The prevalence of nonalcoholic fatty liver disease in Chinese adults screened by vibration controlled transient elastography and its diagnostic discrepancy compared with ultrasound

BackgroundThe prevalence of non-alcoholic fatty liver disease (NAFLD) in China as assessed using vibration-controlled transient elastography (VCTE) and its consistency with ultrasound is still unknown. We aimed to conduct a head-to-head comparison of consecutive measurements of NAFLD with ultrasound or VCTE to evaluate the discrepancy in the prevalence and distribution of NAFLD screened by two non-invasive techniques.MethodsWe collected VCTE and ultrasound examination data from 4,388 participants who underwent health check-ups at the Health Promotion Center of Jiangsu Province Hospital between January 2017 and December 2019. The major outcome was the presence of hepatic steatosis, which was defined as a median controlled attenuation parameter (CAP) ≥ 248 dB/m by VCTE or the definition of steatosis by ultrasound.ResultsAmong the 4,388 participants, 2,214 were diagnosed with NAFLD by VCTE (CAP ≥ 248 dB/m, 50.46%). Participants with severe steatosis (CAP ≥ 280 dB/m) were commonly male (77.94% vs. 50.38%, P < 0.001), were obese (45.09% vs. 1.79%, P < 0.001), had a worse metabolic profile, had elevated liver enzyme levels, and had advanced fibrosis. The prevalence of ultrasound-diagnosed NAFLD was 56.42%. After consistency analysis, VCTE and ultrasound showed moderate agreement regarding the diagnosis of NAFLD (κ = 0.475). We then compared the characteristics and clinical features of the four groups classified by the diagnosis results of the two techniques. NAFLD participants diagnosed by VCTE only were older, more obese, and had worse metabolic and biochemical profiles than NAFLD participants diagnosed by ultrasound only; in particular, the former had a higher proportion of abnormal alanine aminotransferase and aspartate aminotransferase levels and a higher proportion of advanced fibrosis than the latter.ConclusionsMore than half of Chinese adults were affected by NAFLD according to VCTE. Screening based on VCTE is more likely to identify NAFLD patients with severe clinical features than ultrasound. Therefore, VCTE is a more practical non-invasive tool for the screening and follow-up of NAFLD in China.     

甘草干姜汤治疗变应性鼻炎大鼠的实验研究

目的:观察甘草干姜汤对变应性鼻炎大鼠外周血中γ-干扰素(IFN-γ)、白细胞介素-4(IL-4)的表达及鼻黏膜组织的影响。方法:120只大鼠随机分为正常组、甘草干姜汤组、模型组及西药组4组,后3组用卵清蛋白(AVO)制作变应性鼻炎动物模型,分别给予甘草干姜汤2~2.5 m L/只、西替利嗪溶液2~2.5 m L/只、生理盐水2~2.5 m L/只灌胃(模型组及对照组),每天1次;每组大鼠分别在灌胃10、20及30 d时处死10只,检测大鼠血清中IFN-γ和IL-4水平,同时观察各组大鼠各时点的行为学和鼻黏膜组织学变化。结果:灌胃10 d,甘草干姜汤组和西药组与模型组大鼠行为学表现无明显差异(P>0.05),但与正常组存在明显差异(P<0.01);灌胃20 d,甘草干姜汤组和西药组大鼠与模型组和正常组均有明显的差异(P<0.01);灌胃30 d,甘草干姜汤组和西药组行为学变化接近正常组(P>0.05);甘草干姜汤组和西药组灌胃10和20 d时,血清中IFN-γ、IL-4水平与正常组、模型组均有明显差异(P<0.01);灌胃30 d,甘草干姜汤组、西药组IFN-γ和IL-4与模型组比较,分别有明显升高和下降(P<0.01),但与正常组无明显差异(P>0.05);HE染色示甘草干姜汤组与西药组灌胃30 d,鼻黏膜结构逐渐修复,嗜酸细胞显著减少,而正常组与模型组未见明显改变。结论:甘草干姜汤能改善变应性鼻炎大鼠的症状,对鼻黏膜有一定修复作用,其机制可能与调节IFN-γ-及IL-4水平有关。     

REGγ和p16在乳腺癌中的表达及意义

目的：分析REGγ蛋白酶复合体通过ATP-泛素化的过程介导下调 p16的体内作用机制。方法利用免疫组织化学染色的实验方法检测在人类乳腺癌REGγ和p16蛋白水平的表达,分析在乳腺癌中二者表达的相关性。结果77例乳腺癌组织中,49例呈REGγ阳性表达(63．63%),51例呈p16阳性表达(66．23%);23例癌旁正常组织中,3例呈REGγ阳性表达(13．04%),15例呈p16阳性表达(65．22%)。结论 REGγ在人类乳腺癌组织中高表达,p16在乳腺癌旁正常组织中高表达,两者之间存在相关性,REGγ可能通过下调p16这一途径在乳腺癌的发生发展中发挥其功能。     

白细胞介素4和干扰素γ及转化生长因子β_1在支气管哮喘发病机制中的研究进展

支气管哮喘是由多种细胞和细胞因子参与的肺部慢性炎症性疾病,其发病机制尚未完全清楚。现在认为Th1/Th2比例和功能失衡是支气管哮喘的主要免疫学发病机制之一,其中白细胞介素4和干扰素γ在支气管哮喘的发病过程中起着重要作用,并与哮喘的严重程度相关。呼吸道重构是支气管哮喘的重要病理特征之一,是呼吸道炎症反复损伤和修复的结果,转化生长因子β1通过多种途径参与支气管哮喘呼吸道炎症和呼吸道重构。     

硬膜外阻滞对老年腹腔镜胃癌根治术患者围术期Th1/TH2平衡的影响

目的 研究硬膜外阻滞对腹腔镜胃癌根治术老年患者围术期Th1/Th2平衡的影响.方法 对60例择期行腹腔镜胃癌根治术老年患者采用随机数字表法分为硬膜外阻滞组(Ⅰ组)和对照组(Ⅱ组),每组30例.麻醉诱导前行T8-9间隙行硬膜外穿刺置管.Ⅰ组切皮前约30min时硬膜外腔注射0.25％罗哌卡因+0.04mg/ml布托啡诺混合液10ml.Ⅱ组给予等量0.9％氯化钠溶液.两组患者均在术毕硬膜外腔注射0.25％罗哌卡因+0.04mg/ml布托啡诺混合液10ml后接PCEA泵.于硬膜外穿刺前(T0)、术前(T1)、术毕(T2)、术后24h(T3)和72 h(T4)抽取外周血,采用放射免疫法检测血浆皮质醇(Cor)水平,采用ELISA法测定血浆干扰素(IFN)-γ、IL-4水平.结果 与T0时比较,Ⅱ组T2、T3时Cor水平升高,Ⅰ组仅在T2时升高(P＜0.05).与Ⅱ组比较,Ⅰ组T2、T3时Cor水平明显降低(P＜0 05).与T0比较,两组T2、T3、T4时IFN-γ水平明显上升(P＜0.05).Ⅰ组T2、T3时IFN-γ水平明显高于Ⅱ组(P＜0.05).Ⅰ组T3时IL-4水平低于T0 (P＜0.05).与Ⅱ组比较,Ⅰ组T4时IL-4水平明显降低(P＜0.05).与T0时比较,两组T2、T3、T4时IFN-γ/IL-4均升高(P＜0.05);Ⅰ组T3时IFN-γ/IL-4明显高于Ⅱ组(P＜0.05).结论 硬膜外阻滞能减轻腹腔镜胃癌根治术老年患者手术后Th1/Th2平衡的漂移程度,改善机体手术创伤后免疫受抑状态.     

硫化氢对动脉粥样硬化的影响及其与 CX3CR1 的关系

目的在高脂饮食ApoE基因敲除小鼠动脉粥样硬化模型中,探讨硫化氢对动脉粥样硬化斑块的影响及其与斑块内趋化因子受体CX3CR1的关系。方法10周龄、雄性纯合子ApoE基因敲除小鼠予以高脂饮食喂养,在高脂饮食喂养第4、8、12、24周时处死小鼠并留取血浆和主动脉,通过化学比色法和Western Blot技术检测血浆硫化氢水平和主动脉胱硫醚-γ-裂解酶（CSE）表达情况。一部分小鼠在高脂饮食4或12周后开始每天予以硫化氢供体药物NaHS（1mg-kg^-1,i．P．）或生理盐水。高脂饮食24周后,通过超声生物显微镜成像技术评估小鼠主动脉及其主要分支内的动脉粥样硬化情况,随后处死小鼠并留取主动脉,通过H＆E染色和免疫组化技术进一步观察小鼠头臂干动脉粥样斑块的病变情况及CX3CR1的表达水平。结果在动脉粥样硬化斑块形成早期,即出现了CSE表达水平的显著降低,随着斑块的进展,CSE的表达水平进一步下调和CSE活性明显下降,最终导致血浆硫化氢水平的显著降低。动脉粥样硬化早期或中晚期予以NariS均可显著延缓动脉粥样硬化斑块的形成和进展,但是NaHS早期干预,其抗动脉粥样化的益处显著优于中晚期干预。NariS的抗动脉粥样硬化益处可能与其抑制斑块内CX3CR1的表达有关。结论动脉粥样硬化过程中存在着内源性硫化氢代谢紊乱,予以NaHS干预可抑制斑块内CX3CR1的表达和延缓动脉粥样硬化的进展,早期NaHS干预的疗效显著优于中晚期干预。     

The effect of pharmacological PI3Kγ inhibitor on eotaxin-induced human eosinophil functions

BackgroundAsthma is characterized by chronic inflammation caused by activation of immune cells including Th2 lymphocytes and eosinophils. Phosphoinositide 3-kinase (PI3K) γ deficient asthmatic mice did not develop lung eosinophilia, although the detailed mechanisms are not well known. A CC chemokine eotaxin (CCL11) plays a prominent role in developing eosinophilic inflammation through CCR3. In this study, we tested the roles of PI3Kγ in eotaxin-induced eosinophil functions using a pharmacological inhibitor.MethodHuman peripheral blood eosinophils were isolated by CD16-negative selection method. The effect of AS605240, synthetic PI3Kγ inhibitor on eotaxin-induced adhesion, chemotaxis, and degranulation were studied using intracellular adhesion molecule-1 (ICAM-1)-coated plates, Boyden chamber system, ELISA for eosinophil-derived neurotoxin (EDN) levels in the culture supernatant, respectively. CCR3 expression levels and extracellular signal-regulated kinase 1/2 (ERK1/2) phosphorylation were assessed by flowcytometry. Involvement of PI3Kγ in spontaneous apoptosis was studied using flowcytometry.ResultsAlthough AS605240 did not affect the eosinophil spontaneous apoptosis, eotaxin-induced chemotaxis, adhesion to ICAM-1 coated plate, and EDN release were inhibited by AS605240. AS605240 also inhibited the eotaxin-induced ERK1/2 phosphorylation without down-regulation of surface CCR3 expression.ConclusionThese results indicate that PI3Kγ inhibitor attenuates eotaxin-induced eosinophil functions by suppressing the downstream signaling of CCR3 without significant cytotoxicity. PI3Kγ plays an important role in the development of eosinophilic inflammation and blockade of PI3Kγ might be a therapeutic strategy for treatment of eosinophil-related diseases including asthma.     

一氧化氮对胎兔动脉导管胱硫醚-γ-裂解酶/硫化氢体系的影响

目的探讨H2S、NO对早产胎兔动脉导管的作用及其相互影响,进一步探索动脉导管开放与关闭的病理生理机制、意义及其影响因素,为临床上全面认识动脉导管的开放与关闭提供理论依据。方法将孕21d日本大耳白兔24只随机分成四组：空白对照组及三个处理组,处理组待孕龄23d和25d时分别腹腔注射以不同剂量的一氧化氮前体-硝普钠,待孕龄26d时解剖孕兔取胎兔,胎兔心脏取血1mL后立即解剖胎兔取动脉导管组织,进行实验。结果随着注射硝普钠浓度的增加,胎兔血浆中硫化氢含量、动脉导管组织CSEmRNA表达量均逐渐随注射剂量的增加而增加。各组间相比较,P<0.01,具有显著性差异。结论早产兔血浆中有H2S存在,早产兔动脉导管组织中存在CSEmRNA表达;给孕兔注射不同剂量硝普钠(在一定范围内)对早产兔动脉导管中H2S/CSE体系具有浓度依赖性促进作用。