微生态制剂对细菌性痢疾的辅助治疗及对患者血清C反应蛋白水平的影响

目的探讨微生态制剂对细菌性痢疾的辅助治疗及对患者血清C反应蛋白(CRP)水平的影响。方法选取2016年3月至2018年10月在我院门诊接受治疗的86例细菌性痢疾患者为研究对象,入选患者随机分为对照组和观察组,每组43例。对照组患者给予常规药物进行治疗,观察组患者在此基础上加用布拉氏酵母菌散辅助治疗。比较两组患者临床疗效,不良反应发生率及血清CRP水平。结果治疗后观察组患者临床总有效率为90.40%,显著高于对照组的69.77%,差异有统计学意义(χ^2=5.939,P=0.015)。观察组患者不良反应发生率为9.3%,显著低于对照组的34.88%,差异有统计学意义(χ^2=8.174,P=0.004)。同时,观察组患者治疗后血清CRP水平为(4.32±0.43)mg/L,显著低于对照组的(7.03±0.32)mg/L,差异有统计学意义(t=33.154,P<0.001)。结论微生态制剂辅助治疗细菌性痢疾的临床疗效优于常规治疗方法,能降低患者血清CRP水平,减少患者不良反应,安全有效,值得临床推广。     

Effect of vitamin E on serum aminotransferase and thioredoxin levels in patients with viral hepatitis C

OBJECTIVES: Oxidative stress induces cellular responses such as cell death, gene activation and cell proliferation, in the liver. Vitamin E (Vit. E) has been found to protect the liver against oxidative stress in animal experiments. Thioredoxin (TRX) is a stress inducible, multifunctional protein, secreted during oxidative stress. This study evaluated effects of Vit. E on serum TRX and aminotransferase levels in hepatitis C virus (HCV) patients, partly non-responsive to initial interferon (IFN), with higher than average level of serum alanine aminotransferase (ALT) after receiving anti-inflammatory drug treatment. METHODS: Seventeen HCV patients (male = 3; female = 14) of age 62 +/- 7.65 years receiving anti-inflammatory drug therapy, at least 6 months prior to Vit. E administration, were given d-alpha-tocopherol 500 mg/day, orally, for a period of 3 months. ALT, aspartate aminotransferase (AST), TRX and Vit. E were measured at 0, 1, 2 and 3 months and 1 month after end of treatment. As controls, the same patients biochemical data, 3 months from the start of therapy were used. Patients were divided into three categories: total patients "T", low ALT group "L" (ALT < 70 IU/l) and high ALT group "H" (ALT > 70 IU/l), respectively. RESULTS: The ALT level was lowered, significantly in group H, in the 1st, 2nd, 3rd and 1-month post therapy, compared to the initial value. But group L showed little or no change in ALT. Post Vit. E therapy, in groups T and H, the TRX level was elevated but remained below initial levels, whereas in group L, TRX level remained significantly lower than the pretreatment value. Groups T and L, showed significant reduction (p < 0.05) in serum TRX levels in the 2nd and 3rd month. Group H showed a tendency towards TRX reduction, but not significantly. Serum Vit. E levels increased significantly (p < 0.0001) from the 1st to 3rd month in all three T, H and L groups. CONCLUSION: Oxidative stress induced liver damage is reduced by Vit. E in patients with viral hepatitis C, particularly those with initial ALT levels > 70 IU/l. Vit. E treatment causes reduction of oxidative stress markers as TRX and ALT in sera. Therefore, Vit. E can act as a supportive therapy to combat liver damage caused by oxidative stress, in such patients with continuously high levels of ALT even after anti-viral and anti-inflammatory drug therapy.     

Blood and urine physiological values in farm-cultured Rana catesbeiana (Anura: Ranidae) in Argentina

A total of 302 samples of healthy farm-cultured Rana catesbeiana specimens (9-21 months-old, 50-350 g liveweight, 50% each sex) from the north-east of Argentina, were analyzed through spectrophotometry, electrophoresis, densitometry, refractometry and microscopy in order to obtain blood and urine normal values. Confidence intervals (p<0.05) for PCV (28.6-31.6%), RBC (0.40-0.44 T/L), MCV (686-732 fL), hemoglobin (6.41-7.20 g/dL), MCH (151-164 pg), MCHC (22.6-24.0%), WBC (18.7-22.3 G/L), neutrophils (58.4-63.4%), lymphocytes (23.9-29.8%), monocytes (2.1-3.8%), eosinophils (4.6-7.0%), basophils (2.9-4.1%), bleeding time (289-393s), coagulation time (452-696s), prothrombin time (76-128s), urinary density (1.0061-1.0089 g/mL), urinary pH (6,38-6.96)., fibrinogen (0.59-0.99 g/dL), total protein (4.19-4.49 g/dL), albumin (1.49-1.67 g/dL), alpha-1 globulin (0.20-0.24 g/dL), alpha-2 globulin (0.48-0.54 g/dL), beta globulin (0.68-0.77 g/dL), gamma globulin (1.28-1.42 g/dL), albumin/globulin ratio (0.50-0.58), creatinine (4.09-5.56 mg/L). urea (76.1-92.4 mg/L), uric acid (11.5-15.4 mg/L), triglycerides (0.34-0.52 g/L), total cholesterol (0.56-0.67 g/L), HDL-C (0.03-0.05 g/L), LDL-C (0.34-0.44 g/L), alpha lipoprotein (6.01-8.67%). beta lipoprotein (91.3-93.9%), glucose (0.45-0.54 g/L), Na (116-121 meq/L), K (3.42-3.81 meq/L), Cl (100-116 meq/L), Ca (7.98-8.61 mg/dL). P (8.319.36 mg/dL), Mg (2.26-2.55 mg/dL), Fe (105-178 ug/dL), ALP (144-170 [U/L), ALT (10.0-14.8 IU/L), AST (42.8-53.4 IU/L), GGT (7.8-10.6 IU/L), LDH (99-135 IU/L), CHE (151-185 lU/L) and CPK (365-500 IU/L), were obtained. Some parameter ranges were similar to those obtained in amphibians, birds or mammals; others were very different. These parameters are useful to evaluate sanitary, metabolic and nutritional state on captive bullfrogs.     

Effect of Vitamin E on Serum Aminotransferase and Thioredoxin Levels in Patients with Viral Hepatitis C

Objectives: Oxidative stress induces cellular responses such as cell death, gene activation and cell proliferation, in the liver. Vitamin E (Vit. E) has been found to protect the liver against oxidative stress in animal experiments. Thioredoxin (TRX) is a stress inducible, multifunctional protein, secreted during oxidative stress. This study evaluated effects of Vit. E on serum TRX and aminotransferase levels in hepatitis C virus (HCV) patients, partly non-responsive to initial interferon (IFN), with higher than average level of serum alanine aminotransferase (ALT) after receiving anti-inflammatory drug treatment. Methods: Seventeen HCV patients (male=3; female=14) of age 62±7.65 years receiving anti-inflammatory drug therapy, at least 6 months prior to Vit. E administration, were given d-α´-tocopherol 500?mg/day, orally, for a period of 3 months. ALT, aspartate aminotransferase (AST), TRX and Vit. E were measured at 0, 1, 2 and 3 months and 1 month after end of treatment. As controls, the same patients biochemical data, 3 months from the start of therapy were used. Patients were divided into three categories: total patients “T”, low ALT group “L” (ALT<70?IU/l) and high ALT group “H”(ALT>70?IU/l), respectively.Results: The ALT level was lowered, significantly in group H, in the 1st, 2nd, 3rd and 1-month post therapy, compared to the initial value. But group L showed little or no change in ALT. Post Vit. E therapy, in groups T and H, the TRX level was elevated but remained below initial levels, whereas in group L, TRX level remained significantly lower than the pretreatment value. Groups T and L, showed significant reduction (p<0.05) in serum TRX levels in the 2nd and 3rd month. Group H showed a tendency towards TRX reduction, but not significantly. Serum Vit. E levels increased significantly (p<0.0001) from the 1st to 3rd month in all three T, H and L groups. Conclusion: Oxidative stress induced liver damage is reduced by Vit. E in patients with viral hepatitis C, particularly those with initial ALT levels >70?IU/l. Vit. E treatment causes reduction of oxidative stress markers as TRX and ALT in sera. Therefore, Vit. E can act as a supportive therapy to combat liver damage caused by oxidative stress, in such patients with continuously high levels of ALT even after anti-viral and anti-inflammatory drug therapy.     

Limited Utility of Plasma M30 in Discriminating Non-Alcoholic Steatohepatitis from Steatosis – A Comparison with Routine Biochemical Markers

Introduction

The utility of Cytokeratin-18 fragment, namely CK18Asp396 (M30), for the diagnosis of non-alcoholic steatohepatitis (NASH) is currently uncertain. We aimed to provide further data in this area among multi-ethnic Asian subjects with NAFLD.

Materials and Methods

The accuracy of M30 for detecting NASH was compared with serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma glutamyl transpeptidase (GGT) levels in consecutive adult subjects with biopsy-proven non-alcoholic fatty liver disease (NAFLD).

Results

Data for 93 NAFLD subjects (mean age 51.0±11.1 years old and 51.6% males) and 20 healthy controls (mean age 50.2±16.4 years old and 33.3% males) were analyzed. There were 39 NASH subjects (41.9%) and 54 non-NASH subjects (58.1%) among the NAFLD subjects. Plasma M30 (349 U/L vs. 162 U/L), and serum ALT (70 IU/L vs. 26 IU/L), AST (41 IU/L vs. 20 IU/L) and GGT (75 IU/L vs. 33 IU/L) were significantly higher in NAFLD subjects than in healthy controls. Serum ALT (86 IU/L vs. 61 IU/L), AST (58 IU/L vs. 34 IU/L) and GGT (97 IU/L vs. 56 IU/L) were significantly higher in NASH subjects compared to non-NASH subjects, but no significant difference was observed with plasma M30 (435 U/L vs. 331 U/L). The accuracy of plasma M30, and serum ALT, AST and GGT was good for predicting NAFLD (AUROC 0.91, 0.95, 0.87 and 0.85, respectively) but less so for NASH (AUROC 0.59, 0.64, 0.75 and 0.68, respectively). Serum ALT and AST, but not plasma M30 showed a significant trend with increasing grades of ballooning and lobular inflammation.

Conclusion

The utility of M30 in the detection of NASH in clinical practice appears limited, in comparison to routine biochemical markers.     

Associations between Serum C-reactive Protein and Serum Zinc, Ferritin, and Copper in Guatemalan School Children

Inflammation affects trace nutrient concentrations, but research on copper and particularly in children is limited. We assessed associations between serum C-reactive protein (CRP) and zinc, iron, copper, and other biomarkers (alkaline phosphatase, hemoglobin, and albumin), in 634 healthy 6- to 11-year-old Guatemalan schoolchildren. CRP was measured by a standardized, high-sensitive method. For significant associations with CRP, we stratified nutrient concentrations across categories of CRP and compared concentrations above and below several CRP cutoff points (0.5, 1, 3, 5, and 10 mg/L), and then adjusted values using correction factors (ratios of geometric means of the nutrients in the low and high groups). Prevalence of serum zinc (<65 μg/dL0, ferritin (<15 μg/L), and copper (<90 μg/dL) deficiency were 21%, 2.1%, and 23.8%, respectively. Median (25th and 75th percentiles) CRP was 0.56 (0.26 and 1.54) mg/L. CRP concentration was positively associated with ferritin and copper concentrations (r = 0.23 and 0.29, respectively; P < 0.0001) but not with zinc and other biomarkers (P > 0.05). Regardless of CRP cutoffs, high (> cutoff) vs. low (≤ cutoff) CRP levels had higher ferritin and copper concentrations and lower prevalence of copper deficiency of <90 μg/dL (P < 0.05). Adjustment for inflammation had the greatest influence on recalculated prevalence for the CRP 0.5 mg/L cutoff. The low ferritin prevalence hardly changed (from 2.1% to 2.5%) while the low copper prevalence changed appreciably (from 23.8% to 31.2%). In conclusion, CRP was positively associated with ferritin and copper but not with zinc concentrations. Adjustment for inflammation had little effect on low ferritin prevalence, low to begin with, and a large impact on low copper prevalence. High-sensitive CRP methods and the use of very low CRP cutoffs may be more accurate than traditional CRP methods in the adjustment of serum copper concentrations for inflammation in healthy school children.     

Patterns of co-association of C-reactive protein and nitric oxide in malaria in endemic areas of Iran

In addition to numerous immune factors, C-reactive protein (CRP) and nitric oxide (NO) are believed to be molecules of malaria immunopathology. The objective of this study was to detect CRP and NO inductions by agglutination latex test and Griess microassay respectively in both control and malaria groups from endemic areas of Iran, including Southeastern (SE) (Sistan & Balouchestan, Hormozgan, Kerman) and Northwestern (NW) provinces (Ardabil). The results indicated that CRP and NO are produced in all malaria endemic areas of Iran. In addition, more CRP and NO positive cases were observed amongst malaria patients in comparison with those in control group. A variable co-association of CRP/NO production were detected between control and malaria groups, which depended upon the malaria endemic areas and the type of plasmodia infection. The percentage of CRP/NO positive cases was observed to be lower in NW compare to SE region, which may be due to the different type of plasmodium in the NW (Plasmodium vivax) with SE area (P. vivax, Plasmodium falciparum, mixed infection). The fluctuations in CRP/NO induction may be consistent with genetic background of patients. Although, CRP/NO may play important role in malaria, their actual function and interaction in clinical forms of disease remains unclear.     

CRP is related to higher leptin levels in minority peripubertal females regardless of adiposity levels

Overweight is related to higher levels of C-reactive protein (CRP) and leptin, which have been independently associated with increased risk for diabetes, cardiovascular disease, and the metabolic syndrome. Elevated CRP may trigger leptin resistance by inhibiting the binding of leptin to its receptors. We cross-sectionally examined the relationship between CRP, leptin, BMI z-score, percent body fat (%BF) assessed by air plethysmography (BodPod), and insulin sensitivity (SI) and acute insulin response (AIRg) measured by intravenous glucose tolerance test in 51 Latina and African-American females (77% Latina), mean age 9.2 (±0.9) years, at either Tanner Pubertal Stage (TPS) 1 (n = 25) or TPS 2 (n = 26). Females at TPS 2 had higher BMI z-scores, %BF (23% ± 10.1 vs. 30% ± 10.0, P = 0.02), AIRg (976.7 ± 735.2 vs. 1555.3 ± 1,223 μIU/ml, P = 0.05), fasting insulin (11.0 ± 10.8 vs. 17.2 ± 13.6 μlU/ml, P = 0.00) and leptin levels (11.0 ± 7.1 vs. 19.6 ± 10.9 ng/ml, P < 0.001) than those at TPS 1. There were no ethnic differences in any of the measured variables. CRP was positively correlated with BMI z-score (P = 0.001), %BF (P = 0.006), fasting insulin and AIRg (P = 0.02), and fasting leptin (P = 0.00), and negatively correlated with SI (P = 0.05). A linear regression model showed that CRP independently explained 10% (P = 0.00) of the variance in leptin after adjusting %BF, TPS, ethnicity, habitual physical activity and SI. Hence, low-grade inflammation may contribute to prolonged leptin exposure and leptin resistance, even in healthy children.     

Aldolase predicts subsequent myopathy occurrence in systemic sclerosis

Introduction

Myopathy related to systemic sclerosis (Myo-SSc) is a disabling and unpredictable complication of SSc. We assessed the predictive value of serum aldolase, creatine kinase (CK), alanine transaminase (ALT), aspartate transaminase (AST) and C-reactive protein (CRP) to estimate the risk of developing Myo-SSc.

Methods

We enrolled 137 SSc patients without proximal muscle weakness in a prospective monocentric study to follow them longitudinally over a four-year period. The risk of occurrence of Myo-SSc was ascertained according to the European NeuroMuscular Centre criteria and was analyzed according to levels of plasma aldolase, CK, transaminase enzymes and CRP at inclusion. Performance of each parameter to predict Myo-SSc occurrence was assessed and compared with the others.

Results

The area under the receiver operating characteristic curves (ROC) of plasma aldolase for Myo-SSc occurrence prediction was 0.80 (95% CI: 0.67 to 0.94, P < 0.001), which was higher than that of plasma CK (0.75, P = 0.01), and that of ALT (0.63, P = 0.04). AST and CRP had no predictive value for Myo-SSc occurrence. The best cut-off of aldolase for prediction of Myo-SSc occurrence within three years after inclusion was 9 U/L and higher than the upper normality limit (7 U/L), unlike that of CK and ALT. Myo-SSc occurred more frequently in patients whose plasma aldolase was higher than 9 U/L. Adjusted Hazard Ratio for patients with aldolase > 9 U/L was 10.3 (95% CI: 2.3 to 45.5), P < 0.001.

Conclusions

Increased plasma aldolase level accurately identified SSc patients with high risk to develop subsequent Myo-SSc. This could help initiate appropriate treatment when the disabling muscle damage is still in a reversible stage.     

Association of α-fetoprotein levels with liver stiffness measurement in outpatients with chronic hepatitis B

The association between α-fetoprotein (AFP) levels with the assessment of liver stiffness (LS) in chronic hepatitis B (CHB) patients were explored. A total of 283 outpatients with CHB were enrolled. Patient age, alanine aminotransferase (ALT), aspartate aminotransferase (AST), AFP, platelet (PLT), total bilirubin (TB), direct bilirubin (DB), alkaline phosphatase (ALP), albumin (ALB), globulin, and albumin/globulin (A/G) levels were associated with LS values in the univariate model (P<0.05). Significant associations between AFP and PLT levels with LS values were observed when both variables were included in the multivariate analysis models. Receiver operation characteristic (ROC) analysis indicated that the combination of AFP and PLT levels could enhance the predictive performance of liver fibrosis (area under the curve (AUC) = 0.819, P<0.001) and that PLT levels (PLT < 100 × 10⁹/l) combined with high AFP levels (AFP > 8 ng/ml) significantly increased the prediction of liver fibrosis (OR = 11.216). More importantly, LS values associated with higher AFP levels (AFP > 8 ng/ml), independently of higher ALT or AST values, were significantly higher than those of low AFP level groups. In conclusion, in Chinese outpatients with CHB, AFP outperformed ALT and/or AST levels in terms of their association with LS. AFP and PLT levels were independently associated with LS, and their combined assessment could enhance the diagnostic and predictive performance of liver fibrosis among CHB patients.     

双歧杆菌四联活菌片联合乳果糖对乙肝肝硬化患者肠道菌群 和肠黏膜屏障功能及肝功能水平的影响

目的研究双歧杆菌四联活菌片联合乳果糖对乙肝肝硬化患者肠道菌群、肠黏膜屏障功能及肝功能水平的影响。方法选择2017年12月至2018年12月于我院感染科住院治疗的乙肝肝硬化患者80例,按照随机数字表法分为试验组和对照组各40例。两组患者常规予以抗病毒及保肝治疗。试验组患者加用双歧杆菌四联活菌片和乳果糖口服液。对照组患者仅给予乳果糖口服液。检测患者肠道肠杆菌、肠球菌、双歧杆菌、乳杆菌和白假丝酵母数量。测定患者血清内毒素和血清二胺氧化酶水平及尿乳果糖/甘露醇(L/M)比值。记录两组患者丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)和总胆红素(TBIL)水平。观察治疗过程中的药物不良反应发生情况。结果治疗4周后,试验组患者肠道肠球菌数量高于治疗1周后(18.41±2.92 vs 18.32±3.06),同时试验组患者肠道双歧杆菌数量与治疗前、治疗1周后以及对照组同时期相比差异也有统计学意义(均P0.05)。试验组患者治疗后肠道乳杆菌和白假丝酵母水平与治疗前相比差异均有统计学意义(均P0.05)。治疗4周后,对照组患者肠道肠杆菌水平高于治疗1周后(F=10.192,P=0.019);而白假丝酵母水平高于治疗前(F=8.567,P=0.024)。治疗前两组患者血清内毒素、血清二胺氧化酶和尿L/M以及AST、ALT、TBIL水平差异无统计学意义(均P0.05)。治疗1个月后,两组患者血清内毒素、血清二胺氧化酶和尿L/M以及AST、ALT、TBIL均较治疗前明显下降(均P0.05),且试验组的下降幅度较对照组更大(均P0.05)。两组患者均未发生不良反应。结论双歧杆菌四联活菌片联合乳果糖可以改善乙肝肝硬化患者肝功能状态,调节失衡的肠道菌群,降低肠黏膜通透性,值得临床推广。     

供体骨髓干细胞输注联合肝移植治疗终末期肝病的近期效果观察

目的评价供体骨髓干细胞输注联合肝移植治疗终末期肝病的近期效果。方法2008年3月至2009年1月本中心30例肝移植受者分为两组,实验组8例,行同期供体骨髓干细胞联合肝脏移植;对照组22例,仅行肝脏移植,不行骨髓干细胞输注。观察两组受者术后免疫抑制剂（甲基强的松龙、他克莫司）用量、肝功能（谷氨酸转氨酶、天冬氨酸转氨酶等）变化、急性排斥反应和感染并发症发生情况,以及术后住院时间和费用。采用,检验、方差分析及确切概率法进行统计学分析。结果实验组术后甲基强的松龙总用量和出院时每日他克莫司用量显著低于对照组[甲基强的松龙分别为（1314±105）mg,（1884±256）mg,t=6．060,P=0．000;他克莫司分别为（3．73±0．35）mg／d,（4．93±0．62）mg／d,,=5．147,P=0．000]。术后第1天实验组血清谷氨酸转氨酶、天冬氨酸转氨酶均显著低于对照组[谷氨酸转氨酶分别为（875．2±325．5）IU／L,（1350．4±482．7）IU／L,t=2．543,P=0．016,天冬氨酸转氨酶分别为（646．2±184．9）IU／L,（1021．8±325．4）IU／L,t=3．067,P=0．005]。术后第3天也低于对照组[谷氨酸转氨酶分别为（252．9±35．8）IU／L,（343．5±47．8）IU／L,f=4．866,P=0．000,天冬氨酸转氨酶分别为（227．8±38．0）IU／L,（310．8±61．7）IU／L,t=3．545,P=0．001]。结论同期供体骨髓干细胞联合肝脏移植可以降低术后免疫抑制剂用量,减轻术后早期肝脏损伤,不增加治疗风险,是一种安全有效的治疗方法。     

Influence of aqueous extract of Hibiscus sabdariffa L. petal on cadmium toxicity in rats

The effects of chronic exposure to cadmium (Cd) on some selected biochemical parameters, as well as the possible protective role of aqueous extracts of Hibiscus sabdariffa L petal were studied in 12-wk-old male Wistar albino rats. Exposure to Cd caused a significant increase in plasma l-alanine aminotransferases (ALT) only but with a corresponding decrease in liver l-alanine and l-aspartate aminotransferases (L-ALT, L-AST) when compared to the Cd-free control. Total superoxide dismutase activity was decreased in the liver, testis, and prostate of Cd-exposed rats, whereas malondialdehyde (MDA) concentrations were increased relative to the Cd-free control. The metal significantly increased prostatic acid phosphatase activity in the prostate, but decreased the body weight gain of the rats and organ/body weight ratio for prostate and testis compared to the Cd-free control. Pretreatment of rats with aqueous extract of H. sabdariffa resulted in significantly less hepatotoxicity than with Cd alone as measured by plasma ALT and liver ALT and AST activities. The extract also protected the rats against Cd-induced liver, prostate, and testis lipoperoxidation as evidenced by significantly reduced MDA values in these organs, as well as reduced prostatic acid phosphatase activity in the prostate, when compared to the Cd-only exposed rats. Also, when compared to the organ/body weight ratios obtained from rats exposed to Cd alone the prostate and testis were protected by the extract as shown by enhanced prostate/body weight and testis/body weight ratios of Cd- and extract-treated rats. These data suggest that H. sabdarrifa L might be protective in Cd toxicity.     

The clinical chemistry of chimpanzees. I. Determination of aminotransferase baseline values for hepatitis studies

Viral hepatitis in chimpanzees produces negligible symptomatology, and serum aminotransferase changes may be minimal. To maximize the predictive value of these determinations, which are the only serum indicators available for non-A non-B (NANB) hepatitis infection, normal ranges for aspartate and alanine aminotransferases (AST, ALT) were examined and categorized according to age and sex. Males were found to have higher values than females, and adults higher values than juveniles. The kinetic method used and the values obtained are described. Differences in methodologies and reporting units are discussed.     

血清降钙素原在鉴别细菌性感染与自身免疫性疾病活动期中的应用价值

目的：探讨血清降钙素原（procalcitonin,PCT）在鉴别诊断自身免疫性疾病活动期与细菌感染中的应用价值。方法：选择析深圳市保健办2011年1月-2012年3月收治的30例自身免疫性疾病活动期和34例细菌感染患者为研究对象,测定其血清c反应蛋白（C-reactive protein,CRP）和PCT的水平。结果：感染组患者CRP水平为（0．1162±0．0873）gm,PCT水平（2．37±7．02）±10^-3gm,自身免疫活动期患者CRP水平（0．0639±0．0687）gm,PCT浓度（0．09±0．08）×10^-3g／L。ROC曲线下面积（AUC）和95％可信区间（CI）分别为0．75和0186,0．61-0．83和0．74-0．94,差异具有统计学意义（P〈0．05）。CRP联合PCT水平预测的AUC为0．82．其与单独PCT水平相比没有显著性差别（P=0．74）。CRP的最佳临界值为0．0722g／L,灵敏度为73．5％,特异性为69．2％;PCT的最佳临界值为0．09×10^-3g/L,其灵敏度为82．1％,特异性为72．5％。结论：在鉴别活动期自身免疫疾病患者与细菌感染时,PCT的灵敏度与特异性比CRP高,但其联合CRP对此类诊断并无显著意义。     

Assessment of increased serum aminotransferases in a managed Atlantic bottlenose dolphin (Tursiops truncatus) population

Nonspecific chronic hepatitis and increased activities of serum aminotransferases have been reported in cetaceans (dolphins, porpoises, and whales). We identified bottlenose dolphins in our current population with episodic increases in serum aminotransferases, specifically alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and we hypothesized that hematologic and serum biochemical changes in these animals may provide clues as to potential causes of liver disease in cetaceans. A retrospective case-control study involving 1,288 blood samples collected during 1998-2006 from 18 dolphins (six cases and 12 age- and sex-matched healthy controls) was conducted to compare eosinophil and platelet counts; and serum proteins, albumin, globulins, bilirubin, gamma glutamyltransferase (GGT), cholesterol, triglycerides, glucose, iron, and erythrocyte sedimentation rates. Bottlenose dolphins with increased ALT and AST activities were more likely to have higher serum globulins, bilirubin, GGT, iron, glucose, triglycerides, and cholesterol levels, greater erythrocyte sedimentation rates, and lower platelet counts compared to healthy controls. Our findings suggest that dolphins with chronic increases in aminotransferases may have a chronic hepatitis involving iron overload with similar etiologies and pathophysiology compared to terrestrial mammals. Areas for future research include predisposing metabolic risk factors; associations between iron overload and a diabetes-like condition; and a potential overlap syndrome involving autoimmune responses that may or may not be associated with viral infection.     

Oxidative stress, chronic inflammation, and telomere length in patients with periodontitis

The aim of this study was to determine leukocyte telomere length (LTL) in individuals with periodontitis and controls, exploring its relationship with systemic inflammation and oxidative stress. Five hundred sixty-three participants were recruited for this case-control study: 356 subjects with and 207 subjects without periodontitis. LTL was measured by a qPCR technique from leukocytes' DNA. Global measures of oxidative stress (reactive oxygen metabolites) and biological antioxidant potential in plasma were performed together with high-sensitivity assays for C-reactive protein (CRP). Leukocyte counts and lipid profiles were performed using standard biochemistry. Cases had higher levels of CRP (2.1±3.7mg/L vs 1.3±5.4mg/L, P<0.001) and reactive oxygen metabolites (378.1±121.1 U Carr vs 277.4±108.6 U Carr, P<0.001) compared to controls. Overall, cases had shorter LTL with respect to controls (1.23±0.42 vs 1.12±0.31T/S ratio, P=0.006), independent of age, gender, ethnicity, and smoking habit. When divided by subgroup of periodontal diagnosis (chronic, n=285; aggressive, n=71), only chronic cases displayed shorter LTL (P=0.01). LTL was negatively correlated with age (P=0.001; R=-0.2), oxidative stress (P=0.008; R=-0.2), and severity of periodontitis (P=0.003; R=-0.2) in both the whole population and the subgroups (cases and controls). We conclude that shorter telomere lengths are associated with a diagnosis of periodontitis and their measures correlate with the oxidative stress and severity of disease.     

声触诊组织量化技术（VTQ）测量肝硬度与血清AST/ALT比值评价肝硬化患者严重程度及预后分析

摘要 目的：探讨VTQ测量肝硬度与血清AST/ALT比值对肝硬化患者严重程度及预后的评价价值。方法：回顾性选择2018年1月至2022年10月来我院诊治的肝硬化患者80例,根据Child-Pugh分级将80例患者分为Child-Push A级30例、B级25例、C级25级,根据是否存在并发症将80例患者分为并发症组（45例）与非并发症组（35例）,80例患者均用VTQ法检测VTQ值,检测所有患者的血清ALT、AST水平,计算ALT/AST比值。对比不同Child-Push分级患者不同部位的VTQ值,对比不同Child-Push分级患者的AST、ALT水平及AST/ALT比值,对比有无并发症组的不同部位VTQ值,对比有无并发症组患者的AST、ALT水平及AST/ALT比值,分析80例患者不同部位VTQ值与AST、ALT、AST/ALT比值的相关性。结果：C组患者不同肝脏部位的VTQ值明显较A组及B组高,B组患者不同肝脏部位的VTQ值较A组高（P<0.05）。C组的AST水平、AST/ALT值明显较A组、B组高,B组的AST水平、AST/ALT值明显较A组高（P<0.05）,C组的ALT水平较A组、B组高,B组的ALT水平较A组高,但组间对比无统计学意义（P>0.05）。并发症组不同肝脏部位的VTQ值明显较无并发症组高（P<0.05）。并发症组的AST、AST/ALT比值明显较无并发症组高（P<0.05）,并发症组的ALT较无并发症组高,但组间对比无统计学意义（P>0.05）。80例肝硬化患者的AST、AST/ALT比值与不同部位的VTQ值正相关（P<0.05）,ALT水平与不同部位的VTQ值无相关性（P>0.05）。结论：VTQ测量肝硬度与血清AST/ALT比值可用于评价肝硬化严重程度及预后。     

布拉氏酵母菌散剂对NASH大鼠的疗效及其作用机制探讨

目的观察口服布拉氏酵母菌散剂对NASH大鼠的疗效及其对sR—A的影响。方法42只雄性Sprague Dawley（SD）大鼠,随机分为正常对照组（NG,n=14）、模型组（MG,n=14）和干预组（TB,n=14）;正常组给予普通饲料喂养,模型组给予高脂饲料喂养,17周起干预组给予布拉氏酵母菌散剂灌胃,24周末将所有大鼠一并处死。比较各组血清内毒素、谷丙转氨酶、谷草转氨酶;计算非酒精性脂肪性肝病评分;采用免疫荧光法测定SR—A蛋白的表达,RealtimePCR法检测大鼠肝脏SR-A、TNF—αmRNA水平。结果与正常对照组相比,模型组的大鼠门冬氨酸氨基转氨酶（AST）、丙氨酸氨基转氨酶（ALT）均明显升高;干预组的大鼠AST、ALT与模型组相比均下降;模型组血清内毒素水平与正常对照组相比明显增加[（0．36±0．02）EU／mL vs（0．17±0．01）EU／mL,P〈0．05];而与模型组相比,干预组血清内毒素水平减少（0．22±0．01）EU／mL vs（0．36±0．02）EU／Ml,P〈0．05）。肝组织SR—A在正常对照组呈弥漫性表达,模型组肝脏的表达明显减少,干预组肝组织SR—A的表达较模型组升高。模型组的大鼠肝组织SR—AmRNA水平与正常组相比显著减少（0．52±0．32vs1．43±0．46,P〈0．05）;而与模型组相比,干预组的大鼠肝组织SR—AmRNA增加（0．87±0．34vs0．52±0．32。P〈0．05）。与正常组相比,模型组的大鼠肝组织TNF-αmRNA水平明显增加（1．56±0．35vs0．57±0．23,P〈0．05）;而与模型组相比,干预组的大鼠肝组织TNF—dmRNA水平减少（1．23±0．24vs1．564-0．35,P〈0．05）。结论布拉氏酵母菌散剂能够减轻肝脏脂肪变性及炎症程度,其机制可能与改善肠道菌群、减少肠源性内毒素、增加肝组织SR-A的表达有关。     

乙肝患者肝组织乙型肝炎病毒cccDNA和血清MIF表达的相关性研究

目的:探讨乙肝患者肝组织乙型肝炎病毒(hepatitis B virus,HBV)共价闭合环状DNA(covalently closed circular DNA,cccDNA)和血清巨噬细胞移动抑制因子(Macrophage migration inhibitory factor,MIF)的表达相关性。方法:选择2016年2月到2016年7月在我院诊治的乙肝患者144例作为乙肝组,同期选择体格检查健康者144例作为对照组,采集所有入选者的血清样本,检测血清MIF、谷丙转氨酶(Glutamic pyruvic transaminase,ALT)、谷草转氨酶(Glutamic pyruvic aminotransferase,AST)、总胆红素(total bilirubin,TBIL)的表达,并对乙肝组患者肝组织HBV cccDNA采用荧光定量PCR技术检测表达分析,直线相关分析乙肝组的血清HBV cccDNA表达量与血清ALT、TBi L、AST、MIF含量相关性。结果:乙肝组的血清MIF、ALT、TBi L、AST含量均明显高于对照组(P0.05)。乙肝组的肝组织HBV cccDNA阳性率为54.17%(78/144)。直线相关分析显示乙肝组的肝组织HBV cccDNA表达量与血清ALT、TBi L、AST、MIF含量均呈现明显正相关性(P0.05)。结论:乙肝患者体内血清MIF水平明显升高,伴肝组织HBV cccDNA的表达也升高,两者存在明显的正相关性。因此检测血清MIF水平有助于评估乙肝患者HBV的感染情况。