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 s...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.展开更多
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 analy...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.展开更多
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) predi...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.展开更多
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 tot...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.展开更多
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...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.展开更多
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 a...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.展开更多
基金the Natural Science Foundation of Hunan Province,No.2021JJ70119.
文摘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.
基金Shantou Science and Technology Bureau 1st Fund of the Prevention and Treatment of New Coronavirus Pneumonia,No.2020-1-35.
文摘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.
基金supported by grants from the National Natural Science Foundation of China (81700591, 81520108006, and 81930120)。
文摘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.
文摘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.
文摘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.
文摘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.
