Alteration of serum bile acid profiles of HBV-related hepatocellular carcinoma identified by LC-MS/MS.

BACKGROUND: Hepatocellular carcinoma closely related to metabolic disorders is a common and aggressive liver malignancy. The dysregulation of bile acid homeostasis has emerged as a key factor for the development and progression of HCC. We aimed to investigate the relationship between bile acids and HCC diagnosis and progression. METHODS: A total of 744 HBV-related patients (including 396 HCC patients and 348 patients with chronic liver diseases) were enrolled in the current study. The baseline characteristics of patients were collected from electronic medical records, and the levels of bile acid profiles were determined by LC-MS/MS. Propensity score matching analysis was conducted to reduce the effect of selection bias, and receiver operating characteristic analysis was performed to evaluate the clinical application values of bile acid. RESULTS: Significant differences were observed for most characteristics between the HCC group and the CLD group before PSM analysis. Patients with HCC were older and fatter (p < 0.05). After adjusting with a 1:1 ratio for age, gender and BMI, 42 HCC patients and 42 non-HCC patients were matched in 2 groups, respectively. The total bile acid level in HCC patients was lower than that in patients with chronic liver diseases before and after PSM analysis (p < 0.05). However, patients with HCC had significantly higher levels of DCA, LCA, and GLCA and lower levels of TCDCA, GUDCA, and TUDCA (p < 0.05, respectively). Besides, the TCDCA, TUDCA, GLCA, and GUDCA were significantly correlated with tumor procession. Moreover, the BAs profiles had a superior predictive ability for predicting the development of HCC even in patients with low serum AFP levels. CONCLUSION: Patients with HCC had significantly lower levels of total bile acid, but higher levels of secondary bile acids (DCA, LCA, and GLCA). The levels of primary bile acid (TCDCA) were closely related to tumor size and stage, which indicated that the bile acids were involved in the HCC procession and had important clinical application values.

[The combined application of scalp and body acupuncture by stages for low limb dysfunction of patients with apoplexy].

OBJECTIVE: To verify the clinical efficacy on the function recovery of lower extremities for patients with cerebral apoplexy by the staging treatment with the combined therapy of the scalp and body acupuncture. METHODS: Ninty-six cases were randomized into an observation group and a control group, 48 cases in each one. The conventional medication and rehabilitation therapy were given in each group. In the observation group, the combined therapy of the scalp acupuncture and the body acupuncture was provided by stages. At the flaccid stage, Futu (ST 32), Xuehai (SP 10), Zusanli (ST 36), etc. were selected. At the spasmodic stage, Huantiao (GB 30), Xuehai (SP 10), Yanglingquan (GB 34), etc. were selected. In combination with the scalp acupuncture the anterior oblique line of vertex-temploral (motor area) on the affected side was selected. In the control group, the acupoints were not selected according to the disease stages and no scalp acupuncture was applied, and the cases were treated with the needling technique as "regaining consciousness" and in light of the principle as "Yangming meridians specialized for Wei syndrome". The treatment lasted continuously for 8 weeks. The modified Fugl-Meyer motor function assessment (FMA) and Barthel index (BI) were used to assess the motor function of the lower extremities and the activities of daily living before and after treatment for the patients in two groups separately. RESULTS: FMA and BI score were all improved apparently after treatment for the patients in two groups (all P < 0.05), and FMA and BI score after treatment in the observation group were all higher than those in the control group (both P < 0.05). In 8 weeks treatment, the walking ability rate in the observation group was higher than that in the control group [56.3% (27/48) vs 35./4% (17/48), P < 0.05]. The walking speed in the observation group was faster than that in the control group (P < 0.05). CONCLUSION: The combined therapy of the scalp and body acupuncture in the staging treatment improves obviously the motor function of the lower extremities and the activities of daily living for the patients with cerebral apoplexy. This therapy recovers as quickly as possible the walking ability and speed for the patients, which is superior to the conventional acupuncture in comparison.