[50.67%(38/75)与30.67%(23/75),χ^(2)=6.22,P=0.013]、HBeAg/HBeAb血清转换[28.00%(21/75)与13.33%(10/75),χ^(2)=4.92,P=0.027]高于对照组,差异均有统计学意义;HBsAg转阴率[8.00%(6/75)与5.33%(4/75),χ^(2)=0.43,P=0.513]高于对照组,但差异无统计学意义(P>0.05)。结论柔肝化纤颗粒联合核苷类抗病毒药物对乙型肝炎失代偿期肝硬化患者疗效显著,改善肝肾功能、肝纤维化和门静脉系统血流动力学,增加血管活性功能,降低乙型肝炎病毒(hepatitis B virus,HBV)DNA载量、HBV复制,降低APRI、TLR-4、TGF-β1水平,提高机体免疫状态。
