RESUMO
Non-alcoholic fatty liver disease (NAFLD) is a common liver disorder poising burgeoning health problem to humans. Recent studies have shown that long non-coding RNA (lncRNA) plays critical roles in a myriad of biological processes and human diseases. Since the roles of lncRNA in NAFLD remain unknown, they were investigated in the study. Microarray expression profiling of mRNAs and lncRNAs was conducted using RNA extracted from patients with and without NAFLD. One thousand seven hundred thirty-five lncRNAs and 1485 mRNA were found differentially expressed in NAFLD samples compared with those in control samples. Among them 535 and 1,200 lncRNAs were upregulated and downregulated in NAFLD, respectively; 760 and 725 mRNAs were upregulated and downregulated in NAFLD, respectively. Moreover, seven lncRNAs and seven mRNAs that were highly up- or downregulated in NAFLD samples were validated by quantitative real-time polymer chain reactions. Kyoto Encyclopedia of Genes and Genomes pathway analysis and Gene Ontology analysis for the differentially expressed mRNAs showed that these RNAs are involved in various metabolic processes, cellular components, and molecular functions. Our findings indicate that the expression profiles of lncRNAs have changed in NAFLD as compared with normal liver, and the identified regulated RNAs may provide novel insight into the molecular mechanisms underlying the disease and potential novel diagnostic or therapeutic targets for NAFLD.
Assuntos
Hepatopatia Gordurosa não Alcoólica/metabolismo , RNA Longo não Codificante/metabolismo , Adulto , Biomarcadores/metabolismo , Estudos de Casos e Controles , Feminino , Perfilação da Expressão Gênica , Ontologia Genética , Genoma Humano , Humanos , Fígado/metabolismo , Masculino , Pessoa de Meia-Idade , RNA Longo não Codificante/genética , TranscriptomaRESUMO
OBJECTIVE: Combined the optical principle with automatic control technology and computer real-time image detection technology to develop a non-contact system for noninvasive esophageal varices pressure measurement. METHODS: The system included the adjustable air pump, laser device, image collection and analysis program. The feasibility and accuracy of the system were verified by in vitro experiments. RESULTS: The bionic vascular pressure measured by this system had good correlation and repeatability with the actual pressure. CONCLUSIONS: This system is accurate, feasible and has good application prospects.
Assuntos
Determinação da Pressão Arterial/instrumentação , Varizes Esofágicas e Gástricas , Processamento de Imagem Assistida por Computador , Lasers , SoftwareRESUMO
OBJECTIVE: To compare endoscopic variceal ligation (EVL) with propranolol for prophylaxis of first variceal bleeding. METHODS: We chose 168 patients with cirrhosis and esophageal varices in our hospital and allocated them to EVL and propranolol groups. Treatment effectiveness and safety in the 2 groups were observed. RESULTS: he parameters of two groups were similar before therapy. Follow-up period was 8-36 months. Variceal bleeding occurred in 24 (28.6%) of the EVL group and in 20 (23.9%) of the propranolol group (P>0.05). Overall mortality and death related to bleeding were similar (21.4% vs 17.9%; 7.1% vs 6.0%, P>0.05). Adverse events related to EVL were 43 (3 of them life-threatening) compared to 16 in the propranolol group (51.19% vs 19.05%, P<0.05). CONCLUSION: Propranolol may be the better choice in prophylaxis of variceal bleeding with similar effects and lower adverse events than with EVL.
Assuntos
Endoscopia Gastrointestinal/métodos , Varizes Esofágicas e Gástricas/terapia , Hemorragia Gastrointestinal/prevenção & controle , Cirrose Hepática/complicações , Propranolol/uso terapêutico , Idoso , Varizes Esofágicas e Gástricas/complicações , Varizes Esofágicas e Gástricas/tratamento farmacológico , Varizes Esofágicas e Gástricas/cirurgia , Feminino , Hemorragia Gastrointestinal/etiologia , Humanos , Ligadura/métodos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To evaluate the in vitro differentiation of human amniotic epithelial cells (hAECs ) into hepatocyte-like cells. METHODS: Combined approach of dexamethasone, HGF, IGF and other cytokines were used to induce the differentiation of hAECs into hepatocyte-like cells. The induction lasted 2 weeks. During the induction, the expression of albumin ALB, CYP1A1, CYP1A2, IGFR, c-met and key functional genes related to liver cells as well as transcription factors HNF3, HNF4 and C/EBPa were monitored by RT-PCR. Time dependent changes of the surface marker colony ALB, AFP and CK18 were analyzed by cell flow cytometry. RESULTS: After the 2 week induction, the expressions of liver hepatocyte-like cell functional genes such as albumin, CYP1A1, CYP1A2, c-met, and transcription factors such as HNF3, HNF4, C/EBPa and HNF1 were observed. Six days after the induction, hAECs mainly were stained AFP+, and the positive rate was (15.1 ± 2.1)%. While 10 days after the induction, part of the hAECs showed AFP+/ALB+ (6.5 ± 1.4)%; and on 14th day, hAECs only showed ALB+, and the rate was (13.9 ± 2.3)%. ALB+ cell increase indicated a gradual functional maturation from the hAECs to hepatocyte-like cells. Similaritly, the number of CK18+ cells in the whole population was also increased: On 10th day, the rate was (16.1 ± 1.2)%; on 14th day, that was (21.3 ± 4.6)%, which proved the above hypothesis of the trandifferentiation. By extending the induction time, the expression of functional genes increased gradually, and a maturing process of hAECs was detected by cell surface markers. CONCLUSION: The differentiation of hAECs induced in vitro has the characteristics of hepatocyte-like cells.
Assuntos
Âmnio/citologia , Diferenciação Celular , Células Epiteliais/citologia , Hepatócitos/citologia , Células Cultivadas , Dexametasona/farmacologia , Fator de Crescimento de Hepatócito/farmacologia , Humanos , Somatomedinas/farmacologiaRESUMO
OBJECTIVE: To determine the therapeutic effect of laparoscopic splenectomy, perisoph-agogastric devascularization, and endoscopic variceal ligation (EVL) on patients with portal hypertension. METHODS: We randomly divided 105 patients into 3 groups: 40 had endoscopic band ligation (the ligation group), 35 had splenectomy and perisoph-agogastric devascularization (the laparotomy group), and the other 30 had laparoscopic splenectomy, perisoph-agogastric devascularization and endoscopic variceal ligation (the combination group). Blood samples were analyzed preoperatively and postoperatively on day 1,3,and 7,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),and directed bilirubin(DBIL). The length of stay, blood loss, operation time, anal exhaust time, azygos vein diameter, blood flow velocity and blood flow, recurrence of esophageal varices and rehaemorrhagia were compared. RESULTS: Between the combination group and the laparotomy group, the serum levels of TbIL and Dbil had difference on 1st postoperative day(P<0.05). AST had difference on 7th postoperative day(P<0.05). The length of stay, blood loss, operation time, and anal exhaust time had significant difference(P<0.05). Among the combination group, the laparotomy group and the ligation group, the azygos vein blood flow before and after the treatment, recurrence of esophageal varices and rehaemorrhagia had no difference(P<0.05). CONCLUSION: Laparoscopic splenectomy, perisoph-agogastric devascularization and endoscopic variceal ligation have less trauma, lower recurrence rate, fewer complications and rapid recovery, and may reduce the azygous vein blood flow. It can be used safely for portal hypertension.
Assuntos
Endoscopia/métodos , Varizes Esofágicas e Gástricas/cirurgia , Hipertensão Portal/cirurgia , Laparoscopia/métodos , Adulto , Varizes Esofágicas e Gástricas/complicações , Feminino , Humanos , Hipertensão Portal/complicações , Ligadura/métodos , Masculino , Pessoa de Meia-Idade , Esplenectomia/métodosRESUMO
OBJECTIVE: To observe the effect of subfascial endoscopic perforator vein surgery (SEPS) in the treatment of chronic venous ulceration of the legs. METHODS: Chronic venous ulceration for 91 patients with 102 limbs was treated by SEPS from January 2005 to July 2008. The effect of SEPS on chronic venous ulceration of the leg, the symptoms during and after the operation, and the durations of hospital treatment were analyzed. RESULTS: The symptoms of the 102 legs conducted by SEPS operation, except the pigmentation, were obviously improved (P<0.01). Its cicatrisation rate, the recrudesce rate, and the cut infection rate were 93.1%, 1.96%, and 1.0%, respectively. The time of the operation was short and the hemorrhage was small during the surgery. The durations of hospitalization and the cicatrisation time of ulceration were (6.5+/-3.4) d and (12.2+/-13.7) d, respectively. CONCLUSION: SEPS is simple and effective in treating chronic venous ulceration of the leg, and particularly effective for patients classified into C5 and C6 in clinical-etiological-anatomical-pathophysiology (CEAP).
Assuntos
Angioscopia/métodos , Fasciotomia , Úlcera Varicosa/cirurgia , Procedimentos Cirúrgicos Vasculares , Insuficiência Venosa/cirurgia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Varizes/cirurgia , Insuficiência Venosa/complicaçõesRESUMO
OBJECTIVE: To determine whether there is an impaired Akt and eNOS activation in cirrhotic livers, and to investigate the feasibility of transferring adenovirus-mediated Akt gene to the liver for portal hypertension. METHODS: Recombinant adenovirus Ad-myr-HA-Akt and Ad-EGFP were produced by homologoas recombination in 293 cells . The Methods of compound factor, carbon tetrachloride (CCl4), corn flour, and cholesterol plus alcohol were used to construct the hepatic cirrhosis rat models. Ten normal rats were served as a normal control group, and 40 cirrhotic rats were divided into 4 groups randomly: an untreated group, an Ad-myr-HA-Akt treated group, an Ad-EGFP group, and a saline group. Ad-myr-HA-Akt, Ad-EGFP, and saline were transduced into the Ad-myr-HA-Akt treated group, Ad-EGFP group, and saline group via the tail vein respectively. Portal vein pressure, mean arterial pressure, and heart rate were measured in all rats. Protein abundance and phosphorylation status of Akt and eNOS were examined by Western blot. Spectrophotometry was used to measure the NO level. Frozen sections of the liver, heart, lung, kidney, brain, spleen, and testis were made to examine the expression of enhanced green fluorescent protein (EGFP) by fluorescence microscopy on Day 3 in the Ad-EGFP group. RESULTS: The concentration of recombinant adenovirus Ad-myr-HA-Akt after the purification was 5.5 x 10(11)vp/mL and that of Ad-EGFP was 6.0 x 10(11)vp/mL. Akt and eNOS phosphorylations in the liver of cirrhotic rats were obviously impaired. Adenoviral delivery of myr-Akt restored eNOS phosphorylation, increased the NO level and decreased the portal pressure after 3 days of adenoviral infection. In contrast, the livers infected with Ad-EGFP and saline were not changed. The EGFP expression was mainly found under the fluorescence microscopy on the frozen section of liver. Very little fluorescence was detected in the lung and kidney; and there was no detectable EGFP in other organs. CONCLUSION: There is an impaired Akt and eNOS activation in the cirrhotic livers; myr-Akt gene therapy can restore the Akt activation and NO production in the cirrhotic liver, suggesting that this therapy may be helpful in treating portal hypertension.
Assuntos
Terapia Genética , Hipertensão Portal/terapia , Cirrose Hepática Experimental/terapia , Proteínas Proto-Oncogênicas c-akt/genética , Adenoviridae/genética , Adenoviridae/metabolismo , Animais , Tetracloreto de Carbono , Intoxicação por Tetracloreto de Carbono , Hipertensão Portal/etiologia , Cirrose Hepática Experimental/complicações , Cirrose Hepática Experimental/metabolismo , Masculino , Óxido Nítrico Sintase Tipo III/metabolismo , Distribuição Aleatória , Ratos , Ratos Sprague-DawleyRESUMO
OBJECTIVE: To determine the effect of angiotensin II receptor 1 antagonist losartan on portal hypertensive gastropathy (PHG) in rats and its mechanism. METHODS: Forty-eight Sprague-Dawley rats were randomly divided into 4 groups: a sham-operated group, a model group, a treatment group, and a prevention group. The partial portal vein and left suprarenal vein of rats were ligated to develop PHG. Portal vein pressure (PVP), the level of angiotensin IIin blood, gastric injury index(GI), and pathological diagnosis integral(PI) were measured. In situ hybridization was used to determine the expression and immunolocalization of angiotensin II receptor 1 in rat stomach wall. RESULTS: PVP, GI, and PI of the treatment group and the prevention group were evidently reduced (P<0.01), and the level of angiotensin IIin blood increased obviously. The expression of angiotensin II receptor 1 was negative in the control group, increased significantly in the model group, and decreased significantly in the treatment group and the prevention group. CONCLUSION: The expression of angiotensin II receptor 1 elevates in portal hypertensive gastropathy. Losartan can reduce PVP, inhibit the activation of angiotensin II receptor 1 in gastric submucous layer, and has therapeutic effect on PHG.
Assuntos
Hipertensão Portal/tratamento farmacológico , Losartan/uso terapêutico , Gastropatias/tratamento farmacológico , Angiotensina II/sangue , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacologia , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Animais , Mucosa Gástrica/efeitos dos fármacos , Mucosa Gástrica/metabolismo , Hipertensão Portal/sangue , Hipertensão Portal/complicações , Losartan/farmacologia , Masculino , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Receptor Tipo 1 de Angiotensina/genética , Gastropatias/sangue , Gastropatias/etiologiaRESUMO
OBJECTIVE: To investigate the value of contrast-enhanced ultra sonography for non-surgical treatment response in hepatocellular carcinomas. METHODS: Non-surgical therapies were performed on 56 patients (64 liver neoplasms) who were diagnosed by ultrasonography-guided biopsy before the therapy. Contrast-enhanced ultrasonography(CEUS) and contrast-enhanced helical CT were performed to assess the treatment response. RESULTS: Forty-six of the 64 lesions were not enhanced with CEUS.Partial enhancement was demonstrated in the other 18 lesions. Forty-eight of the 64 lesions were not enhanced with contrast-enhanced helical CT. Partial enhancement were demonstrated in the other 16 lesions.The sensitivity, specificity, and accuracy were 94.4%, 97.8%, and 96.9% for CEUS and 83.3%, 97.8%, and 93.8% for contrast-enhanced helical CT (P>0.05). CONCLUSION: CEUS is a good method in assessing the non-surgical treatment response in hepatocellular carcinomas and is more sensitive and useful than contrast-enhanced helical CT in assessing the treatment response of transcatheter hepatic arterial chemoembolization.
Assuntos
Carcinoma Hepatocelular/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Adulto , Idoso , Carcinoma Hepatocelular/terapia , Feminino , Humanos , Neoplasias Hepáticas/terapia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Espiral , UltrassonografiaRESUMO
OBJECTIVE: To assess the efficacy of endoscopic variceal ligation (EVL) combined with Hassab's procedure in the prevention of variceal recurrence. METHODS: One hundred and thirty-five patients with esophageal varices were randomized to receive EVL alone, Hassab's procedure alone or a combination of EVL and Hassab's procedure for variceal eradication. Ultrasonographic venous network images were recorded by an esophageal microprobe before and after the EVL or Hassab's procedure. The clinical outcome and vascular network images of the 3 groups were analyzed. RESULTS: Esophageal varices were obliterated immediately after EVL alone, while both perforating veins and periesophageal collaterals remained patent, and 83% had recurrence of esophageal varices during an initial 3-year follow-up. Esophageal varices were reduced in size, periesophageal collaterals were obliterated after Hassab's procedure alone, and 30% experienced rebleeding and 95% with variceal recurrence. EVL combined with Hassab's procedure obliterated all esophageal varices, perforating veins and periesophageal collaterals, and only 3 patients (8%) recurred. CONCLUSION: The existence of patent perforating veins and periesophageal collaterals is the reason of esophageal variceal recurrence after EVL alone. EVL combined with Hassab's procedure can effectively prevent the recurrence, even if the cirrhojtic portal hypertension persisted.
Assuntos
Varizes Esofágicas e Gástricas/cirurgia , Esofagoscopia , Esôfago/cirurgia , Esplenectomia , Adolescente , Adulto , Idoso , Varizes Esofágicas e Gástricas/etiologia , Feminino , Seguimentos , Hemorragia Gastrointestinal/prevenção & controle , Humanos , Hipertensão Portal/complicações , Ligadura , Masculino , Pessoa de Meia-Idade , Prevenção SecundáriaAssuntos
Âmnio , Células Cultivadas , Diferenciação Celular , Células Epiteliais , Hepatócitos , HumanosRESUMO
OBJECTIVE: To assess the effects of different treatment complex on esophageal vascular structures in patients with portal hypertension. METHODS: Patients (142 cases) with esophageal varices received either endoscopic variceal ligation (EVL) alone (54 cases), pericardial devascularization procedure (PDP) alone (23 cases), a combination of EVL and partial splenic embolization (PSE) (34 cases), or a combination of EVL and PDP (31 cases) for variceal eradication. Esophageal vascular structures were examined with miniature ultrasonic probe. The recurrence and rebleeding of esophageal varices were investigated. RESULTS: Esophageal submucous varices were obliterated and collateral veins remained unchanged in patients treated by EVL or EVL combined with PSE; esophageal submucous varices were diminished in size and collateral veins were obliterated by PDP, and both esophageal submucous varices and collateral veins were obliterated by the combination of EVL and PDP. CONCLUSIONS: The combination of EVL and Hassab's procedure can effectively shut off the portoazygous shunt, prevent esophageal varices from bleeding and recurrence. It's a simply and less cost procedure.
Assuntos
Varizes Esofágicas e Gástricas/terapia , Hipertensão Portal/complicações , Esplenectomia , Procedimentos Cirúrgicos Vasculares/métodos , Cárdia/irrigação sanguínea , Cárdia/cirurgia , Terapia Combinada , Embolização Terapêutica , Endoscopia do Sistema Digestório , Varizes Esofágicas e Gástricas/diagnóstico por imagem , Varizes Esofágicas e Gástricas/etiologia , Feminino , Humanos , Ligadura/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , UltrassonografiaRESUMO
AIM: To investigate the expression of tumor necrosis factor-alpha (TNF-alpha) and vascular endothelial growth factor (VEGF) in the development of esophageal varices in portal hypertensive rats. METHODS: Thirty male Sprague-Dawley (SD) rats in the model group in which a two-stage ligation of portal vein plus ligation of the left adrenal vein was performed, were divided into three subgroups (M(7), M(14), and M(21)) in which the rats were kiued on the seventh day, the 14(th) d and the 21 d after the complete portal ligation. Thirty male SD rats, which underwent the sham operation in the control group, were also separated into three subgroups (C(7), C(14) and C(21)) corresponding to the models. The expression of TNF-alpha and VEGF in the esophagus of all the six subgroups of rats were measured with immunohistochemical SP technique. RESULTS: The portal pressure in the three model subgroups was significantly higher than that in the corresponding control subgroups (23.82+/-1.83 vs 11.61+/-0.86 cmH(2)O, 20.90+/-3.27 vs 11.43+/-1.55 cmH(2)O and 20.68+/-2.27 vs 11.87+/-0.79 cmH(2)O respectively, P<0.01), as well as the number (9.3+/-1.6 vs 5.1+/-0.8, 11.1+/-0.8 vs 5.4+/-1.3 and 11.7+/-1.5 vs 5.2+/-1.1 respectively, P<0.01) and the total vascular area (78 972.6+/-3 527.8 vs 12 993.5+/-4 994.8 mum(2), 107 207.5+/-4 6461.4 vs 11 862.6+/-5 423.2 mum(2) and 110 241.4+/-49 262.2 vs 11 973.7+/-3 968.5 mum(2) respectively, P<0.01) of submucosal veins in esophagus. Compared to the corresponding controls, the expression of TNF-alpha and VEGF in M(21) was significantly higher (2.23+/-0.30 vs 1.13+/-0.28 and 1.65+/-0.38 vs 0.56+/-0.30 for TNF-alpha and VEGF respectively, P<0.01), whereas there was no difference in M(7) (1.14+/-0.38 vs 1.06+/-0.27 and 0.67+/-0.35 vs 0.50+/-0.24 for TNF-alpha and VEGF respectively, P>0.05) and M(14) (1.20+/-0.25 vs 1.04+/-0.26 and 0.65+/-0.18 vs 0.53+/-0.25 for TNF-alpha and VEGF respectively, P>0.05). And the expression of TNF-alpha and VEGF in M(21) was significantly higher than that in M(7) (2.23+/-0.30 vs 1.14+/-0.38 and 1.65+/-0.38 vs 0.67+/-0.35 for TNF-alpha and VEGF respectively, P<0.01) and M(14) (2.23+/-0.30 vs 1.20+/-0.25 and 1.65+/-0.38 vs 0.65+/-0.18 for TNF-alpha and VEGF respectively, P<0.01), but there was no difference between M(7) and M(14) (1.14+/-0.38 vs 1.20+/-0.25 and 0.67+/-0.35 vs 0.65+/-0.18 for TNF-alpha and VEGF respectively, P>0.05). CONCLUSION: In the development of esophageal varices in portal hypertensive rats, increased TNF-alpha and VEGF may be not an early event, and probably play a role in weakening the esophageal wall and the rupture of esophageal varices.
Assuntos
Varizes Esofágicas e Gástricas/metabolismo , Esôfago/metabolismo , Hipertensão Portal/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Animais , Pressão Sanguínea , Varizes Esofágicas e Gástricas/etiologia , Varizes Esofágicas e Gástricas/patologia , Esôfago/irrigação sanguínea , Esôfago/patologia , Hipertensão Portal/complicações , Hipertensão Portal/patologia , Masculino , Mucosa/irrigação sanguínea , Mucosa/metabolismo , Ratos , Ratos Sprague-Dawley , Ruptura , Veias/patologiaRESUMO
OBJECTIVE: To investigate variations of plasma endothelin (ET) and its clinical significance in portal hypertensive patients with esophageal variceal hemorrhage. METHODS: Sixty-six patients with portal hypertension were randomly divided into 2 groups. Group I (32 patients) received general therapy and Group II (34 patients) received general therapy and UTI after hemorrhage. The plasma ET concentration and liver function were determined at 1, 2, 4, 7, 10, and 14 d after the hemorrhage. Another 20 patients without the hemorrhage were elected as the control group. RESULTS: At 7 and 14 d after the hemorrhage, the levels of TBIL, ALT and AST were elevated at first and then decreased in Groups I and II. The decrease of TBIL, ALT and AST levels was significantly faster in Group II than in Group I (P < 0.05, P < 0.01, P < 0.05, respectively) on 14 d after the hemorrhage. At 1 d after the hemorrhage the ET concentration was markedly increased in Group I and II as compared with the control group (P < 0.01). Then it was gradually decreased on 10 d after the hemorrhage. The ET concentration in Group II was decreased more rapidly than that in Group I on 2, 4 and 7 d after the hemorrhage (P < 0.05; P < 0.01; P < 0.05, respectively). The ET concentration was positively correlated to TBIL levels in groups I and II (r = 0.734, P < 0.01). And the decreased index of ET concentration was negatively correlated to the increased index of TBIL (r = -0.486, P < 0.05). CONCLUSION: The increased plasma ET in portal hypertensive patients with hemorrhage may contribute to liver injury. UTI can protect the liver function by inhibiting ALT, AST, TBIL and ET level.
Assuntos
Endotelina-1/sangue , Varizes Esofágicas e Gástricas/etiologia , Glicoproteínas/uso terapêutico , Hipertensão Portal/complicações , Adulto , Idoso , Varizes Esofágicas e Gástricas/sangue , Feminino , Humanos , Hipertensão Portal/sangue , Falência Hepática/prevenção & controle , Masculino , Pessoa de Meia-Idade , Inibidores da Tripsina/uso terapêuticoRESUMO
Non-alcoholic fatty liver disease (NAFLD) has emerged as a public health issue with a prevalence of 15-30% in Western populations and 6-25% in Asian populations. Certain studies have revealed the alteration of microRNA (miRNA or miR) profiles in NAFLD and it has been suggested that miR-21 is associated with NAFLD. In the present study, we measured the serum levels of miR-21 in patients with NAFLD and also performed in vitro experiments using a cellular model of NAFLD to further investigate the effects of miR-21 on triglyceride and cholesterol metabolism. Furthermore, a novel target through which miR-21 exerts its effects on NAFLD was identified. The results revealed that the serum levels of miR-21 were lower in patients with NAFLD compared with the healthy controls. In addition, 3-hydroxy-3-methylglutaryl-co-enzyme A reductase (HMGCR) expression was increased in the serum of patients with NAFLD both at the mRNA and protein level. To mimic the NAFLD condition in vitro, HepG2 cells were treated with palmitic acid (PA) and oleic acid (OA). Consistent with the results obtained in the in vivo experiments, the expression levels of miR-21 were decreased and those of HMGCR were increased in the in vitro model of NAFLD. Luciferase reporter assay revealed that HMGCR was a direct target of miR-21 and that miR-21 exerted an effect on both HMGCR transcript degradation and protein translation. Furthermore, the results from the in vitro experiments revealed that miR-21 decreased the levels of triglycerides (TG), free cholesterol (FC) and total cholesterol (TC) in the PA/OA-treated HepG2 cells and that this effect was attenuated by HMGCR overexpression. Taken together, to the best of our knowledge, the present study is the first to report that miR-21 regulates triglyceride and cholesterol metabolism in an in vitro model of NAFLD, and that this effect is achieved by the inhibition of HMGCR expression. We speculate that miR-21 may be a useful biomarker for the diagnosis and treatment of NAFLD.
Assuntos
Colesterol/metabolismo , Regulação da Expressão Gênica , Hidroximetilglutaril-CoA Redutases/genética , MicroRNAs/genética , Hepatopatia Gordurosa não Alcoólica/genética , Hepatopatia Gordurosa não Alcoólica/metabolismo , Triglicerídeos/metabolismo , Regiões 3' não Traduzidas , Estudos de Casos e Controles , Células Hep G2 , Humanos , Hidroximetilglutaril-CoA Redutases/química , Hidroximetilglutaril-CoA Redutases/metabolismo , MicroRNAs/química , Interferência de RNA , RNA Mensageiro/química , RNA Mensageiro/genética , RNA Mensageiro/metabolismoRESUMO
Using optics combined with automatic control and computer real-time image detection technology, a novel noninvasive method of noncontact pressure manometry was developed based on the airflow and laser detection technology in this study. The new esophageal venous pressure measurement system was tested in-vitro experiments. A stable and adjustable pulse stream was produced from a self-developed pump and a laser emitting apparatus could generate optical signals which can be captured by image acquisition and analysis system program. A synchronization system simultaneous measured the changes of air pressure and the deformation of the vein wall to capture the vascular deformation while simultaneously record the current pressure value. The results of this study indicated that the pressure values tested by the new method have good correlation with the actual pressure value in animal experiments. The new method of noninvasive pressure measurement based on the airflow and laser detection technology is accurate, feasible, repeatable and has a good application prospects.
Assuntos
Determinação da Pressão Arterial/instrumentação , Varizes Esofágicas e Gástricas/diagnóstico , Varizes Esofágicas e Gástricas/fisiopatologia , Esofagoscópios , Lasers , Pressão Venosa/fisiologia , Animais , Desenho de Equipamento , Análise de Falha de Equipamento , Humanos , Coelhos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
OBJECTIVE: To calculate esophageal variceal wall tension by sonographic and noninvasive pressure measurements and to study the role of esophageal variceal wall tension in predicting the likelihood of esophageal variceal rupture. METHODS: In 28 patients with esophageal varices, a 20 MHz ultrasonographic transducer was used to image esophageal varices; the radius and wall thickness of the varices were calculated. Esophageal variceal pressure measurements were obtained noninvasively. The correlation between the esophageal wall tension and esophageal variceal pressure gradient were studied. RESULTS: There was a linear correlation between the esophageal wall tension and the variceal pressure gradient after curve fitting (r=0.87, p < 0.05). CONCLUSION: Esophageal variceal wall tension is an important parameter in predicting variceal rupture.
Assuntos
Varizes Esofágicas e Gástricas/fisiopatologia , Adulto , Varizes Esofágicas e Gástricas/diagnóstico por imagem , Feminino , Humanos , Masculino , Manometria/métodos , Pessoa de Meia-Idade , UltrassonografiaRESUMO
OBJECTIVE: To evaluate the feasibility and efficacy of a new method of endoscopic esophageal variceal ligation combined with partial splenic embolization (EVL-PSE) for the patients with portal hypertension. METHODS: From May 1999 to February 2003, sixty-eight patients with portal hypertension underwent EVL-PSE, and hemodynamics of the portal trunk (PT), the left gastric vein and azygos vein, including maximum velocity, flow volume, vein diameter, were assessed using color ultrasound Doppler. RESULTS: The esophageal varices and hypersplenism were greatly ameliorated after operation in patients who had undergone EVL-PSE. Postoperative portal trunk flow volume and velocity were significantly reduced (P < 0.05), and flow volume of the left gastric vein as well as the azygos vein were also reduced after operation. During 2 - 24-month follow-up, no recurrent bleeding was found. CONCLUSIONS: EVL-PSE is less traumatic with less complications, and results in marked eradication of esophageal varices, it can be carried out safely in the clinical treatment for patients with portal hypertension.
Assuntos
Embolização Terapêutica , Varizes Esofágicas e Gástricas/terapia , Esofagoscopia , Hipertensão Portal/terapia , Adulto , Idoso , Terapia Combinada , Feminino , Humanos , Ligadura , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To investigate the prevention of esophageal varices recurrence by laser inducing esophageal mucosal fibrosis. METHODS: Our study included 42 patients after esophageal varices eradicated by endoscopic varices ligation, and they were divided into 2 groups randomly, each group included 21 patients. One group was assigned to received laser treatment, and indocyanine green solution (1 mg/ml) was injected submucosally, a diode laser (power 10 watts) was applied to the surface from the esophagogastric junction to 5 cm above it. Another group was controlling without any treatments. All patient were followed up by endoscopy every 3 months until 12 months. RESULTS: Laser irradiation was performed safely without any major complications. And lower esophageal mucosa produced fibrosis widely after laser irradiated 1 month. After 12 months follow up, the cumulative recurrence rate was significantly lower than the control group, 14% (3/21) vs 43% (9/21) (chi(2) = 4.20, P < 0.05). CONCLUSIONS: Our study indicates that laser inducing mucous fibrosis is safely and can prevent recurrence of esophageal varices.
Assuntos
Varizes Esofágicas e Gástricas/cirurgia , Esôfago/patologia , Fotocoagulação a Laser/métodos , Adulto , Varizes Esofágicas e Gástricas/patologia , Esofagoscopia , Feminino , Fibrose , Seguimentos , Humanos , Ligadura , Masculino , Pessoa de Meia-Idade , Mucosa/patologia , Prevenção SecundáriaRESUMO
A new device that allows noninvasive measurement of venous pressure has been invented in our laboratory and tested for its feasibility and validity. The device consists of four parts: 1. the air infusion system; 2. the pressure sensor gauge; 3. signal transducer and data processing system 4. the fixing apparatus. The correlation between noninvasive pressure and invasive pressure has been studied in vitro test on a saphenous vein model and in vitro test on dog's portal venous system. In vitro and vivo study, an excellent correlation between noninvasive pressure and invasive pressure was obtained(r = 0.99, P < 0.0005; r = 0.97, P < 0.005). These data suggest that the new device allows a noninvasive measurement of venous pressure especially for the large veins such as vena cava, venae pulmonales and esophageal varices.