A new index for non-invasive assessment of liver fibrosis

AIM:To construct and evaluate a new non-invasive fibrosis index for assessment of the stage of liver f ibrosis. METHODS:A new f ibrosis index (Fibro-Stiffness index) was developed in 165 of 285 patients with chronic hepatitis C, and was validated in the other 120 patients where liver biopsy was performed. Its usefulness was compared with liver stiffness (LS) measured by FibroScan, the aminotransferase-to-platelet ratio index, the Forns index and the FibroIndex. RESULTS: The Fibro-Stiffness index consists of LS,platelet count and prothrombin time. The values of the Fibro-Stiffness index differed signif icantly between neighboring f ibrosis stages except F0-F1. The area under the receiver operating characteristics curves of the Fibro-Stiffness index for prediction of F≥2 (0.90), F≥ 3 (0.90) and F= 4(0.92) in the estimation group and those for F≥ 3 (0.93) and F =4 (0.97) in the validation group were the highest among the 5 methods examined. The accuracy of the Fibro-Stiffness index had highest values for F≥2, F≥3 and F=4 in both the estimation and validation groups. The diagnostic performance for F= 4 was improved by a combination of the Fibro-Stiffness index with serum hyaluronic acid level. CONCLUSION: The Fibro-Stiffness index was constructed and validated. It showed superior diagnostic performance to other indices for F ≥ 2,3 and 4.

Influence of reduced-port laparoscopic surgery on perioperative indicators, postoperative recovery, and serum inflammation in patients with colorectal carcinoma

BACKGROUND Conventional five-port laparoscopic surgery,the current standard treatment for colorectal carcinoma(CRC),has many disadvantages.AIM To assess the influence of reduced-port laparoscopic surgery(RPLS)on perioperative indicators,postoperative recovery,and serum inflammation indexes in patients with CRC.METHODS The study included 115 patients with CRC admitted between December 2019 and May 2023,52 of whom underwent conventional five-port laparoscopic surgery(control group)and 63 of whom underwent RPLS(research group).Comparative analyses were performed on the following dimensions:Perioperative indicators[operation time(OT),incision length,intraoperative blood loss(IBL),and rate of conversion to laparotomy],postoperative recovery(first postoperative exhaust,bowel movement and oral food intake,and bowel sound recovery time),serum inflammation indexes[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)],postoperative complications(anastomotic leakage,incisional infection,bleeding,ileus),and therapeutic efficacy.RESULTS The two groups had comparable OTs and IBL volumes.However,the research group had a smaller incision length;lower rates of conversion to laparotomy and postoperative total complication;and shorter time of first postoperative exhaust,bowel movement,oral food intake,and bowel sound recovery;all of which were significant.Furthermore,hs-CRP,IL-6,and TNF-αlevels in the research group were significantly lower than the baseline and those of the control group,and the total effective rate was higher.CONCLUSION RPLS exhibited significant therapeutic efficacy in CRC,resulting in a shorter incision length and a lower conversion rate to laparotomy,while also promoting postoperative recovery,effectively inhibiting the inflammatory response,and reducing the risk of postoperative complications.

EFFECT OF INHALED NANO-TiO_2 ON LUNG AND SERUM BIOCHEMICAL INDEXES OF MICE

The effect of inhaled nano-TiO2 on lung histology and serum biochemical indexes is evaluated in healthy and adult Kunming mice（eight in each group）after exposure to TiO2 aerosols（1 500 mg/m3）in a sealed chamber.Another eight mice are exposed to indoor air to be served as a control group.Lung tissue and blood are collected after euthanizing the animals.The results show that lactate dehydrogenase（LDH）activity increases in all experimental groups.Alanine aminotransferase（ALT）activity and blood urea nitrogen（BUN）levels are increased in the group exposed to TiO2 aerosols for 28 d,and creatinine（Cr）levels are increased in 14 d and 28 d samples（P0.05）.No obvious changes are observed in other serum indexes.Lungs of mice exposed to 28 d exposure show significant but moderate increase in pulmonary inflammation,and many TiO2 particles are found in the interstitium of pulmonary alveoli.

Non-invasive diagnosis of liver fibrosis and cirrhosis

The evaluation and follow up of liver fibrosis and cirrhosis have been traditionally performed by liver biopsy. However, during the last 20 years, it has become evident that this "gold-standard" is imperfect; even according to its proponents, it is only "the best" among available methods. Attempts at uncovering non-invasive diagnostic tools have yielded multiple scores, formulae, and imaging modalities. All are better tolerated, safer, more acceptable to the patient, and can be repeated essentially as often as required. Most are much less expensive than liver biopsy. Consequently, their use is growing, and in some countries the number of biopsies performed, at least for routine evaluation of hepatitis B and C, has declined sharply. However, the accuracy and diagnostic value of most, if not all, of these methods remains controversial. In this review for the practicing physician, we analyze established and novel biomarkers and physical techniques. We may be witnessing in recent years the beginning of the end of the first phase for the development of non-invasive markers. Early evidence suggests that they might be at least as good as liver biopsy. Novel experimental markers and imaging techniques could produce a dramatic change in diagnosis in the near future.

Non-invasive diagnosis of alcoholic liver disease

Alcoholic liver disease(ALD)is the most common liver disease in the Western world.For many reasons,it isunderestimated and underdiagnosed.An early diagnosis is absolutely essential since it(1)helps to identify patients at genetic risk for ALD;(2)can trigger efficient abstinence namely in non-addicted patients;and(3)initiate screening programs to prevent life-threateningcomplications such as bleeding from varices,spontaneous bacterial peritonitis or hepatocellular cancer.The two major end points of ALD are alcoholic liver cirrhosis and the rare and clinically-defined alcoholic hepatitis(AH).The prediction and early diagnosis of both entities is still insufficiently solved and usually relies on acombination of laboratory,clinical and imaging findings.It is not widely conceived that conventional screeningtools for ALD such as ultrasound imaging or routine laboratory testing can easily overlook ca.40%of manifest alcoholic liver cirrhosis.Non-invasive methods such as transient elastography(Fibroscan),acoustic radiation force impulse imaging or shear wave elastography have significantly improved the early diagnosis of alcoholiccirrhosis.Present algorithms allow either the exclusion or the exact definition of advanced fibrosis stages in ca.95%of patients.The correct interpretation of liver stiffness requires a timely abdominal ultrasound and actual transaminase levels.Other non-invasive methods such as controlled attenuation parameter,serum levels of M30 or M65,susceptometry or breath tests are under current evaluation to assess the degree of steatosis,apoptosis and iron overload in these patients.Liver biopsy still remains an important option to rule out comorbidities and to confirm the prognosis namely for patients with AH.

Correlation of serum albumin and prognostic nutritional index with outcomes following pancreaticoduodenectomy

BACKGROUND Pancreaticoduodenectomy(PD) is a complex surgical procedure with a high morbidity rate. The serious complications are major risk factors for poor longterm surgical outcome. Studies have reported an association between early postoperative prognostic nutritional index(PNI) and prediction of severe complications after abdominal surgery. However, there have been no studies on the use of early postoperative PNI for predicting serious complications following PD.AIM To analyze the risk factors and early postoperative PNI for predicting severe complications following PD.METHODS We retrospectively analyzed 238 patients who underwent PD at our hospital between January 2007 and December 2017. The postoperative complications were classified according to the Dindo-Clavien classification. Grade Ⅲ-Ⅴ postoperative complications were classified as serious. The risk factors for serious complications were analyzed by univariate analysis and multivariate logistic regression analysis.RESULTS Overall complications were detected in 157 of 238 patients(65.9%) who underwent PD. The grade Ⅲ-Ⅴ complication rate was 26.47%(63/238 patients).The mortality rate was 3.7%(9/238 patients). Multivariate logistic regression analysis revealed that preoperative serum albumin [odds ratio(OR): 0.883, 95%confidence interval(CI): 0.80-0.96; P < 0.01] and PNI on postoperative day 3 <40.5(OR: 2.77, 95%CI: 1.21-6.38, P < 0.05) were independent factors associated with grade Ⅲ-Ⅴ postoperative complications.CONCLUSION Perioperative albumin is an important factor associated with serious complications following PD. Low early postoperative PNI(< 40.5) is a predictor for serious complications.

Body mass index and serum lipid profile influence serum prostate-specific antigen in Chinese men younger than 50 years of age

This study is to assess the potential factors that could affect the serum prostate-specific antigen （PSA） level in healthy younger men. We evaluated the associations of age, body mass index （BMI） and serum lipid profile with serum PSA level in 6774 Chinese men （aged 20-49 years） who received a routine health examination. Eligible men were classified into 10-year age groups, BMI was categorized as underweight （〈18.5）, normal （18.5-22.9）, overweight （23.0-24.9）, obese （25.0-29,9） and very obese （〉30） according to the redefined World Health Organization （WHO） criteria for the Asia-Pacific region. PSA levels were compared among groups as well, In multiple linear regression analysis, PSA was positively correlated with age （P〈0.0001）. Negative correlations existed between PSA and BMI （P〈0.0001） and triglyceride level （P=0.01）. No relationship could be found between PSA and serum cholesterol （P=0.711） or high-density lipoprotein （HDL; P =0.665）. In addition, we found that serum PSA levels increased with age and decreased with BMI. Our study demonstrates that age, BMI and triglyceride levels influence the PSA level in men 〈50 years of age.

Non-invasive tests for the prediction of primary hepatocellular carcinoma

Hepatocellular carcinoma(HCC)is one of the most common malignancies in the world and it is one of the main complications of cirrhosis and portal hypertension.Even in the presence of a well-established follow-up protocol for cirrhotic patients,to date poor data are available on predictive markers for primary HCC occurrence in the setting of compensated advanced chronic liver disease patients(cACLD).The gold standard method to evaluate the prognosis of patients with cACLD,beyond liver fibrosis assessed with histology,is the measurement of the hepatic venous pressure gradient(HVPG).An HVPG≥10 mmHg has been related to an increased risk of HCC in cACLD patients.However,these methods are burdened by additional costs and risks for patients and are mostly available only in referral centers.In the last decade increasing research has focused on the evaluation of several,simple,non-invasive tests(NITs)as predictors of HCC development.We reviewed the currently available literature on biochemical and ultrasound-based scores developed for the noninvasive evaluation of liver fibrosis and portal hypertension in predicting primary HCC.We found that the most reliable methods to assess HCC risk were the liver stiffness measurement,the aspartate aminotransferase to platelet ratio index score and the fibrosis-4 index.Other promising NITs need further investigations and validation for different liver disease aetiologies.

Effects of Dietary Crude Fiber Levels on Growth Performance and Serum Biochemical Index of Dingan Geese Aged from 35 to 70 Days

[Objective] The study was carried out to investigate the effects of dietary crude fiber on growth performance and serum biochemical in-dex of Dingan geese aged from 35 to 70 days.[Method] A total of 120 Dingan geese on day 28 with the same genetic background and similar initial weight(1 384.83.73±0.76 g) were randomly assigned into 3 groups, with 4 replicates per group and 10 geese per replicate. Geese were fed the diets containing 4.29%, 5.29% and 6.29 % crude fiber, respectively. The experiment lasted 35 d.[Result] Final weight and daily gain of 5.29 %CF group were significantly higher than those of 6.29 % CF group(P<0.05);Feed intake was markedly higher than those of 4.29% and 6.29 % CF groups(P<0.05);Feed gain ratio was significantly lower than that of 6.29 % CF group(P<0.05). Compared with 4.29% and 6.29 % CF groups, serum albumin concentrations of 5.29 % CF group increased significantly(P<0.05), while serum total protein and globin contents were higher(P>0.05), but serum uric acid level was lower(P>0.05).[Conclusion] 5.29 % crude fiber could lead to higher growth performance of Dingan geese.

Validation of conventional non-invasive fibrosis scoring systems in patients with metabolic associated fatty liver disease

BACKGROUND Non-invasive fibrosis scores are not yet validated in the newly defined metabolic associated fatty liver disease(MAFLD).AIM To evaluate the diagnostic performance of four non-invasive scores including aspartate aminotransferase to platelet ratio index(APRI),fibrosis-4 index(FIB-4),body mass index,aspartate aminotransferase/alanine aminotransferase ratio,diabetes score(BARD),and nonalcoholic fatty liver disease fibrosis score(NFS)in patients with MAFLD.METHODS Consecutive patients with histologically confirmed MAFLD were included.The discrimination ability of different non-invasive scores was compared.RESULTS A total of 417 patients were included;156(37.4%)of them had advanced fibrosis(Metavir≥F3).The area under receiver operating characteristic curve of FIB-4,NFS,APRI,and BARD for predicting advanced fibrosis was 0.736,0.724,0.671,and 0.609,respectively.The area under receiver operating characteristic curve of FIB-4 and NFS was similar(P=0.523),while the difference between FIB-4 and APRI(P=0.001)and FIB-4 and BARD(P<0.001)was statistically significant.The best thresholds of FIB-4,NFS,APRI,and BARD for diagnosis of advanced fibrosis in MAFLD were 1.05,-2.1,0.42,and 2.A subgroup analysis showed that FIB-4,APRI,and NFS performed worse in the pure MAFLD group than in the hepatitis B virus-MAFLD group.CONCLUSION APRI and BARD scores do not perform well in MAFLD.The FIB-4 and NFS could be more useful,but a new threshold is needed.Novel non-invasive scoring systems for fibrosis are required for MAFLD.

Effects of Compound Herbal Medicine on Serum Biochemical Indexes and Egg Nutritional Quality in Laying Hens

[ Objective] To investigate the effects of traditional Chinese medicine compound preparation on serum biochemical indexes and egg nutri- tional quality of laying hens. [Method] A total of 1 200 chickens at the age of 44 weeks were selected and randomly divided into five groups. After administration with different dosages of astragalus polysaccharides and berberine for 9 weeks, serum biochemical indexes were determined and nu- trient contents of egg were detected. [ ltesultl The contents of total protein, globulin, high-density lipoprotein cholesterol （HDL-C） and alkaline phosphatase （ALP） in all treatment groups were significantly （ P 〈 0.05 or 0.01 ） higher than those in the control group. The cholesterol contents of all treatment groups were significantly （ P 〈 0.05 or 0.01 ） lower than those of the control group. E Conclusion~ The optimal concentrations of as- tragalus polysacchaddes and berberine in basic diets are 200 and 30 mg/kg, respectively.

Evolving strategies for liver fibrosis staging: Non-invasive assessment

Transient elastography and the acoustic radiation force impulse techniques may play a pivotal role in the study of liver fibrosis. Some studies have shown that elastography can detect both the progression and regression of fibrosis. Similarly, research results have been analysed and direct and indirect serum markers of hepatic fibrosis have shown high diagnostic accuracy for advanced fibrosis/cirrhosis. The prognosis of different stages of cirrhosis is well established and various staging systems have been proposed, largely based on clinical data. However, it is still unknown if either noninvasive markers of liver fibrosis or elastography may contribute to a more accurate staging of liver cirrhosis, in terms of prognosis and fibrosis regression after effective therapy. In fact, not enough studies have shown both the fibrosis regression in different cirrhosis stages and the point beyond which the prognosis does not change- even in the event of fibrosis regression. Therefore, future studies are needed to validate noninvasive methods in predicting the different phases of liver cirrhosis.

Effects of Crude Fiber Levels on Production Performance, Organ Index and Serum Biochemical Parameters of Dingan Geese Aged from 1 to 28 Days

[Objective]The paper was to investigate the effects of dietary crude fiber level on production performance,organ index and serum biochemical parameters of Dingan geese aged from 1 to 28 days.[Method]A total of 144 1-day-old Dingan geese with the same genetic background and similar initial weight(88.75±0.21g)were randomly assigned into 3 groups with 4 replicates per group and 12 geese per replicate,and fed with the diets containing 2.56%,3.52% and 4.48% crude fiber,respectively.The trial lasted 28 d.[Result]1)The final weight and daily gain of 3.52% CF group were significantly higher than those of 2.56% CF group(P<0.05);the feed/gain ratio was markedly lower than that of 2.56% CF group(P<0.05).2)The slaughter rate,semi-eviscerated rate and leg muscle rate of 3.52% CF group were higher than those of 2.56% and 4.48% CF groups(P>0.05).3)As the dietary crude fiber levels rose,the abdominal fat rate showed a downward trend(P>0.05).4)The liver index of 3.52% CF group was significantly higher than that of 2.56% CF group(P<0.05).4)Compared with 2.5%and 4.48% CF groups,the serum albumin concentrations of 3.52% CF group markedly increased(P<0.05),the serum total protein and globin contents were higher(P>0.05),but the serum uric acid level was lower(P>0.05).[Conclusion]When the crude fiber level was 3.52%,the production performances of Dingan geese aged from 1 to 28 days were better,and the liver index and serum albumin level could be obviously improved.

Effects of Fermentation Bed Padding on Intestinal Flora,Serum Biochemical Indexes and Immune Function of Growing-finishing Pigs

[Objective]The paper was to study the effects of fermentation bed padding on intestinal flora,serum biochemical indexes and immune function of growing-finishing pigs.[Method]A total of 90 growing-finishing pigs(Duroc × Landrace × Yorkshire)with the body weight of(30.5±0.8)kg were randomly divided into five groups,three replicates each group,six pigs each replicate.The padding of five groups were:50%rice husk+50%sawdust(control group),100%spent mushroom substrate of Pleurotus eryngii(100%spent mushroom substrate group),15%rice husk+15%sawdust+70%spent mushroom substrate(70%spent mushroom substrate group),25%rice husk+25%sawdust+50%spent mushroom substrate(50%spent mushroom substrate group),35%rice husk+35%sawdust+30%spent mushroom substrate(30%spent mushroom substrate group).The pre-trial lasted 7 d,and the formal trial lasted 90 d.[Result]Compared with the control group,the number of Escherichia col in 100%,70%and 50%spent mushroom substrate groups decreased by 35.4%,24.0%and 20.8%,respectively(P<0.05);the number of salmonella successively decreased by 29.4%,19.3%and 15.2%,respectively(P<0.05);the number of lactobacillus successively increased by 21.7%,15.9%and 12.2%,respectively(P<0.05);and the number of bifidobacteria successively increased by 20.2%,16.7%and 11.8%,respectively(P<0.05).Compared with the control group,the total serum protein content in 100%,70%,50%and 30%spent mushroom substrate groups increased by 30.6%,33.0%,28.0%and 18.4%,respectively(P<0.05);and the serum urea nitrogen content decreased by 32.4%,34.5%,33.9%and 22.0%,respectively(P<0.05).There was no significant difference in serum albumin,aspartate aminotransferase(AST)and alanine aminotransferase(ALT)between treatment groups and control group.The IgA,IgG,IgM and IL-6 levels in serum of each treatment group were significantly different from those of the control group(P<0.05).There was no significant difference in IgA,IgG,IgM and IL-6 levels among 100%,70%and 50%spent mushroom substrate groups.[Conclusion]It improves the balance of intestinal microecological flora of growing-finishing pigs and enhances the immune performance of pigs by using spent mushroom substrate of P.eryngii as the fermentation bed padding.15%rice husk+15%sawdust+70%spent mushroom substrate is the optimal proportion of spent mushroom substrate for growing-finishing pigs.

Application of non-invasive ventilator in the treatment of acute heart failure merged with respiratory failure in ICU

Objective:To observe the application effect of non-invasive ventilator in the treatment of acute heart failure merged with respiratory failure in ICU.Methods:A total of 80 patients with acute heart failure merged with respiratory failure who were admitted in ICU from January, 2015 to January, 2016 were included in the study and randomized into the observation group and the control group with 40 cases in each group. The patients in the two groups were given routine treatments after admission. On this basis, the patients in the observation group were given non-invasive ventilator. The patients in the control group were given continuous low flow oxygen inhalation. PaO2, pH, PaCO2, SaO2, and PaO2/FiO2 before and after treatment between the two groups were compared. The serum NT-pro BNP and cTnI levels before treatment, 24 h and 48 h after treatment in the two groups were compared.Results:The comparison of PaO2, pH, PaCO2, SaO2, and PaO2/FiO2 before treatment between the two groups was not statistically significant. PaO2, pH, SaO2, and PaO2/FiO2 after treatment in the two groups were significantly elevated, while PaCO2 was significantly reduced when compared with before treatment. PaO2, pH, SaO2, and PaO2/FiO2 after treatment in the observation group were significantly higher than those in the control group, while PaCO2 was significantly lower than that in the control group. The comparison of NT-pro BNP and cTnI levels before treatment between the two groups was not statistically significant. NT-pro BNP and cTnI levels 12 h and 24 h after treatment in the two groups were significantly elevated when compared with before treatment. NT-pro BNP and cTnI levels 12 h and 24 h after treatment in the observation group were significantly lower than those in the control group.Conclusions:Non-invasive ventilator in the treatment of acute heart failure merged with respiratory failure can effectively improve the ventilation function, reduce NT-pro BNP and cTnI levels, and is of great significance in enhancing the rescued effect.

Relationship Between Serum Leptin Concentration and Lipids & Body Mass Index in Patients With Chronic Congestive Heart Failure

Objectives To investigate the relationship of serum leptin concentration with the lipids and body mass index （BMI） in patients with chronic congestive heart failure（CHF）. Methods The serum concentration of leptin in 39 patients with CHF （14 in cardiac function class Ⅱ , 21 in class Ⅲ, 4 in classⅣ , NYHA） and in 46 patients with cardiac function class Ⅰ （NYHA） were assessed by radioimmunoassay. Results The serum concentration of leptin were 9.018±4.519 μg/l in CHF group （cardiac function class Ⅱ 11.492±5.649 μg/l, class Ⅲ 7.763±3.321 μg/l, class Ⅳ 6.100±2.657 μg/l）; 11.674± 6.911 μg/l in class Ⅰ group. The serum concentrations of leptin were significantly lower in CHF group, as compared with class Ⅰ group （P〈 0.05）. Moreover, the decrease of serum leptin concentration was significantly correlated with the decreased serum concentrations of total cholesterol, triglyceride, body mass index and left ventricular ejection fraction in CHF group, respectively （P 〈 0.05）. Conclusions The significance of the decrease in serum leptin in CHF patients needs further study.

EFFECTS OF INHALED TiO_2 NANOTUBES ON LUNG TISSUE AND SERUM BIOCHEMICAL INDEXES OF MICE

To evaluate the acute lung toxicity and the effect on serum biochemical indexes of inhaled TiO2 nanotubes , healthy and adult Kunming mice are exposed to aerosols of TiO2nanotubes in a sealed chamber , the concentration of which is 250mg / m 3 while another group of mice are exposed to room air only served as control.The blood , alveolar lavaged fluid and lungs of the mice are collected and examined after exposed for 7 , 14and 28d , respectively.The serum analysis shows that glucose ( Glu ) values with 7dexposure , alanine aminotransferase ( ALT ) and aspartate aminotransferase ( AST ) activities with 28dinhalation , and total bile acid ( TBA ) values with 7 , 28d as well as the creatine kinase ( CK ) levels with 28dexposure are significantly different from those of controls ( P< 0.05 ) .The pathological findings exhibit that more TiO 2 nanotubes are found in the interstitium of pulmonary alveoli with the experimental time prolonged.The results suggest that TiO 2 nanotubes do produce adverse responses to the lung and serum biochemical indexes of mice.Moreover , the responses become severer with the exposed-time prolonged.

Association between Serum Uric Acid to HDL-Cholesterol Ratio and Nonalcoholic Fatty Liver Disease Risk among Chinese Adults

Objective The aim of this case-control study was to explore the association between serum uric acid to high density lipoprotein cholesterol ratio(UHR) and the risk of nonalcoholic fatty liver disease(NAFLD) in Chinese adults.Methods A total of 636 patients with NAFLD and 754 controls were enrolled from the Affiliated Hospital of Qingdao University, China, between January and December 2016. All patients completed a comprehensive questionnaire survey and underwent abdominal ultrasound examination and a blood test. NAFLD was diagnosed using ultrasonography after other etiologies were excluded. Logistic regression and restricted cubic spline model were conducted to evaluate the relationship of UHR with NAFLD risk.Results The multivariable adjusted odds ratio(95% confidence interval, CI) for NAFLD in the highest versus lowest quartile of UHR was 3.888(2.324–6.504). In analyses stratified by sex and age, we observed significant and positive associations between UHR and the risk of NAFLD in each subgroup. In analyses stratified by body mass index(BMI), a significant and positive association was found only in individuals with a BMI of ≥ 24 kg/m2. Our dose-response analysis indicated a linear positive correlation between UHR and the risk of NAFLD.Conclusion UHR is positively associated with the risk of NAFLD and may serve as an innovative and noninvasive marker for identifying individuals at risk of NAFLD.

A Retrospective Analysis of Three Non-Invasive Tests for Initial Diagnosis of <i>Helicobacter pylori</i>Infection in Children

Proper diagnosis in the pediatric population is required to eradicate Helicobacter pylori (H. pylori) and prevent gastric cancer. Our aim was to assess the performance of non-invasive tests to diagnose H. pylori infection in pediatric patients. A retrospective analysis was performed on 141 pediatric patients requiring endoscopic evaluation and diagnostic tests for H. pylori infection to define the cause of abdominal symptoms. Non-invasive tests included the 13C-urea breath test (UBT), a monoclonal stool antigen test using enzyme-linked immuno-sorbent assay (mSAT), and a serum immunoglobulin G antibody test using antigens derived from Japanese individuals (S-Ab). This study investigated sensitivity, specificity, likelihood ratios for a positive and a negative test (LR+ and LR-), and accuracy of non-invasive tests, in comparison with invasive tests. Eighty two of 141 patients (58%) were recognized as H. pylori positive by invasive methods. When UBT, mSAT or S-Ab were analyzed, all were found to be effective over 94% accurate. Specificity ranged between 86.7% and 95.8%, and sensitivity ranged between 93.8% and 97.1%. When subjects were stratified into three distinct age groups, the best performance was achieved for 1-6 years old with mSAT at 100% for sensitivity, specificity, and accuracy. S-Ab yielded the best results for children 7-12 years old and the UBT test performed best for 13-18 years old. These results demonstrate the utility of UBT, mSAT, and S-Ab non-invasive tests in diagnosing H. pylori but suggest that certain tests may be optimal for children of distinct ages. Three non-invasive tests, UBT, mSAT and S-Ab showed sufficient sensitivity, specificity and accuracy for the initial diagnosis of H. pylori infection among pediatric patients. Non-invasive tests may contribute to achieving minimum invasive diagnosis with combining with a histological test and a culture test in children.

Effects of Dietary Picria felterrae Lour Extracts on Serum Biochemical Indexes and Immune Function of Guangxi Partridge Chickens

[Objective] This trial was to investigate the effect of dietary Picria felterrae Lour extracts on serum biochemical indexes and immune function of Guangxi Partridge chickens. [Method] Totally 500 individuals of 1-day-old Guangxi Partridge chickens were randomly divided into five groups, five replicates each group and 20 chicks each replicate. Groups A, B and C were treatment groups supplemented with 0.70%, 0.35% and0.175% P. felterrae extracts in the basal diet, respectively; group D was a medical control group supplemented with 0.01% colistin sulfate premix in the basal diet; and group E was a control group with basal diet. Serum samples were collected from 10 chickens in each group at 21, 35 and 49 days of age, to analyze the biochemical and immune indexes. [Result] It had no significant impact on serum TP and GLU contents of chickens by adding different levels of P. felterrae extracts in the basal diet（P 〉0.05）. However, at 21 and 35 days of age, the TBILI content of chickens in groups A, B and C were extremely lower or significantly lower than that in group E（ P〈0.01; P〈0.05）. At 35 days of age, the serum AKP activities in groups A, B and C were extremely higher than that in group E（P〈0.01）, and the serum GOT activities at 21 and 35 days of age in group C were significantly higher than that in group E（P〈0.05）. At 49 days of age, the serum Ig G content in groups A, B and C and the IL-2 content in group B and group C were significantly lower or extremely lower than that in group E（ P〈0.05; P〈0.01）; the T-AOC content in group B was significantly higher than that in group E（P〈0.05）; the GSH content in groups A, B and C were significantly higher than that in group E（ P〈0.05）. Adding different levels of P. felterrae extracts in the diet significantly decreased the TBILI content, reduced the Ig G, IL-2 and IL-6 contents, and improved the AKP and GOT activities and the T-AOC and GSH contents of Guangxi Partridge chicken. [Conclusion] Adding 0.35% P. felterrae extracts in the basal diet received the best effort.