Upregulation of miR-143-3p attenuates oxidative stress-mediated cell ferroptosis in cardiomyocytes with atrial fibrillation by degrading glutamic-oxaloacetic transaminase 1

Oxidative stress-mediated cell death in cardiomyocytes contributes to the development of atrial fibrillation.However,the detailed mechanisms are still unclear.In the present study,we established atrial fibrillation models in mice.The cardiomyocytes were isolated from atrial fibrillation mice and normal mice and were cultured in vitro,respectively.The results showed that cell proliferation and viability in cardiomyocytes with atrial fibrillation were significantly lower than the cells from the normal mice.Consistently,atrial fibrillation cardiomyocytes were prone to suffer from apoptotic cell death.Also,the oxidative stress and ferroptosis-associated signatures were significantly increased in atrial fibrillation cardiomyocytes compared to normal cardiomyocytes,and ferroptosis inhibitor and NAC rescued cell viability in atrial fibrillation cardiomyocytes during in vitro cell culture.In addition,low-expressed miR-143-3p was observed in atrial fibrillation cardiomyocytes compared to normal cardiomyocytes,and overexpression of miR-143-3p increased cell proliferation and inhibited cell death in atrial fibrillation cardiomyocytes.Furthermore,glutamic-oxaloacetic transaminase 1 could be negatively regulated by miR-143-3p in normal cardiomyocytes,and miR-143-3p overexpression inhibited cell ferroptosis in atrial fibrillation cardiomyocytes by sponging glutamic-oxaloacetic transaminase 1.Collectively,overexpression of miR-143-3p increased cell viability and promoted cell proliferation in cardiomyocytes with atrial fibrillation by inhibiting glutamic-oxaloacetic transaminase 1 mediated oxidative damages and cell ferroptosis.

Diagnostic value of methylated branched chain amino acid transaminase 1/IKAROS family zinc finger 1 for colorectal cancer

BACKGROUND The diagnostic value of combined methylated branched chain amino acid transaminase 1(BCAT1)/IKAROS family zinc finger 1(IKZF1)in plasma for colorectal cancer(CRC)has been explored since 2015.Recently,several related studies have published their results and showed its diagnostic efficacy.AIM To analyze the diagnostic value of methylated BCAT1/IKZF1 in plasma for screening and postoperative follow-up of CRC.METHODS The candidate studies were identified by searching the PubMed,Embase,Cochrane Library,CNKI,and Wanfang databases from May 31,2003 to June 1,2023.Sensitivity,specificity,and diagnostic accuracy were calculated by merging ratios or means.RESULTS Twelve eligible studies were included in the analysis,involving 6561 participants.The sensitivity of methylated BCAT1/IKZF1 in plasma for CRC diagnosis was 60%[95%confidence interval(CI)53-67]and specificity was 92%(95%CI:90-94).The positive and negative likelihood ratios were 8.0(95%CI:5.8-11.0)and 0.43(95%CI:0.36-0.52),respectively.Diagnostic odds ratio was 19(95%CI:11-30)and area under the curve was 0.88(95%CI:0.85-0.91).The sensitivity and specificity for CRC screening were 64%(95%CI:59-69)and 92%(95%CI:91-93),respectively.The sensitivity and specificity for recurrence detection during follow-up were 54%CONCLUSION The detection of methylated BCAT1/IKZF1 in plasma,as a non-invasive detection method of circulating tumor DNA,has potential CRC diagnosis,but the clinical application prospect needs to be further explored.

Pocket Modification of x-Amine Transaminase AtATA for Overcoming the Trade-Off Between Activity and Stability Toward 1-Acetonaphthone

Amine transaminases(ATAs)catalyze the asymmetric amination of prochiral ketones or aldehydes to their corresponding chiral amines.However,the trade-off between activity and stability in enzyme engineering represents a major obstacle to the practical application of ATAs.Overcoming this trade-off is important for developing robustly engineered enzymes and a universal approach for ATAs.Herein,we modified the binding pocket of co-ATA from Aspergillus terreus(AtATA)to identify the key amino acid residues controlling the activity and stability of AtATA toward 1-acetonaphthone.We discovered a structural switch comprising four key amino acid sites(R128,V149,L182,and L187),as well as the"best"mutant(AtATAD224K/V149A/L182 F/L187F;termed M4).Compared to the parent enzyme AtATAD224K(AtATAPa),M4 increased the catalytic efficiency(k_(cat)/K_(m)^(1-acetonaphthone),where kcatis the constant of catalytic activities and is 10.1 min^(-1),K_(m)^(1-acetonaphthoneis) Michaelis-Menten constant and is 1.7 mmol·L^(-1))and half-life(t1/2)by 59-fold to 5.9 L·min^(-1)·mmol-1and by 1.6-fold to 46.9 min,respectively.Moreover,using M4 as the biocatalyst,we converted a 20 mmol·L^(-1)aliquot of 1-acetonaphthone in a 50 mL scaled-up system to the desired product,(R)-(+)-1(1-naphthyl)ethylamine((R)-NEA),with 78%yield and high enantiomeric purity(R>99.5%)within 10 h.M4 also displayed significantly enhanced activity toward various 1-acetonaphthone analogs.The related structural properties derived by analyzing structure and sequence information of robust ATAs illustrated their enhanced activity and thermostability.Strengthening of intramolecular interactions and expansion of the angle between the substratebinding pocket and the pyridoxal 5’-phosphate(PLP)-binding pocket contributed to synchronous enhancement of ATA thermostability and activity.Moreover,this pocket engineering strategy successfully transferred enhanced activity and thermostability to three other ATAs,which exhibited 8%-22%sequence similarity with AtATA.This research has important implications for overcoming the trade-off between ATA activity and thermostability.

Persistent hypertransaminasemia in asymptomatic children: A stepwise approach

We aimed to examine the major causes of isolated chronic hypertransaminasemia in asymptomatic children and develop a comprehensive diagnostic flow diagram. A MEDLINE search inclusive of publications throughout August 2012 was performed. We found only a small number of publications that had comprehensively investigated this topic. Consequently, it was difficult to construct a diagnostic flowchart similar to those already available for adults. In children, a "retesting panel" prescription, including gamma-glutamyl transpeptidase and creatine kinase in addition to aminotransferases, is considered a reasonable approach for proficiently confirming the persistence of the abnormality, ruling out cholestatic hepatopathies and myopathies, and guiding the subsequent diagnostic steps. If re-evaluation of physical and historical findings suggests specific etiologies, then these should be evaluated in the initial enzyme retesting panel. A simple multistep diagnostic algorithm incorporating a large number of possible pediatric scenarios, in addition to the few common to adults, is available. Accurately classifying a child with asymptomatic persistent hypertransaminas-emia may be a difficult task, but the results are critical for preventing the progression of an underlying, possibly occult, condition later in childhood or during transition. Given the high benefit/cost ratio of preventing hepatic deterioration, no effort should be spared in diagnosing and properly treating each case of persistent hypertransaminasemia in pediatric patients.

Aspartate transaminase to platelet ratio index in hepatitis C virus and Schistosomiasis coinfection

AIM: To assess the diagnostic accuracy,of aminotransferase-to-platelet ratio index(APRI) alone and with antischistosomal antibody(Ab) in patients with hepatitis C virus(HCV) and schistosomiasis coinfection. METHODS: This retrospective study included medical records of three hundred and eighty three Egyptianmen patients who had undergone percutaneous liver biopsy between January 2006 to April 2014 in tertiary care hospital in Qatar for diagnosis or monitoring purpose were selected. Data of patients > 18 years of age were included in the study. The values of HCV RNA titer and antischistosomal antibody titer were also taken into consideration. Patients were excluded from the study if they had any other concomitant chronic liver disease,including; history of previous antiviral or interferon therapy,immunosuppressive,therapy,chronic hepatitis B infection,human immunodeficiency virus co-infection,autoimmune hepatitis,decompensated liver disease,hepatocellular carcinoma,prior liver transplantation,and if no data about the liver biopsy present. RESULTS: Median age of patients was 46 years. About 7.1% had no fibrosis,whereas 30.4%,37.5%,20.4%,and 4.6% had fibrosis of stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ respectively. In bivariate analysis,APRI score,levels of AST,platelet count and age of patient showed statistically significant association with liver fibrosis(P < 0.0001); whereas antischistosomal antibody titer(P = 0.52) and HCV RNA titer(P = 0.79) failed to show a significant association. The respective AUC values for no fibrosis,significant fibrosis,severe fibrosis and cirrhosis of APRI score were 63%,73.2%,81.1% and 88.9% respectively. This showed good sensitivity and specificity of APRI alone for grading of liver fibrosis. But the inclusion of anti-Schistosoma antibody did not improve the prediction of fibrosis stage. CONCLUSION: The study results suggest that noninvasive biochemical markers like APRI are sensitive and specific in diagnosing the degree of fibrosis and cirrhosis in patients with coinfection of HCV and schistosomiasis as compared to biopsy. The addition of antischistosomal Ab to APRI did not improve sensitivity for predicting the degree of cirrhosis.

Diagnosis of Infectious Mononucleosis by Combined Detection of Atypical Lymphocytes and Transaminase

In order to explore the value of combined detection of atypical lymphocytes （ATL） and transaminase （alanine aminotransferase, ALT＇ asparate aminotransferase, AST） in the diagnosis of infectious mononucleosis （IM）, The data of blood routine and liver function were collected from 54 IM patients, 34 acute hepatitis （AH） patients, 44 upper respiratory infection （URI） patients in Union Hospital during March 2002 to March 2005. Same data were also collected from 40 healthy children as normal control. These data were analyzed retrospectively. Both proportion of atypical lymphocytes and enzyme activity of transaminase were elevated simultaneously （ALT〉40 IU/L, AST〉45 IU/L） in 57.4% （31/54） IM patients. There was significant difference （P〈0.01） between IM group and the other groups. Combined detection of atypical lymphocytes and transaminase can be regarded as a diagnostic marker of infectious mononucleosis.

Prevalence of advanced liver fibrosis and steatosis in type-2 diabetics with normal transaminases:A prospective cohort study

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)and type-2 diabetes mellitus(T2DM)have an intricate bidirectional relationship.Individuals with T2DM,not only have a higher prevalence of non-alcoholic steatosis,but also carry a higher risk of progression to nonalcoholic steatohepatitis.Experts still differ in their recommendations of screening for NAFLD among patients with T2DM.AIM To study the prevalence of NAFLD and advanced fibrosis among our patient population with T2DM.METHODS During the study period(November 2018 to January 2020),59 adult patients with T2DM and 26 non-diabetic control group individuals were recruited prospectively.Patients with known significant liver disease and alcohol use were excluded.Demographic data and lab parameters were recorded.Liver elastography was performed in all patients.RESULTS In the study group comprised of patients with T2DM and normal alanine aminotransferase levels(mean 17.8±7 U/L),81%had hepatic steatosis as diagnosed by elastography.Advanced hepatic fibrosis(stage F3 or F4)was present in 12%of patients with T2DM as compared to none in the control group.Patients with T2DM also had higher number of individuals with grade 3 steatosis[45.8%vs 11.5%,(P<0.00001)and metabolic syndrome(84.7%vs 11.5%,P<0.00001)].CONCLUSION A significant number of patients with T2DM,despite having normal transaminase levels,have NAFLD,grade 3 steatosis and advanced hepatic fibrosis as measured by liver elastography.

Disproportional exaggerated aspartate transaminase is a useful prognostic parameter in late leptospirosis

AIM: To evaluate the hepatic dysfunction in leptospirosis is usually mild and resolved eventually. However,sequential follow-up of liver biochemical data remained lacking..METHODS: The biochemistry data and clinical symptoms of 11 sporadic patients were collected and analyzed, focusing on the impacts of leptospirosis upon liver biochemistry tests.RESULTS: The results disclosed that of the 11 cases, 5 or 45% died. The liver biochemistry data in the beginning of the disease course were only mildly elevated.Nevertheless, late exaggerated aspartate transaminase (AST)elevations were noted in three cases who finally died when compared with the typical course. Besides, significant higher AST/alanine transaminase (ALT) ratios (AARs) of the peak levels for transaminase were also noted in the cases who eventually succumbed. The mean±SD of AARs for the survival group and dead group were 5.65±2.27 (n = 5)and 1.86±0.64 (n = 6) respectively (P= 0.006). The ratios of the cases who finally died were all more than 3.0.Conversely, the survival group's ratios were less than 3.0.CONCLUSION: Serial follow-up of transaminase might provide evidence to predict some rare evolutions in leptospirosis. If AST elevated progressively without a concomitant change of ALT, it might indicate an acute disease course with ensuing death. Additionally, AAR is another prognostic parameter for leptospirosis. Once the value was higher than 3.0, a grave prognosis is inevitable.

A dose-up of ursodeoxycholic acid decreases transaminases in hepatitis C patients

AIM:To examine whether a dose-up to 900 mg of ursodeoxycholic acid(UDCA) decreases transaminases in hepatitis C patients.METHODS:From January to December 2007,patients with chronic hepatitis C or compensated liver cirrhosis with hepatitis C virus(HCV)(43-80 years old) showing positive serum HCV-RNA who had already taken 600 mg/d of UDCA were recruited into this study.Blood parameters were examined at 4,8 and 24 wk after increasing the dose of oral UDCA from 600 to 900 mg/d.RESULTS:Serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),and gamma-glutamyl transpeptidase(GGT) levels were signifi cantly decreased following the administration of 900 mg/d as compared to 600 mg/d.The decrease in ALT from immediately before the dose-up of UDCA to 8 wk after the dose-up was 14.3 IU/L,while that for AST was 10.5 IU/L and for GGT was 9.8 IU/L.Platelet count tended to increase after the dose-up of UDCA,although it did not show a statistically signifi cant level(P=0.05).Minor adverse events were observed in 3 cases,although no drop-outs from the study occurred.CONCLUSION:Oral administration of 900 mg/d of UDCA was more effective than 600 mg/d for reducing ALT,AST,and GGT levels in patients with HCV-related chronic liver disease.

Changes of liver fat content and transaminases in obese children after 12-mo nutritional intervention

AIM:To assess a relationship between longitudinal changes in liver fat content and biochemical parameters in obese children after 1-year nutritional intervention.METHODS:Forty-six obese children, 21 males and 25females, aged 6-14 years, underwent metabolic measurements, liver ultrasonography(US) and chemicalshift magnetic resonance imaging(MRI) examinations at baseline and after 1-year nutritional intervention. A child was defined obese if her/his body mass index(BMI)was above the age- and sex-adjusted BMI Cole's curve passing through the cut-off of 30 kg/m2 at 18 years.BMI Z scores were calculated and adjusted for age and gender by using the Cole's LMS-method and Italian reference data. Biochemistry included serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST). Abdominal US and chemical-shift MRI were performed according to a randomized sequence.The same radiologist performed US by a GE Logiq 9(General Electric Healthcare Medical Systems, Milwaukee, WI, United States) using a 3.5-MHz convex array transducer. Liver echogenicity was evaluated independently on videotape by 3 radiologists unaware of the child and MRI outcomes, and a consensus was established. Another experienced radiologist, unaware of the child and US data, performed the abdominal chemicalshift MRI with a 1-t system NT-Intera(Philips Medical Systems, Best, The Netherlands) and a phased-array coil. Liver fat fraction(FF) on MRI was judged elevated when greater than 9%. A FF>18% was considered expressing more severe cases of fatty liver according to Fishbein. A nutritional-behavioral intervention was recommended to promote a normocaloric balanced diet and active lifestyle based on the Italian guidelines for treatment of childhood obesity.RESULTS:Compared to baseline, at the end of intervention children showed lower intakes of energy(mean± SD:2549±1238 Kcal vs 1770±622 Kcal, P<0.0001), total fat(90±47 g vs 52± 23g, P<0.0001),carbohydrates(356±174g vs 241±111 g, P=0.001),and protein(99±48g vs 75±23g, P=0.006) intakes. Prevalence of FF≥9% declined from 34.8%to 8.7%(P<0.01), with a mean reduction of 7.8%(95%CI:5.0-10.6). At baseline, FF was associated with liver biochemical parameters(maximum P<0.001). At the end of the intervention association was found with AST(P=0.017). Change of FF was associated with change in AST(P =0.027) and ALT(P=0.024). Rate of increased liver echogenicity declined from 45.6% to21.7%(P<0.0001). Liver echogenicity was associated with ALT at baseline only(P<0.001). An age-and sexadjusted multiple regression analysis showed that FF change was independently associated with change in serum AST(adjusted regression coefficient 0.348, P=0.048).CONCLUSION:The results suggest that in obese children longitudinal changes in liver fat content based on MRI may be associated with change in serum transaminases suggesting novelty in monitoring nonalcoholic fatty liver disease.

Investigation of minerals, testosterone, and transaminases in the semen and serum of fertile and infertile men belongs to different age groups

The present study was aimed to assess the potential of infertility to induce the adverse effects with reference to testosterone, Triiodothyronine (T3), Thyroxine (T4), Alanine Aminotransferase (ALT), Aspartate Amino-transferase (AST), zinc, copper and iron. All the samples were divided into four groups according to age and disorder (Group 1, 10 infertile men of 25-40 years;Group 2, 10 fertile men of 25-40 years;Group 3, 10 infertile men of 41- 60 years and Group 4, 10 fertile men of 41-60 years). Semen and blood samples were analyzed by atomic absorption spectrophotometry to determine minerals while, Testosterone, T3 and T4 were determined by enzyme immunoassay kits. ALT and AST were determined using standard kit assay method. The levels of testosterone and T3 and AST in the fertile semen of 41-60 years age group were increased significantly (P ≤ 0.001) as compared to that of fertile semen of 25-40 years age group. While, the level of T4 in the fertile semen of 41-60 years age group was decreased significantly (P ≤ 0.001) as compared to that of fertile semen of 25-40 years age group. In case of fertile serum, only the level of testosterone was significantly decreased (P ≤ 0.05) in the 41-60 years age group as compared to 25-40 years age group. The levels of testosterone and Cu in the infertile serum of 41-60 years age group were decreased significantly (P ≤ 0.001). While, the levels of T3, T4, ALT and Fe in the infertile serum of 41-60 years age group were increased significantly (P ≤ 0.05) as compared to that of infertile serum of 25-40 years age group.

Glutathione Reductase, Liver Transaminases and Atypical Lymphocytes Count as Early Predictive Biomarkers in Diagnosis of Thrombocytopenia in Dengue Viral Infection

Objective: The aim of the study is to identify whether Atypical Lymphocyte (AL), liver transaminases, and Glutathione Reductase (GR) can be used as potential biomarkers in the assessment of severity and thrombocytopenia in dengue. Methods: A cross-sectional analytical study was carried out on diagnosed dengue patients admitted to Nawaloka Hospital, Sri Lanka. Blood samples were taken from patients (n = 50) on the day of admission, 3rd and 5th day from admission for analysis of GR, aspartate transaminase, alanine transaminase, platelets, white blood cells, and Atypical Lymphocytes (AL). Results: GR level of all three measured stages had a higher area under the curve (>88%), high sensitivity and specificity compared to liver transaminases. A significant regression model represents on admission GR and AL levels as predictive variables to platelet levels in day 03 from admission (Day 3 Platelet level = 127155.3 - 383 * GR - 0.431 * AL). Conclusion: Liver transaminases, GR, and AL% can be considered as a profile of predictive biomarkers in early diagnosis of severity of dengue infection. The degree of thrombocytopenia can be predicted using on admission GR and AL% level in acute dengue viral infection.

Activity of transaminase enzyme and testosterone hormone in blood of Awassi rams during different season

Objective:To monitor the levels of aspartate transaminase (AST) and alanine transaminase (ALT) enzymes and testosterone hormone in months and seasons of Iraq.Methods: In this experiment, 20 (2.0-3.5 years old) Iraqi Awassi rams were used which were housed in semi opened shade. Blood samples (2-3 mL) were collected once a week for over period 12 mo. AST and ALT activities were measured by using colorimetric method, and testesterone analysis was performed with an automatic analyzer.Results: The activities of both AST and ALT enzymes were increased significantly (P<0.05) during summer, on monthly basis, June showed the significantly highest value (P<0.05). The present study revealed that testosterone in autumn and summer was recorded significantly highest (P<0.05) in comparison with other seasons and on monthly basis the significant (P<0.05) highest level of testosterone was found between September and August months.Conclusions: AST and ALT enzymes are the highest during summer, and on monthly basis they are the highest in June, while testosterone level is recorded highest in autumn season, and on monthly basis November shows the highest value.

Prognostic performance of an index based on lactic dehydrogenase and transaminases for patients with liver steatosis and COVID-19

BACKGROUND Metabolic associated fatty liver disease(MAFLD)is associated with complications and mortality in patients with coronavirus disease 2019(COVID-19).However,there are no prognostic scores aimed to evaluate the risk of severe disease specifically in patients with MAFLD,despite its high prevalence.Lactate dehydrogenase,aspartate aminotransferase and alanine aminotransferase have been used as markers of liver damage.Therefore,we propose an index based on lactate dehydrogenase,aspartate aminotransferase and alanine aminotransferase for the prediction of complications and mortality in patients with MAFLD and COVID-19.AIM To evaluate the prognostic performance of an index based on lactate dehydrogenase and transaminases(aspartate aminotransferase/alanine aminotransferase)in patients with COVID-19 and MAFLD[liver fibrosis and nutrition(LNF)-COVID-19 index].METHODS In this retrospective cohort study,two cohorts from two different tertiary centers were included.The first was the derivation cohort to obtain the score cutoffs,and the second was the validation cohort.We included hospitalized patients with severe COVID-19 and MAFLD.Liver steatosis was evaluated by computed tomography scan.Area under the receiver operating characteristic(ROC)curve analysis and survival analysis were used.RESULTS In the derivation cohort,44.6%had MAFLD;ROC curve analysis yielded a LFN-COVID-19 index>1.67 as the best cutoff,with a sensitivity of 78%,specificity of 63%,negative predictive value of 91%and an area under the ROC curve of 0.77.In the multivariate analysis,the LFN-COVID-19 index>1.67 was independently associated with the development of acute kidney injury(odds ratio:1.8,95%confidence interval:1.3-2.5,P<0.001),orotracheal intubation(odds ratio:1.9,95%confidence interval:1.4-2.4,P<0.001),and death(odds ratio:2.86,95%confidence interval:1.6-4.5,P<0.001)in both cohorts.CONCLUSION LFN-COVID-19 index has a good performance to predict prognosis in patients with MAFLD and COVID-19,which could be useful for the MAFLD population.

ω-转氨酶的筛选和异源表达用于制备S-甲氧基异丙胺

根据转氨酶家族进化分类和底物特异性,构建一个包含36个ω-转氨酶的酶库;将酶库中的基因克隆进大肠杆菌E.coli BL21 (DE3)中进行异源重组表达,考察酶蛋白表达水平并测定相应的酶活以及对映体选择性。通过筛选,获得最佳的ω-转氨酶为来源于巨大芽孢杆菌Bacillus megaterium的ω-转氨酶BmeTA,其重组表达粗酶活为2.0 U/mL,纯酶比活为9.5 U/mg蛋白;酶学性质表征发现其最适温度为35℃,最适pH为8.0。在此基础上进一步优化其催化反应工艺条件,在20 g/L加酶量、0.5 mmol/L辅酶添加量以及1.4的氨基供体/氨基受体比例条件下,反应18 h获得450 mmol/L的S-甲氧基异丙胺,原料转化率达到90%,为实现生物催化制备S-甲氧基异丙胺的工业化奠定基础。

谷氨酰胺转氨酶对板栗粉面团理化特性的影响

为改善板栗粉在无麸质食品领域的品质特性及加工性能,考察谷氨酰胺转氨酶(glutamine transaminase,TG)添加量分别为0、0.9、1.8、2.7、3.6 U/g(按板栗全粉质量计)时对板栗粉面团质构特性、流变特性、糊化特性等的影响,并从游离巯基含量的变化加以解释,最后通过扫描电子显微镜观察板栗面团的微观结构。结果表明:TG的添加可以增强板栗面团的黏度、硬度、弹性、咀嚼性和回复性,与空白对照相比,添加量为2.7 U/g时,其最终黏度增加6.8 cP、硬度增加7.55 g、弹性增加0.38、咀嚼性增加33.62 g、回复性增加0.118,板栗面团内部的结构更加稳定;随着TG添加量的增加,板栗面团的弹性模量和黏性模量均增加,综合黏弹性上升,抗外界形变能力增强,面团稳定性及加工性能随之提高;板栗面团游离巯基的含量随TG添加量的增加而减少,添加量为2.7 U/g与未添加时的相比,游离巯基含量减少了0.16 mmol/g。但TG添加量过多会导致蛋白过度交联,淀粉粒被迫外露,面团整体的稳定性降低。综上,当TG添加量为2.7 U/g时,改善板栗面团的理化特性效果达到最佳。

年龄>30岁、ALT水平正常HBV感染孕妇的抗病毒治疗时机

《慢性乙型肝炎防治指南(2022版)》扩大了慢性乙型肝炎患者抗病毒治疗适应证。ALT水平正常的慢性HBV感染者,HBV DNA阳性,年龄>30岁,指南建议开始抗病毒治疗。但对于年龄>30岁的孕妇,是否立即启动抗病毒治疗尚无统一观点。有观点认为,ALT水平正常的孕妇多为免疫耐受期,抗病毒治疗效果不佳,且孕期用药可能影响母婴安全。因此,即使孕妇年龄>30岁,也不主张在孕早期开始抗病毒治疗;也有观点认为,孕期机体的免疫改变可能是HBV免疫清除的特殊时期,若年龄>30岁,即使ALT水平正常,也应该立即抗病毒治疗,孕妇可能获得更好的病毒学甚至血清学应答。本文将针对上述问题,从孕期抗病毒治疗目的、治疗时机和停药时机等方面展开论述。

儿童HBV感染:ALT水平正常患儿的抗病毒治疗

慢性乙型肝炎(CHB)是全球范围内的重大公共卫生问题,目前我国约有200万儿童HBV感染者。儿童感染HBV后更容易慢性化,成年后发生肝硬化以及肝癌的风险高。传统观点认为儿童HBV感染多数处于免疫耐受期,无需考虑抗病毒治疗,仅对免疫活动期和代偿期或失代偿期肝硬化的儿童CHB启动抗病毒治疗。越来越多的儿童CHB临床研究结果显示,儿童CHB抗病毒治疗(特别是以干扰素为基础的方案)应答率高,低龄儿童是临床治愈的优势人群,但对于ALT水平正常,特别是处于免疫耐受期的HBV感染的患儿是否接受抗病毒治疗仍然存在争议。本文针对儿童HBV感染的特点及ALT水平正常患儿抗病毒治疗必要性,特别是关于治疗时机等方面进行综述。

ALT水平正常的慢性乙型肝炎患者的血清学特征及肝组织病理学分析

目的分析ALT水平正常的慢性乙型肝炎(CHB)患者的肝组织病理学特点及与血清学指标间的关系。方法收集2018年4月—2021年6月无锡市第五人民医院137例ALT水平正常CHB患者的临床资料,分析肝组织病理与血清学指标间的差异及相关性。计数资料组间比较采用χ^(2)检验。采用Speraman秩相关进行相关性分析。采用Logistic回归进行多因素分析。结果ALT水平<20 U/L、20~29 U/L、30~40 U/L患者中分别有57.4%、53.4%、75%具有显著炎症坏死(≥G2),63.8%、62.1%、75%具有显著纤维化(≥S2)。HBeAg阳性/阴性、不同水平的血清HBV DNA、不同水平的血清HBV RNA在炎症活动程度分级上差异均有统计学意义(χ^(2)值分别为10.008、6.911、7.946,P值均<0.05);HBeAg阳性/阴性、不同水平的血清HBV RNA在纤维化分期上差异均有统计学意义(χ^(2)值分别为7.996、10.874,P值均<0.05)。肝脏炎症程度及纤维化分期与血清HBV DNA无明显相关性(r_(s)=0.024,P=0.785;r_(s)=0.039,P=0.652),与血清HBV RNA存在显著相关性(r_(s)=0.222,P=0.009;r_(s)=0.187,P=0.029)。多因素分析提示HBeAg阳性是CHB患者肝脏发生炎症坏死(OR=−0.302,95%CI:−1.160~0.386,P=0.002)及纤维化(OR=−0.387,95%CI:−1.160~0.386,P=0.011)的独立危险因素。结论ALT水平正常的CHB患者的肝脏组织存在不同程度的显著炎症坏死及纤维化,HBeAg阳性是这类患者肝脏组织出现显著炎症坏死及纤维化的独立危险因素。

DEB-TACE治疗肝功能Child-Pugh评分8分肝细胞癌的疗效评价

目的探讨对于肝功能Child-Pugh评分8分的肝细胞癌使用载药微球经肝动脉化疗栓塞术(drug-eluting beads-transarterial chemoembolization,DEB-TACE)治疗的疗效。方法选取2021年11月—2022年11月安庆市立医院连续纳入20例肝功能Child-Pugh分级B级8分的肝癌患者,均接受DEB-TACE治疗。分析患者治疗前后肝功能及发生不良反应的情况。结果20例患者均行CalliSpheres载药微球进行治疗,过程顺利。术后1个月,患者治疗效果为疾病进展(progressive disease,PD)2例、部分缓解(partial response,PR)11例、完全缓解(complete response,CR)2例、疾病稳定(sable disease,SD)5例,且客观缓解率(objective response rate,ORR)为65.0%(13/20)。7例后续接受了靶免系统治疗。术后1周天门冬氨酸氨基转移酶(aspartate transaminase,AST)、总胆红素和谷氨酸氨基转移酶(alanine transaminase,ALT)水平都有所上升,与术前相比,差异有统计学意义(P<0.05);白蛋白水平变化较术前差异无统计学意义(P>0.05)。与术前对比,经手术治疗1个月后,患者的肝功能基本恢复至正常水平,差异无统计学意义(P>0.05)。患者仅发生了轻微不良反应,如疼痛、发热、恶心、呕吐等。结论DEB-TACE治疗肝功能Child-Pugh评分8分的肝细胞癌的近期疗效确切、安全性高。