Influences of Chloropazine, Nimodipine and Their Combination on the Toxic Effects of Cadmium in Liver and Kidney of Mice

The influences of the calmodulin antagonist chlorpromazine (CPZ), and calcium channel blocker nimodipine (NIMO) and their combination on cadmium (Cd) poisoning of mice were studied. A seties of biochemical parameters including urinary enzyme activities, blood and urine Cd levels, metallothionein (MT) contents in liver and kidney, hepatic ultrastructure and Ca2+ -Mg2+ AT-Pase activity in erythrocyte membrane were determined. Animal models for Cd poisoning were established by peritoneal injection of 1/5 LD50 CdCl2. The experimental groups were protected by administration of CPZ, NIMO and CPZ and NIMO in combination l h before the injection of CdCl2. Five days later, samples were collected for analysis. The data showed that Crs could protect kidney tissue against Cd-induced damage, as the urinary γ-glutamyl traspepti dase (γ- GT ) and N- acetyl-β-D-glucosaminidase (NAG) activities were reduced significantly. There was neither evidence of the protective effect of NIMO on kidney tissue nor an indication of a synergistic effecf of Crs and NIMO.Both CPZ and NIMO showed a considerable protective effect against the deerease in Ca2+ -Mg2+ AT-Pase activity, and a synergistic action was observed. Cd content in blood was reduced significanily by CPZ or the combination of CPZ and NIMO, but elevated by NIMO. Both CPZ and NIMO consideraby increased MT contents in livers and kidneys and ameliorated damaged to the hepatic ultrastructures caused by Cd. The results indicated that these inhibitors could protect mice against the toxic effects of Cd in liver and kidney tissues, while CPZ was more efficient than NIMO. The combination of CPZ and NIMO exerted a synergistic action. The protective action of these two drugs might be relevent to the function of MT.

Impact of bariatric surgery on glucose and lipid metabolism and liver and kidney function in food-induced obese diabetic rats

BACKGROUND Obesity usually causes diabetes mellitus(DM)and is a serious danger to human health.Type 2 DM(T2DM)mostly occurs along with obesity.Foodborne obesityinduced DM is caused by an excessive long-term diet and surplus energy.Bariatric surgery can improve the symptoms of T2DM in some obese patients.But different types of bariatric surgery may have different effects.AIM To investigate the effect of bariatric surgery on glucose and lipid metabolism and liver and kidney function in rats.METHODS Male Sprague-Dawley rats aged 6-8 wk underwent Roux-en-Y gastric bypass surgery(RYGB),sleeve gastrectomy(SG),or gastric banding(GB).Glucose and insulin tolerance tests,analyses of biochemical parameters,histological examination,western blot,and quantitative real-time polymerase chain reaction were conducted.RESULTS In comparison to the sham operation group,the RYGB,SG,and GB groups had decreased body weight and food intake,reduced glucose intolerance and insulin insensitivity,downregulated biochemical parameters,alleviated morphological changes in the liver and kidneys,and decreased levels of protein kinase Cβ/P66shc.The effect in the RYGB group was better than that in the SG and GB groups.CONCLUSION These results suggest that RYGB,SG and GB may be helpful for the treatment of foodborne obesity-induced DM.

Effects of Noise Pollution on Functions of the Liver and Kidney of Rats

To study the effects of noise pollution on the functions of the liver and kidney of rats, a total of 40 male SPF Wistar rats were randomly divided into a control group and three experimental groups. The rats in the experimental groups were respectively stimulated with 38, 55 and 70 dB noise for 15 days, and the levels of blood components were determined by an automatic biochemical analyzer. The results showed that in compari-son with the control group, the level of the blood glucose in the experimental groups increased by 23.53%, 52.94% and 88.24%, respectively, and the differences were statistically significant （P〈0.01）. The levels of triglyceride in the blood rose by 20.83%, 38.54% and 79.68%, respectively, and the differences were also statistically significant （P〈0.01）. The level of globulin in the blood increased by 16.49%, 21.13% and 51.78%, and the level of albumin in the blood rose by 9.51 %, 12.67% and 17.89%, respectively. The level of total bilirubin in the blood increased by 27.04%, 41.63% and 73.67%, respectively, and the differences were statistically significant （P〈0.01）. The level of creatinine in the blood rose by 9.72%, 10.21% and 20.99%, respectively. The level of amylase in the blood reduced by 6.6%, 13.05% and 23.89%, respectively. The level of creatine kinase in the blood decreased by 19.81%, 27.37% and 36.81 %, respectively, and the level of urea in the blood reduced by 11.19%, 12.77% and 19.26%, respectively. The results revealed that noise pollution could significantly affect the levels of blood components and the functions of the liver and kidney of rats.

Diabetes mellitus is a risk factor of acute kidney injury in liver transplantation patients

Background: Diabetes mellitus has become an increasing global health burden with rapid growing prevalence. Patients with diabetes have higher susceptibility to acute kidney injury(AKI). Liver transplantation(LT) predisposes the kidney to injury. However, the association between diabetes and AKI in LT patients remains unclear. Methods: We conducted a retrospective cohort study examining risk factors for AKI in patients undergone orthotopic LT. Potential risk factors including baseline estimated glomerular filtration rate(e GFR), the model for end-stage liver disease(MELD) score, diabetes, hypertension and intraoperative blood loss were screened. The primary endpoint was AKI occurrence. Multivariate logistic regression was used to analyze the association between potential risk factors and AKI. Results: A total of 291 patients undergone orthotopic LT were included in the present study. Among them, 102 patients(35.05%) developed AKI within 5 days after LT. Diabetes was identified as an independent risk factor for AKI. Patients who developed AKI had worse graft function recovery and higher mortality within 14 days after LT compared to those who did not develop AKI. AKI patients with diabetes had a significant decline of e GFR within the first postoperative year, compared with patients who did not develop AKI and who developed AKI but without diabetes. Conclusions: Diabetes is an independent risk factor for AKI after orthotopic LT. AKI is associated with delayed graft function recovery and higher mortality in short-term postoperative period. Diabetic patients who developed AKI after LT experience a faster decline of e GFR within the first year after surgery.

Dynamic monitoring of serum liver function indexes in patients with COVID-19

BACKGROUND Some patients with the novel 2019 coronavirus disease(COVID-19)display elevated liver enzymes.Some antiviral drugs that can be used against COVID-19 are associated with a risk of hepatotoxicity.AIM To analyze the clinical significance of the dynamic monitoring of the liver function of patients with COVID-19.METHODS This was a retrospective study of patients diagnosed with COVID-19 in January and February 2020 at the Department of Infection,Shantou Central Hospital.The exclusion criteria for all patients were:(1)History of chronic liver disease;(2)History of kidney disease;(3)History of coronary heart disease;(4)History of malignancy;or(5)History of diabetes.The serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyltransferase,and total bilirubin of patients with COVID-19 were measured on days 1,3,7 and 14 after admission,and compared to non-COVID-19 patents.RESULTS Twelve patients with COVID-19(seven men and five women)and twelve controls(eight men and four women)were included.There were one,two,and nine patients with severe,mild,and moderate COVID-19,respectively.There were no differences in age and sex between the two groups(both P>0.05).No significant differences were found in albumin,ALT,AST,γ-glutamyltransferase,or total bilirubin between the controls and the patients with COVID-19 on day 1 of hospitalization(all P>0.05).Serum albumin showed a decreasing trend from days 0 to 7 of hospitalization,reaching the lowest level on day 7.Total bilirubin was higher on day 3 than on day 7.ALT,AST,andγ-glutamyltransferase did not change significantly over time.The severe patient was observed to have ALT levels of 67 U/L and AST levels of 75 U/L on day 7,ALT of 71 U/L and AST of 35 U/L on day 14,and ALT of 210 U/L and AST of 123 U/L on day 21.CONCLUSION Changes in serum liver function indicators are not obvious in the early stage of COVID-19,but clinically significant changes might be observed in severe COVID-19.

Value of serum PCT content for evaluating inflammatory factor release and organ function injury in neonatal septicemia

Objective: To explore the value of serum PCT content for evaluating inflammatory factor release and organ function injury in neonatal septicemia. Methods: 48 children who were diagnosed with neonatal septicemia in our hospital between March 2015 and May 2018 were selected as the septicemia group, and 50 healthy neonates delivered in our hospital during the same period were selected as the normal control group. The differences in PCT and inflammatory factor contents in serum as well as liver and kidney function index levels in peripheral blood were compared between the two groups. Pearson test was used to evaluate the correlation of serum PCT content with inflammatory factor release as well as liver and kidney function injury in children with neonatal septicemia. Results: The serum PCT content of septicemia group was significantly higher than that of normal control group;serum hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-8 (IL-8) and soluble intercellular adhesion molecule-1 (sICAM-1) contents were higher than those of normal control group;peripheral blood aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (γ-GGT) and alkaline phosphatase (ALP) levels were higher than those of normal control group;peripheral blood blood urea nitrogen (BUN), serum creatinine (Scr) and serum β2-microglobulin (β2-M) levels were higher than those of normal control group (P<0.05). Correlation analysis showed that serum PCT content in children with neonatal septicemia was directly correlated with the degree of inflammatory response as well as the degree of liver and kidney function injury (P<0.05). Conclusion: The serum PCT content abnormally increases in children with neonatal septicemia, and the specific content is consistent with the disease severity and has certain clinical value for the judgment of children's condition.

Serum RAAS molecules and their relationship with the systemic inflammatory response and target organ function in patients with severe acute pancreatitis

Objective:To explore the relationship of renin-angiotensin-aldosterone system (RAAS) activity with the systemic inflammatory response and target organ function in patients with severe acute pancreatitis.Methods: A total of 78 patients with severe acute pancreatitis who were treated in our hospital between August 2012 and March 2016 were selected as the observation group, and 50 healthy people who underwent physical examination in our hospital during the same period were selected as the normal control group. The differences in the contents of RAAS indexes, inflammation indexes as well as liver and kidney function indexes were compared between the two groups, and Pearson test was used to evaluate the correlation between RAAS activity and illness in patients with severe acute pancreatitis. Results: Serum RAAS indexes E, Ang-Ⅱ and ALD levels of observation group were higher than those of normal control group;serum inflammation indexes IL-6, IL-8, IL-10 and CRP levels were higher than those of normal control group;serum liver function indexes ALP,γ-GT and AST levels were higher than those of normal control group;serum kidney function indexes Scr, BUN and UA levels were higher than those of normal control group. The RAAS activity of patients with severe acute pancreatitis was directly correlated with serum levels of inflammation indexes as well as liver and kidney function indexes.Conclusion: The RAAS activity increases in patients with severe acute pancreatitis, and the specific increase extent is consistent with systemic inflammatory response as well as liver and kidney function damage.

Biochemical,Enzymatic,and Immunological Study on Antimutagenic Achillea millefolium Methanolic Extract in vivo

Traditionally medicinal plants are used for its potential chemotherapeutic action and for safety upon the continued use of these plants.Achillea millefolium(AM)is an ancient herb which is used to treat wounds,headaches,disorder in gastrointestinal and hepatobiliary,pain,and inflammation.This study was aimed to investigate the biochemical parameter of antimutagenic methanolic extract for AM in vivo.Plant extract together with MTX decreased the damage caused by the drug on the concentrations of total cholesterol and triglycerides(160.3±2.26 and 108.7±2.71),significant increase in total protein concentration(8.51±0.17,9.46±0.19 and 10.8±2.71 g\dL)for 100 and 200 mg\kg was observed.Also plant extracts counteract the damage caused by drug through the reduction for both creatinin and albumin concentrations to 1.57±0.03 mg\dL and 4.56±0.09 g\dL,respectively.On enzymatic level,the results of interactions indicated the ability of plant to modulating harmful effects of the drug(57.1±1.3,130±3.1 and 111.1±2.1 U\L)for GOT,GPT and ALP,respectively.On the other hand,the plant possesses the ability to enhance the concentrations of all immunoglobulin(IgM,IgA and IgG)in the two doses tested.Therefore,the results of this study indicate the antimutagenic potential of AM extract and encouraging its consumption with MTX as one of the promising therapies.

Studies on Preclinical Toxicology of a New Tumor Photolocalizing and Photochemotherapeutic Agent, Photocarcinorin(PsD-007)

Photocarcinorin was prepared in our Lab and its composition was differentfrom that of any other hematoporphyrin photosensitizers by TLC and HPLC analyses.The 95% fiducial limits of iv LD in mice were 176-236 mg·kg-1.The iv MLD indogs was 171 mg·kg-1.The acute and subacutc toxic tests in 37 dogs showed that theintoxicated manifestations were characterized by a complex syndrome always seen inporphyrias.The biological,laboratory and histopathologic findings revealed that theliver,kidney and erythroeytic series were the target organs.The damages were dose-related and reversible within 2 wk.he phototoxicity was determined in mice with UV ra-diation and compared with that of HpD.The extent of its phototoxic reactions waslower than that of HpD’s.

Evaluation of Anti-Oxidant Status and Radioprotective Activity of a Novel Anti-Cancer Drug in Mice

Various approaches have been developed for diminishing the effects of radiation on normal tissues or enhancing tumor cell killing by ionizing radiation. Recently, there has been an increase in the interest in research on synthetic and/or natural radioprotective agents. An important potential use for these agents is to modify and improve the outcome of radiation therapy. The aim of this study was to examine the potential radioprotective role and antioxidant potency of the novel synthetic anticancer agent, quinoline sulfonamide (PIQSA) against tissue injury and oxidative stress induced by the exposure to gamma radiation and/or incidence of cancer in experimental animals. Mice (normal and bearing solid tumors) administered PIQSA (0.350 mg/kg body weight ip. three times a week for 21 days. At the last week of 30 days experimental period, an animal group was subjected to three successive doses of γ-radiation each of 2 Gy;another group was treated with combined administration of PIQSA 20 minutes before γ-irradiation. Some biochemical parameters (LPx, GSH, SOD, and CAT in liver homogenates, also plasma lipid profile (total lipids, total cholesterol, total triglycerides (TG), HDLc and LDLc were measured. To examine any adverse effect which could be attained by chemical treatment, liver enzymes (AST, ALT), and kidney function (creatinine and urea) were estimated in blood plasma, in addition to examination of some haematological indexes. The results indicated that the deleterious effects due to exposure to γ-radiation, and/or incidence of cancer on most of the estimated parameters could be controlled to a certain extent by administration of PIQSA to animals prior to irradiation. The results also confirmed that there were no significant adverse effects on mice due to the treatment with this chemical compound.

Effect of mixing lard with soybean oil in cooking on hepatic antioxidative ability and renal metabolic activity

A simulate daily oriental dietary pattern(a blend of lard and soybean oil)was performed in this research to investigate influence on liver and kidney function.Sixty mice were randomly divided into 6 groups with diets of different fat added oils respectively for 12 weeks.Malondialdehyde and uric acid contents in mice fed with blended oil were significantly lower than in those fed only with soybean oil and lard due to the improved activities of antioxidant enzymes.Daily use of a blend of lard with soybean oil significantly increased antioxidant capacity,reduced lipid peroxidation of liver and serum uric acid production,thus protected liver and renal function.It also suggests that the oriental dietary pattern might reduce the risk of gout.

Changes of serum pancreatic stone protein and cholinesterase contents in children with sepsis and their correlation with systemic inflammatory response and target organ damage

Objective: To study the changes of serum pancreatic stone protein (PSP) and cholinesterase (ChE) contents in children with sepsis and their correlation with systemic inflammatory response and target organ damage. Methods: A total of 64 children with sepsis who were treated in the hospital between January 2015 and January 2017 were selected as observation group, and 50 healthy children who received vaccination in the hospital during the same period were selected as normal control group. The contents of PSP, ChE, inflammatory factors as well as liver and kidney function indexes in the two groups were detected. Pearson test was used to assess the correlation of serum PSP and ChE contents with systemic inflammatory response and target organ damage in children with sepsis. Results: Serum PSP content of observation group was higher than that of control group while ChE content was lower than that of control group;serum inflammatory factors PCT, CRP, IL-1, IL-6 and IL-10 contents of observation group were higher than those of normal control group;liver function indexes TBIL, ALT and AST contents were higher than those of normal control group;kidney function indexes Scr and BUN contents were higher than those of normal control group. Pearson test showed that the serum PSP and ChE contents in children with sepsis were directly correlated with the systemic inflammatory response as well as liver and renal function injury. Conclusion: Serum PSP content significantly increases while ChE content significantly decreases in children with sepsis and the specific change is directly correlated with the overall disease severity.

Prognostic and diagnostic scoring models in acute alcoholassociated hepatitis:A review comparing the performance of different scoring systems

Alcohol-associated hepatitis(AAH)is a severe form of liver disease caused by alcohol consumption.In the absence of confounding factors,clinical features and laboratory markers are sufficient to diagnose AAH,rule out alternative causes of liver injury and assess disease severity.Due to the elevated mortality of AAH,assessing the prognosis is a radical step in management.The Maddrey discriminant function(MDF)is the first established clinical prognostic score for AAH and was commonly used in the earliest AAH clinical trials.A MDF>32 indicates a poor prognosis and a potential benefit of initiating corticosteroids.The model for end stage liver disease(MELD)score has been studied for AAH prognostication and new evidence suggests MELD may predict mortality more accurately than MDF.The Lille score is usually combined to MDF or MELD score after corticosteroid initiation and offers the advantage of assessing response to treatment a 4-7 d into the course.Other commonly used scores include the Glasgow Alcoholic Hepatitis Score and the Age Bilirubin international normalized ratio Creatinine model.Clinical AAH correlate adequately with histologic severity scores and leave little indication for liver biopsy in assessing AAH prognosis.AAH presenting as acute on chronic liver failure(ACLF)is so far prognosticated with ACLF-specific scoring systems.New artificial intelligence-generated prognostic models have emerged and are being studied for use in AAH.Acute kidney injury(AKI)is one possible complication of AAH and is significantly associated with increased AAH mortality.Predicting AKI and alcohol relapse are important steps in the management of AAH.The aim of this review is to discuss the performance and limitations of different scoring models for AAH mortality,emphasize the most useful tools in prognostication and review predictors of recurrence.

Effects of hemoperfusion combined with hemodialysis on target organ damage in patients with acute paraquat poisoning

Objective: To investigate the effects of hemoperfusion combined with hemodialysis on target organ damage in patients with acute paraquat poisoning. Methods: A total of 42 patients with acute paraquat poisoning who were admitted and treated in our hospital between December 2013 and October 2017 were selected as the research subjects, and their therapies were reviewed and used to divide them into the control group (n=20) who received hemoperfusion alone and the combined treatment group (n=22) who received hemoperfusion combined with hemodialysis. The differences in the levels of liver and kidney function indexes in peripheral blood as well as lung function indexes in arterial blood were compared between the two groups of patients immediately after admission, after 1 d of treatment and after 3 d of treatment. Results: Immediately after admission, the differences in the levels of liver and kidney function indexes in peripheral blood as well as lung function indexes in arterial blood were not statistically significant between the two groups. After 1d of treatment and after 3 d of treatment, kidney function indexes Scr, BUN and β2-MG levels in peripheral blood of combined treatment group were lower than those of control group at corresponding time points respectively;liver function indexes ALT, AST, TB and ALP levels in peripheral blood were lower than those of control group at corresponding time points respectively;lung function indexes PaO2, BE and PCO3- levels in arterial blood were higher than those of control group at corresponding time points respectively whereas PaCO2 levels were lower than those of control group at corresponding time points respectively. Conclusion: Compared with hemoperfusion alone, hemoperfusion combined with hemodialysis is more advantageous in protecting the functions of liver, kidney, lungs and other target organs of patients with acute paraquat poisoning.

UDCA联合SAMe治疗慢性乙肝合并妊娠期ICP疗效及其不良妊娠结局影响因素分析

目的:探讨熊去氧胆酸(UDCA)联合丁二磺酸腺苷蛋氨酸(SAMe)治疗慢性乙肝合并妊娠期肝内胆汁淤积症(ICP)疗效及其不良妊娠结局影响因素。方法:选取2020年6月-2023年6月本院治疗的慢性乙肝合并妊娠期ICP患者86例,根据治疗方式分为联合组40例(UDCA联合SAMe治疗)和对照组46例(单药UDCA治疗),比较两组临床疗效,检测两组肝功能指标谷草转氨酶(AST)、谷丙转氨酶(ALT)、血清总胆红素(TBIL)并分析其对妊娠结局的影响。结果:治疗后临床总有效率联合组(92.5%)高于对照组(76.1%),肝功能相关指标两组均得到改善但联合组更佳(均P<0.05);两组不良反应发生率(5.0%、4.3%)无差异(P>0.05),不良妊娠结局发生率联合组(7.5%)低于对照组(23.9%)(P<0.05)。多因素logistic回归分析发现,肝功能指标ALT、AST、HbsAg升高均是慢性乙肝合并妊娠期ICP患者不良妊娠结局发生的独立危险因素(P<0.05)。结论:UDCA联合SAMe治疗慢性乙肝合并妊娠期ICP疗效提高,且未增加不良反应;ALT、AST、HbsAg升高均是慢性乙肝合并妊娠期ICP患者不良妊娠结局发生的危险因素。

Two cases of combined liver-kidney transplantation

To report the clinical experiences of simultaneous hepatorenal transplantation Methods We performed simultaneous hepatorenal transplantation in one patient with liver cirrhosis of hepatitis B and uremia of chronic nephritis on February 1, 1999 and one patient with liver cirrhosis of hepatitis B complicated by hepatorenal syndrome on March 12,1999 The donors were heart arrest cases Rapid multiple organ harvesting techniques and UW solution infusion in situ were used Liver and kidney transplantation were orthotopic and ordinary methods, respectively Immunosuppressive drugs consisted of cyclosporine, Cellcept, ALG and cortstco steroids Lamividine was used on day 50 and day 40 postoperation, respectively Results Both transplanted organs rapidly achieved normal function postoperation and the patients recovered well but suffered mild kidney rejection day 110 postoperation in No 1 patient In No 2 patient, acute renal function failure, mental symptoms, muscle spasm, cerebral artery thrombosis, inhalation pneumonia and chronic liver graft rejection ensured sequentially but were controlled The patients have survived for more than nine and eight months, respectively, with normal life quality Conclusions Combined hepatorenal transplant is a radical treatment method for liver and kidney function failure and requires more comprehensive techniques than isolated single organ transplantation Preventing the recurrence of hepatitis B by oral lamividine may be a key to long term survival

经皮胆管穿刺引流介入对肝门部胆管癌患者肝功能恢复、肿瘤标志物及血清MMP-9的影响

目的经皮胆管穿刺引流介入对肝门部胆管癌患者肝功能恢复、肿瘤标志物及血清基质金属蛋白酶9(MMP-9)的影响。方法选择2019年8月至2022年8月安阳市肿瘤医院收治的79例肝门部胆管癌患者,随机分为对照组(39例)和研究组(40例)。给予对照组患者经内镜鼻胆管引流治疗,给予研究组患者经皮胆管穿刺引流介入治疗。将两组患者临床相关指标,治疗前后肝功能指标,血清肿瘤标志物指标、MMP-9水平,以及术后并发症总发生情况进行对比。结果两组患者手术时间、术中出血量、术后住院时间、并发症总发生率等进行对比,无差异(均P>0.05);相较于治疗前,治疗后两组患者总胆红素(TBi L)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)均下降,且研究组患者TBi L、AST水平均比对照组低(均P<0.05);治疗后两组患者癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原50(CA50)、MMP-9均相较于治疗前下降,且研究组均比对照组低(均P<0.05)。结论相较于经内镜鼻胆管引流,经皮胆管穿刺引流介入治疗应用肝门胆管癌患者的治疗中,可有助于肝功能的恢复,降低血清肿瘤标志物水平及MMP-9水平,且不会增加并发症的发生。

肝癌患者术后肺部感染对机体免疫功能及RAAS的影响及机制研究

目的探讨肝癌患者术后肺部感染对机体免疫功能和肾素-血管紧张素-醛固酮系统(RAAS)的影响。方法选取2017年1月至2018年1月于我院行手术治疗的130例肝癌患者为考察对象,并依据患者术后肺部感染与否分为感染组(n=43)和非感染组(n=87)。测定2组手术前后免疫功能、RAAS系统、营养状态及其他血生化指标水平变化。结果与术前相比,术后感染组患者CD3+T淋巴细胞比例、CD4+/CD8+、NK细胞比例及IgM、IgG、IgA水平、总蛋白、白蛋白水平均明显降低(P <0.01),且显著低于非感染组(P <0.01)。与术前相比,术后2组Ang-Ⅱ、ALD、NE水平以及MMP-1、MMP-2、MMP-9水平均明显升高(P <0.01),且感染组显著高于非感染组(P <0.01)。结论肝癌术后肺部感染可对患者免疫系统和RAAS系统产生更深的影响,而明确术后感染原因和发病机制对提高患者预后效果具有重要意义。

86例急性冠脉综合征患者他汀类药物治疗对肝功能的影响

目的 探讨他汀类药物治疗急性冠脉综合征对肝功能的影响及其安全性.方法 收集2014年2～7月在我院心内科住院治疗的86例急性冠脉综合征患者病例资料.所有病例入院即刻给予常规剂量他汀类药物治疗,检测24h内、7d、15 d的肝功能,根据服用他汀类药物7d后肝功能[丙氨酸转氨酶（ALT）]正常与否分成2组：肝功能正常组（36例）与肝功能异常组（50例）,分析两组转氨酶变化趋势.结果 两组入院后7d、15 d无转氨酶超过正常高限3倍以上的病例.两组患者天冬氨酸转氨酶（AST）入院24h内均数中度及轻度增高[肝功能异常组（146.1±40.6）U/L,肝功能正常组（80.5±20.4）U/L],服药后7d、15 d降至正常范围内[肝功能异常组为（32.5±7.1）U/L和（25.0±10.3）U/L,肝功能正常组为（29.8±7.1）U/L和（26.3±7.1）U/L].肝功能异常组入院24h内ALT均数呈轻中度增高,服药后7d、15 d无明显变化[（51.3±13.5）U/L和（38.1±14.3）U/L];肝功能正常组入院24h内ALT均数呈轻度增高,服药后7d、15 d降至正常[（30.5±9.1）U/L和（29.5±8.5）U/L）].结论 部分患者服用他汀类药物后肝功能ALT轻度增高,AST降至正常范围.急性冠脉综合征患者服用常规剂量他汀是安全的.

急性胰腺炎伴肝功能异常患者的预后影响因素分析

目的 探讨急性胰腺炎伴肝功能异常患者预后的影响因素。方法 采用回顾性研究方法,选取2017年1月至2021年5月在江苏省人民医院就诊的急性胰腺炎伴肝功能异常患者236例,分析在住院期间不同预后患者高血压、糖尿病、临床资料差异。结果 预后不良组年龄、急性生理功能和慢性健康状况评分Ⅱ(APACHEⅡ)评分、急性胰腺炎严重程度床边指数(BISAP)评分、改良CT严重指数(MCTSI)评分和乳酸脱氢酶(LDH)高于预后良好组,差异有统计学意义(P<0.05);预后不良组高血压病、糖尿病比例高于预后良好组,差异有统计学意义(P<0.05)。logistic回归分析结果显示,年龄、糖尿病、APACHEⅡ评分、BISAP评分、MCTSI评分和LDH是患者预后的影响因素(OR>1,P<0.05)。Logit(P)=-12.321+0.519×年龄+0.722×糖尿病+1.054×APACHEⅡ评分+1.544×BISAP评分+1.201×MCTSI评分+0.822×LDH方程预测患者预后的ROC曲线下面积为0.891(P<0.05),灵敏度和特异度分别为80.00%和82.00%。结论 急性胰腺炎伴肝功能异常患者预后受患者年龄、糖尿病、APACHEⅡ评分等多种因素影响,临床治疗时应加以重视。