Efficacy,safety and treatment satisfaction of transition to a regimen of insulin degludec/aspart:A pilot study

BACKGROUND There is a lack of clinical evidence on the efficacy and safety of transitioning from a thrice-daily pre-mixed insulin or basal-prandial regimen to insulin degludec/aspart(IDegAsp)therapy,with insufficient data from the Chinese population.AIM To demonstrate the efficacy,safety,and treatment satisfaction associated with the transition to IDegAsp in type 2 diabetes mellitus(T2DM).METHODS In this 12-week open-label,non-randomized,single-center,pilot study,patients with T2DM receiving thrice-daily insulin or intensive insulin treatment were transitioned to twice-daily injections of insulin IDegAsp.Insulin doses,hemoglobin A1c(HbA1c)levels,fasting blood glucose(FBG),hypoglycemic events,a Diabetes Treatment Satisfaction Questionnaire,and other parameters were assessed at baseline and 12-weeks.RESULTS This study included 21 participants.A marked enhancement was observed in the FBG level(P=0.02),daily total insulin dose(P=0.03),and overall diabetes treatment satisfaction(P<0.01)in the participants who switched to IDegAsp.There was a decrease in HbA1c levels(7.6±1.1 vs 7.4±0.9,P=0.31)and the frequency of hypoglycemic events of those who switched to IDegAsp decreased,however,there was no statistically significant difference.CONCLUSION The present findings suggest that treatment with IDegAsp enhances clinical outcomes,particularly FBG levels,daily cumulative insulin dose,and overall satisfaction with diabetes treatment.

Anti-N-methyl-D-aspartate receptor type autoimmune encephalitis with severe pneumonia:a case report

Autoimmune encephalitis(AE)is a type of encephalitis caused by autoimmune disease.AE was included on a list of the first batch of 121 rare diseases published by the Chinese National Health Commission on 11^(th)May 2018.Currently,patients with AE account for 10%-20% of encephalitis cases,with 54%-80% of those cases classified as the anti-N-methyl-D-aspartate receptor(NMDAR)type,which is the most common type.[1]In 2010,China reported the first case of a patient withanti-NMDARtype AE.

Determination of Carbon and Nitrogen Isotope Fractions in Asparagine, Aspartic Acid, Threonine and Methionine

The nomenclature for compounds that are modified with isotopes is growing every day. Compounds can be modified with isotopes either individually, in a functional group or groups, or completely with all atomic centers of the element. This diversity of isotope-modified compounds increases the range of researches that can be studied using them. Compounds modified with isotopes of carbon-13 or nitrogen-15 can be converted into carbon monoxide, carbon dioxide and molecular nitrogen. Currently, only the average value of carbon-13 or nitrogen-15 isotopes can be determined. However, by directly determining the atomic share of these isotopes in organic compounds modified with isotopes, information about the isotopic centers of the element can be obtained. The atomic fraction of an element is defined as a single carbon or nitrogen isotope-modified center or centers, or all centers that are isotope-modified with that element at the same time. Carbon-13 or nitrogen-15 isotopes’ atomic fraction can be determined molecularly or with fragment ions of different elemental content, or both. This makes the method self-verifying, increasing the accuracy and reliability of the results obtained. Amino acids, such as asparagine, aspartic acid, methionine, and threonine, are essential for the human body. This proposed method of isotopic analysis will increase the possibilities for scientific research using these compounds.

Ornithine aspartate effects on bacterial composition and metabolic pathways in a rat model of steatotic liver disease

BACKGROUND Metabolic-dysfunction associated steatotic liver disease(MASLD)is a hepatic manifestation of metabolic syndrome.Studies suggest ornithine aspartate(LOLA)as drug therapy.AIM To analyze the influence of LOLA intake on gut microbiota using a nutritional model of MASLD.METHODS Adult male Sprague Dawley rats were randomized into three groups:Control(10 rats fed with a standard diet),MASLD(10 rats fed with a high-fat and choline-deficient diet),and LOLA(10 rats receiving 200 mg/kg/d LOLA,after the 16th week receiving high-fat and choline-deficient diet).After 28 wk of the experiment,animals were euthanized,and feces present in the intestine were collected.Following fecal DNA extraction,the V4 region of the 16S rRNA gene was amplified followed by sequencing in an Ion S5™system.RESULTS Alpha and beta diversity metrics were comparable between MASLD and LOLA.3 OTUs were differentially abundant between MASLD and LOLA,which belong to the species Helicobacter rodentium,Parabacteroides goldsteinii,and Parabacteroides distasonis.The functional prediction provided two different metabolic profiles between MASLD and LOLA.The 9 pathways differentially abundant in MASLD are related to a change in energy source,adenosine/purine nucleotides degradation as well as guanosine and adenosine deoxyribonucleotides biosynthesis.The 14 pathways differentially abundant in LOLA are associated with four major metabolic functions primarily influenced by L-aspartate,including tricarboxylic acid cycle pathways,purine/guanosine nucleotides biosynthesis,pyrimidine ribonucleotides biosynthesis and salvage as well as lipid IVA biosynthesis.CONCLUSION Although LOLA had no influence on alpha and beta diversity in this nutritional model of MASLD,it was associated with changes in specific gut microbes and their related metabolic pathways.

High Temperature During Rice Grain Filling Enhances Aspartate Metabolism in Grains and Results in Accumulation of AspartateFamily Amino Acids and Protein Components

Global warming causes the exacerbation of rice growing environment, which seriously affects rice growth and reproduction, and finally results in the decrease of rice yield and quality. We investigated the activities of aspartate metabolism enzymes in grains, and the contents of Aspartate-family amino acids and protein components to further understand the effects of high temperature （HT） on rice nutritional quality during rice grain filling. Under HT, the average activities of aspartate aminotransferase （AAT） and aspartokinase （AK） in grains significantly increased, the amino acid contents of aspartate （Asp）, lysine （Lys）, threonine （Thr）, methionine （Met） and isoleucine （lie） and the protein contents of albumin, globulin, prolamin and glutelin also significantly increased. The results indicated that HT enhanced Asp metabolism during rice grain filling and the enhancement of Asp metabolism might play an important role in the increase of Asp-family amino acids and protein components in grains. In case of the partial appraisal of the change of Asp-family amino acids and protein components under HT, we introduced eight indicators （amino acid or protein content, ratio of amino acid or protein, amino acid or protein content per grain and amino acid or protein content per panicle） to estimate the effects of HT. It is suggested that HT during rice grain filling was benefit for the accumulation of Asp-family amino acids and protein components. Combined with the improvement of Asp-family amino acid ratio in grains under HT, it is suggested that HT during grain filling may improve the rice nutritional quality. However, the yields of parts of Asp-family amino acids and protein components were decreased under HT during rice grain filling.

胰岛素泵持续皮下输注Aspart治疗糖尿病酮症酸中毒临床观察

目的 评价胰岛素泵持续皮下输注Aspart治疗糖尿病酮症酸中毒的疗效。 方法 60例住院的糖尿病酮症 (DK)或糖尿病酮症酸中毒 (DKA)患者随机分为胰岛素泵持续皮下输注Aspart(CSII组 )与常规小剂量胰岛素持续静滴 (对照组 )各3 0例 ,观察两种不同的治疗方法对血糖达标时间、尿酮体转阴时间、平均胰岛素的用量、低血糖发生率的影响。结果 两组患者达到目标血糖值的时间相似 ,差异无显著意义 (P >0 0 5 ) ;CSII组尿酮转阴所需要的时间、平均胰岛素的用量、低血糖发生率均较对照组的明显减少 ,差异有显著意义 (P <0 0 1)。结论 胰岛素泵持续皮下输注Aspart是治疗糖尿病酮症酸中毒更有效、更安全的方法。

Effects of the Amino Acids of Aspartate Family on the Biosynthesis of CoQ_(10) in Rhodopseudomonas palustris J001

[Objective]The study aimed to investigate the effects of the amino acids of aspartate family on the biosynthesis of CoQ10 in Rhodpseudomonas palustris J001.[Method]The impacts of amino acids of this family on the biosynthesis of CoQ10 in Rhodopseudomnas palustris J001 were investigated by feeding these amino acids at the end of the logarithmic phase during incubation,which aim was for the optimization of the fermentation medium and genetic improvement of the strain for CoQ10 production.[Result]The results showed that feeding proper amount of methione(125 mg/L)could increase CoQ10 production by 20.2%,but feeding of lysine(above 500 mg/L),threonine(above 400 mg/L)and/or isoleucine(above 400 mg/L)repressed the biosynthesis of CoQ10.The results indicated that the aspartate kinase is subject to feedback inhibition or repression by lysine,threonine and isoleucine in the strain,which was unfavorable to the formation of methioine and then caused the decrease of CoQ10 production.[Conclusion]Lysine,threonine and isoleucine auxotrophic mutants with resistance to analogues of lysine,threonine and isoleucine could increase the production of CoQ10.

胰岛素类似物Aspart应用于胰岛素泵治疗2型糖尿病急性并发症疗效分析

比较了Aspart与短效可溶性胰岛素对高渗性非酮症糖尿病昏迷(hyperosmolar dia-betic nonketotic coma HONK)或酮症酸中毒(diabetic ketoacidosis DKA)的治疗差异。发现胰岛素泵持续皮下注射治疗组和短效可溶性胰岛素(诺和灵R)对照组间年龄、血糖和体重指数(BMI)无显著性差异;观察血糖、血酮、尿酮体及渗透压、血钠的变化,低血糖的发生率,结果表明:(1)两组患者的血糖经治疗后均明显下降,但达标血糖值的时间治疗组较对照组缩短,药物用量较对照组减少,差异较显著;(2)两组患者血酮恢复正常时间、尿酮体转阴时间、血气pH值恢复正常时间与对照组相比均无显著性差异(P>0.05);(3)治疗组低血糖发生率〔(0.32)次/人〕较对照组〔(1.7)次/人〕低,差异有显著意义(P<0.01)。胰岛素类似物Aspart胰岛素泵持续皮下注射治疗DKA、HONK同短效可溶性胰岛素胰岛素泵持续皮下注射均能取得较好疗效,但前者更有效,安全性更好。

N-methyl-D-aspartate receptor subunit 1 regulates neurogenesis in the hippocampal dentate gyrus of schizophrenia-like mice

N-methyl-D-aspartate receptor hypofunction is the basis of pathophysiology in schizophrenia. Blocking the N-methyl-D-aspartate receptor impairs learning and memory abilities and induces pathological changes in the brain. Previous studies have paid little attention to the role of the N-methyl-D-aspartate receptor subunit 1 (NR1) in neurogenesis in the hippocampus of schizophrenia. A mouse model of schizophrenia was established by intraperitoneal injection of 0.6 mg/kg MK-801, once a day, for 14 days. In N-methyl-D-aspartate-treated mice, N-methyl-D-aspartate was administered by intracerebroventricular injection in schizophrenia mice on day 15. The number of NR1-, Ki67- or BrdU-immunoreactive cells in the dentate gyrus was measured by immunofluorescence staining. Our data showed the number of NR1-immunoreactive cells increased along with the decreasing numbers of BrdU- and Ki67-immunoreactive cells in the schizophrenia groups compared with the control group. N-methyl-D-aspartate could reverse the above changes. These results indicated that NR1 can regulate neurogenesis in the hippocampal dentate gyrus of schizophrenia mice, supporting NR1 as a promising therapeutic target in the treatment of schizophrenia. This study was approved by the Experimental Animal Ethics Committee of the Ningxia Medical University, China (approval No. 2014-014) on March 6, 2014.

Isolated elevated aspartate aminotransferase in an asymptomatic woman due to macro-aspartate aminotransferase: A case report

BACKGROUND Macro-aspartate aminotransferase(AST), a macroenzyme, is a high-molecular mass complex formed by self-polymerization or association with other serum components that are difficult for the kidney to clear, leading to the isolated elevation of serum AST activity. Cases of macro-AST formation are rare, with only 3 published in the English language literature up to September 2019 in China. In this paper, we present a case in which an asymptomatic woman with persistent isolated elevated AST was confirmed as having macro-AST by the polyethylene glycol precipitation method.CASE SUMMARY A 34-year-old woman was referred to our clinic for elevated AST levels with normal levels of other liver-associated enzymes on November 12, 2018. Her AST level of liver function test had been abnormal for 7 mo before she came to the clinic. The patient was asymptomatic with a normal physical examination. There was no relevant family history and no alcohol consumption or smoking. She had a several-month history of traditional Chinese medical taking and had stopped it 1 year prior. The laboratory tests in our clinic showed only the elevation of AST(89.5 U/L) with no other significant abnormalities. We performed the precipitation technique with polyethylene glycol to confirm the presence of macro-AST. Then for almost a year, her AST level still fluctuated in the abnormal range.CONCLUSION This case highlights that clinical physicians should be familiar with this rare condition of persistent isolated AST elevation due to the presence of macro-AST to avoid unnecessary investigation and patient anxiety.

Aspartate transferase-to-platelet ratio index-plus: A new simplified model for predicting the risk of mortality among patients with COVID-19

BACKGROUND Coronavirus disease 2019(COVID-19)has a spectrum of clinical syndromes with serious involvement of the lung and frequent effection of the liver and hemostatic system.Blood biomarkers are affordable,rapid,objective,and useful in the evaluation and prognostication of COVID-19 patients.AIM To investigate the association between aspartate transferase-to-platelet ratio index(APRI)and in-hospital mortality to develop a COVID-19 mortality prediction model.METHODS A multicenter cohort study with a retrospective design was conducted.Medical records of all consecutive adult patients admitted to Al-Azhar University Hospital(Assiut,Egypt)and Chest Hospital(Assiut,Egypt)with confirmed COVID-19 from July 1,2020 to October 1,2020,were retrieved and analyzed.The patient cohort was classified into the following two categories based on the APRI:(1)COVID-19 presenting with APRI≤0.5;and(2)COVID-19 presenting with APRI(>0.5 and≤1.5).The association between APRI and all-cause in-hospital mortality was analyzed,and the new model was developed through logistic regression analyses.RESULTS Of the 353 patients who satisfied the inclusion criteria,10%were admitted to the intensive care unit(n=36)and 7%died during the hospital stay(n=25).The median age was 40 years and 50.7%were male.On admission,49%had aspartate transferase-dominant liver injury.On admission,APRI(>0.5 and≤1.5)was independently associated with all-cause in-hospital mortality in unadjusted regression analysis and after adjustment for age and sex;after stepwise adjustment for several clinically relevant confounders,APRI was still significantly associated with all-cause inhospital mortality.On admission,APRI(>0.5 and≤1.5)increased the odds of mortality by fivetimes(P<0.006).From these results,we developed a new predictive model,the APRI-plus,which includes the four predictors of age,aspartate transferase,platelets,and serum ferritin.Performance for mortality was very good,with an area under the receiver operating curve of 0.90.CONCLUSION APRI-plus is an accurate and simplified prediction model for mortality among patients with COVID-19 and is associated with in-hospital mortality,independent of other relevant predictors.

N-methyl-D-aspartate受体阻断剂MK801对离体海马脑片CA1区锥体细胞缺氧期间电生理的影响

目的 应用细胞内记录技术 ,研究 N- methyl- D- aspartate(NMDA)受体阻断剂 MK80 1对离体海马脑片 CA1区锥体细胞缺氧期间电生理的影响。方法 成年雄性 SD大鼠海马脑片随机分为单纯缺氧组 (Con组 ,n=1 0 )和 MK80 1组 (M组 ,n=1 0 )。Con组海马脑片给予 1 0分钟缺氧 ;而 M组的海马脑片在缺氧前 1 0分钟及 1 0分钟的缺氧期间分别应用 1 0 0 μmol/ L 的 MK80 1。所有脑片均给予 6 0分钟的复氧。应用细胞内记录技术记录海马 CA1区神经元缓慢去极化及快速去极化的时间、快速去极化的幅度。在复氧末 ,应用细胞内注入电流及经 Schaffer通路刺激 ,观察神经元对刺激的反应。结果 Con组海马 CA1区锥体神经元缓慢去极化速率为 (0 .2 2± 0 .0 5 ) m V/ s,显著高于 M组的 (0 .0 8± 0 .0 3) m V/ s (P<0 .0 5 ) ;NMDA受体阻断剂 MK80 1可以显著延迟神经元的快速去极化的时间 ,M组神经元的快速去极化时间为 (5 37± 1 39) s,显著高于 Con组的 (2 6 1± 2 6 ) s (P<0 .0 5 ) ;M组 CA1区神经元的快速去极化幅度为 (4± 1 3) m V,显著小于 Con组的 (5 3± 7) m V(P<0 .0 5 )。在复氧末 ,M组的 1 0例神经元中 ,9例神经元恢复对刺激的反应。结论 NMDA受体阻断剂可显著减轻神经元的缺氧性损伤 ,促进复氧后神经元功?

胰岛素类似物——Aspart30

未修饰的人胰岛素分子之间由于自我联合形成六聚体,导致胰岛素从皮下注射部位吸收进入血循环的时间延迟。速效胰岛素类似物Aspart,因其β链的28位上的氨基酸被天门冬氨酸所取代,至使胰岛素分子彼此排斥,而降低了胰岛素分子的耦联生成6聚体,从而使之经皮快速吸收。Aspart30是由30%可溶性门冬氨酸胰岛素和70%鱼精蛋白结晶体门冬氨酸胰岛素组成。因此本文对Aspart30药代动力学及临床研究做一综述。

胰岛素类似物aspart与CSII联用治疗不稳定型糖尿病

目的 观察胰岛素类似物aspart与胰岛素泵CSⅡ联合使用对血糖不稳定的1型及部分2型糖尿病患者的疗效和应用前景.方法 选择应用口服降糖药和胰岛素血糖难以控制平稳的患者83例,采用治疗组与对照组前后对照的方法,观察用aspart加胰岛素泵前后的血糖曲线（7次）、胰岛素用量、低血糖次数、糖化血红蛋白、血糖控制时间、血浆C肽、动态血糖监测等指标.结果 胰岛素泵治疗组较对照组血糖控制时间、夜间低血糖发生次数、胰岛素用量及费用均较低,差异有统计学意义.结论 胰岛素类似物aspart与CSII联用治疗不稳定型糖尿病较多次注射方法控制血糖更稳定,低血糖发生率低.

2型糖尿病病人持续输注Aspart的临床研究

目的 观察胰岛素泵持续输注Aspart对 2型糖尿病病人全天血糖的影响。方法 将 62例 2型糖尿病病人分成普通胰岛素组与Aspart组 ,两组同用胰岛素泵强化治疗两周 ,比较两组全天血糖情况 ,控制血糖完全达标胰岛素用量情况等。结果 普通胰岛素组、Aspart组空腹血糖完全达达标所需的时间为 (12 0 .3± 2 4.3 )hvs(91.7± 2 3 .7)h ,两组有统计学意义(P <0 .0 0 5 ) ;普通胰岛素组、Aspart组空腹血糖完全达标胰岛素用量为(5 5 .8± 9.7)Uvs (4 5 .7± 10 .2 )U ,有统计学意义 (P <0 .0 0 5 ) ;普通胰岛素组、Aspart组空腹血糖完全达标后的 3餐后 2h血糖为 (10 .3 2± 1.73 )mmol/Lvs (8.79± 1.92 )mmol/L(P <0 .0 1)。结论 胰岛素泵持续输注Aspart可较快地控制血糖 ,尤其对餐后血糖控制更为理想。

Diagnostic value of gamma-glutamyltransferase/aspartate aminotransferase ratio, protein induced by vitamin K absence or antagonist II, and alpha-fetoprotein in hepatitis B virus-related hepatocellular carcinoma

BACKGROUND Researchers have investigated the diagnostic value of protein induced by vitamin K absence or antagonist II (PIVKA-II) and alpha-fetoprotein (AFP) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC), and obtained abundant clinical diagnostic data. However, PIVKA-II and AFP have unsatisfactory specificity and sensitivity in the diagnosis of early-stage HBV-related HCC. Gamma-glutamyltransferase (γ-GT) and aspartate aminotransferase (AST) are common biomarkers for evaluating liver function, and we hypothesized that the γ-GT/AST ratio in combination with PIVKA-II and AFP would improve the diagnosis of early-stage HBV-related HCC. AIM To evaluate the diagnostic value of γ-GT/AST ratio alone or in combination with PIVKA-II and AFP in HBV-related HCC. METHODS Serum levels of γ-GT, AST, PIVKA-II, and AFP were detected and analysed in 176 patients with HBV-related HCC and in 359 patients with chronic hepatitis B. According to tumour size and serum level of HBV DNA, HBV-related HCC patients were divided into the following categories: Early-stage HCC patients, HCC patients, HBV DNA positive (HBV DNA+) HCC patients, and HBV DNA negative (HBV DNA-) HCC patients. Receiver-operating characteristic (ROC) curves were used to analyse and compare the diagnostic value of the single and combined detection of various biomarkers in different types of HBV-related HCC. RESULTS Tumour size was positively correlated with serum levels of PIVKA-II and AFP in HCC patients (r = 0.529, aP < 0.001 and r = 0.270, bP < 0.001, respectively), but there was no correlation between tumour size and the γ-GT/AST ratio (r = 0.073, P = 0.336). The areas under the receiver-operating characteristic curves (AUROCs) of the γ-GT/AST ratio in early-stage HCC patients, HBV DNA+ HCC patients and HBV DNA- HCC patients were not significantly different from that in the total HCC patients (0.754, 0.802, and 0.705 vs 0.779, respectively;P > 0.05). When PIVKA-II was combined with the γ-GT/AST ratio in the diagnosis of earlystage HCC, HCC, and HBV DNA+ HCC, the AUROCs of PIVKA-II increased, with values of 0.857 vs 0.835, 0.925 vs 0.913, and 0.958 vs 0.954, respectively. When AFP was combined with the γ-GT/AST ratio in the diagnosis of early-stage HCC, HCC, HBV DNA+ HCC, and HBV DNA- HCC, the AUROCs of AFP increased, with values of 0.757 vs 0.621, 0.837 vs 0.744, 0.868 vs 0.757, and 0.840 vs 0.828, respectively. CONCLUSION The γ-GT/AST ratio may be better than PIVKA-II and AFP in the diagnosis of early-stage HBV-related HCC, and its combination with PIVKA-II and AFP can improve the diagnostic value for HBV-related HCC.

Diagnostic value of FIB-4, aspartate aminotransferaseto-platelet ratio index and liver stiffness measurement in hepatitis B virus-infected patients with persistently normal alanine aminotransferase

AIM To assess the diagnostic value of FIB-4, aspartate aminotransferase-to-platelet ratio index(APRI), and liver stiffness measurement(LSM) in patients with hepatitis B virus infection who have persistently normal alanine transaminase(PNALT).METHODS We enrolled 245 patients with chronic hepatitis B: 95 in PNALT group, 86 in intermittently elevated alanine transaminase(PIALT1) group [alanine transaminase(ALT) within 1-2 × upper limit of normal value(ULN)], and 64 in PIALT2 group(ALT > 2 × ULN). All the patients received a percutaneous liver biopsy guided by ultrasonography. LSM, biochemical tests, and complete blood cell counts were performed.RESULTS The pathological examination revealed moderate inflammatory necrosis ratios of 16.81%(16/95), 32.56%(28/86), and 45.31%(28/64), and moderate liverfibrosis of 24.2%(23/95), 33.72%(29/86), and 43.75%(28/64) in the PNALT, PIALT1, and PIALT2 groups, respectively. The degrees of inflammation and liver fibrosis were significantly higher in the PIALT groups than in the PNALT group(P < 0.05). No significant difference was found in the areas under the curve(AUCs) between APRI and FIB-4 in the PNALT group; however, significant differences were found between APRI and LSM, and between FIB-4 and LSM in the PNALT group(P < 0.05 for both). In the PIALT1 and PIALT2 groups, no significant difference(P > 0.05) was found in AUCs for all comparisons(P > 0.05 for all). In the overall patients, a significant difference in the AUCs was found only between LSM and APRI(P < 0.05).CONCLUSION APRI and FIB-4 are not the ideal noninvasive hepatic fibrosis markers for PNALT patients. LSM is superior to APRI and FIB-4 in PNALT patients because of the influence of liver inflammation and necrosis.

Validation of aspartate aminotransferase to platelet ratiofor diagnosis of liver fibrosis and prediction of postoperativeprognosis in infants with biliary atresia

Validation of aspartate aminotransferase to platelet ratiofor diagnosis of liver fibrosis and prediction of postoperativeprognosis in infants with biliary atresia pathological Metavir fibrosis score of the liver wedgespecimens of 91 BA infants. The prognostic value ofpreoperative APRI for jaundice persistence, liver injury,and occurrence of cholangitis within 6 mo after KP wasstudied based on the follow-up data of 48 BA infants.RESULTS： APRI was significantly correlated withMetavir scores （rs = 0.433; P 〈 0.05）. The mean APRIvalue was 0.76 in no/mild fibrosis group （Metavir scoreF0-F1）, 1.29 in significant fibrosis group （F2-F3）, and2.51 in cirrhosis group （F4） （P 〈 0.001）. The areaunder the ROC curve （AUC） of APRI for diagnosingsignificant fibrosis and cirrhosis was 0.75 （P 〈 0.001）and 0.81 （P = 0.001）, respectively. The APRI cut-offof 0.95 was 60.6% sensitive and 76.0% specific forsignificant fibrosis diagnosis, and a threshold of 1.66was 70.6% sensitive and 82.7% specific for cirrhosis.The preoperative APRI in infants who maintainedjaundice around 6 mo after KP was higher than thatin those who did not （1.86 ± 2.13 vs 0.87 ± 0.48, P 〈0.05）. The AUC of APRI for prediction of postoperativejaundice occurrence was 0.67. A cut-off value of0.60 showed a sensitivity of 66.7% and a specificityof 83.3% for the prediction of jaundice persistence.Preoperative APRI had no significant association withlater liver injury or occurrence of cholangitis.CONCLUSION： Our study demonstrated that APRIcould diagnose significant liver fibrosis, especiallycirrhosis in BA infants, and the elevated preoperativeAPRI predicts jaundice persistence after KP.

Serum γ-glutamyltransferase,alanine aminotransferase,and aspartate aminotransferase activity in Iranian healthy blood donor men

AIM: To determine serum γ-glutamyltransferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) activity, and to assess their correlation with demographic and clinical findings in healthy blood donors. METHODS: This cross-sectional study was performed in 934 male blood donors, aged 18 to 68 years, who consecutively attended Tehran blood transfusion service in 2006. All participants were seronegative for HBV or HCV infections, non alcohol users, and all underwent a standard interview and anthropometric tests. Clinical and biochemical parameters including AST, ALT, and GGT activities were determined. Patients taking drugs known to cause hepatic fat deposition were excluded. For AST, ALT, and GGT variables, we used 33.33 and 66.66 percentiles, so that each of them was divided into three tertiles. RESULTS: Mean AST, ALT, and GGT activities were 25.26 ± 12.58 U/L (normal range 5-35 U/L), 33.13 ± 22.98 (normal range 5-35 U/L), and 25.11 ± 18.32 (normal range 6-37 U/L), respectively. By univariate analyses, there were significant associations between increasing AST, ALT, or GGT tertiles and age, body weight, body mass index, and waist and hip circumferences (P < 0.05). By multiple linear regression analyses, ALT was found to be positively correlated with dyslipidemia (B = 6.988, P = 0.038), whereas ALT and AST were negatively correlated with age. AST, ALT, and GGT levels had positive correlation with family history of liver disease (B = 15.763, P < 0.001), (B = 32.345, P < 0.001), (B =24.415, P < 0.001), respectively.CONCLUSION: Although we did not determine the cutoffs of the upper normal limits for AST, ALT, and GGT levels, we would suggest screening asymptomatic patients with dyslipidemia and also subjects with a family history of liver disease.

Microwave-assisted Synthesis of Modified Polyaspartic Acid in Solvent

Polyaspartic acid(PASP)is suitable for the inhibition of scale deposition from water.To enhance its in- hibition efficiency,PASP was modified by reacting aspartic acid(Asp)with glutamic acid(Glu)to provide Asp-Glu copolymer under microwave irradiation.The influence of reaction parameters on conversion,molecular weight and inhibition of CaCO3 precipitation was investigated Infra-red.(IR), 1H nuclear magnetic resonance( 1H NMR)and 13C nuclear magnetic resonance( 13C NMR)spectroscopies were used to characterize the copolymer.The results show that copolymerization of aspartic acid and glutamic acid is catalyzed by a small amount of phosphorous acid (H3PO4)in solvent,the product conversion is 98.05%under the following conditions:the molar ratio of glutamic acid to reactant[Glu/(Asp+Glu)]is 0.3 and that of catalyst(Cat)to reactant[Cat/(Glu+Asp)]is 0.05(0.65ml H3PO4),the volume of solvent dimethylformamide is 16ml,the microwave power used is 720W and the reaction for 3 min.The weight average molecular weight of copolymer synthesized under these conditions is 2709 and the inhi- bition rate for CaCO3 is 97.75%.