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Nonalcoholic steatohepatitis (NASH) is a spectrum of chronic liver disease characterized by hepatic lipid metabolism disorder. Recent reports emphasized the contribution of triglyceride and diglyceride accumulation to NASH, while the other lipids associated with the NASH pathogenesis remained unexplored. The specific purpose of our study was to explore a novel pathogenesis and treatment strategy of NASH via profiling the metabolic characteristics of lipids. Herein, multi-omics techniques based on LC-Q-TOF/MS, LC-MS/MS and MS imaging were developed and used to screen the action targets related to NASH progress and treatment. A methionine and choline deficient (MCD) diet-induced mouse model of NASH was then constructed, and Schisandra lignans extract (SLE) was applied to alleviate hepatic damage by regulating the lipid metabolism-related enzymes CES2A and CYP4A14. Hepatic lipidomics indicated that MCD-diet led to aberrant accumulation of phosphatidylethanolamines (PEs), and SLE could significantly reduce the accumulation of intrahepatic PEs. Notably, exogenous PE (18:0/18:1) was proved to significantly aggravate the mitochondrial damage and hepatocyte apoptosis. Supplementing PE (18:0/18:1) also deteriorated the NASH progress by up regulating intrahepatic proinflammatory and fibrotic factors, while PE synthase inhibitor exerted a prominent hepatoprotective role. The current work provides new insights into the relationship between PE metabolism and the pathogenesis of NASH.
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Objective To explore the reasons for withdrawal from peritoneal dialysis (PD) in our hospital.Methods This was a single-center,retrospective cohort study.Patients who started PD in the Department of Nephrology,the First Affiliated Hospital of Nanchang University from November 1st,2005 to February 28th,2017,were enrolled,and followed up to May 31,2017.Patients who continued PD after May 31,2017 were as the control group.Patients who withdrew from PD were divided into 4 subgroups:death group,hemodialysis group,kidney transplantation group and loss of follow-up group.The clinical characters of 4 subgroups were compared with the control group.Results A total of 998 patients were enrolled with age of (49.36± 14.94) when PD started and median dialysis duration of 27.13(12.84,42.29) months,in whom 570 patients (57.11％) were male.Five hundred and seventeen dropout events were recorded,and the dropout rate was 51.80％.The main reason for withdrawal from PD was death (258 patients,49.90％),followed by hemodialysis (166patients,32.11％),kidney transplantation (66 patients,12.77％) and loss to follow-up (27 patients,5.22％).The leading cause of death was cardio-cerebro-vascular diseases (136 cases,52.71％),followed by infection (42 cases,16.28％),dyscrasia (20 cases,7.75％) and tumor (5 cases,1.94％).The main reason for transfering to hemodialysis was insufficient dialysis (76 cases,45.78％),followed by peritonitis (55 cases,33.13％) and catheter dysfunction (24 cases,14.46％).Compared with those in the control group,in the death group patients were older at PD commencement,and had higher proportions of hypertension,diabetes and cardio-cerebro-vascular diseases (all P ＜ 0.05).The proportions of male and diabetes mellitus were higher in the hemodialysis group than those in the control group (both P ＜0.05).Biochemical indicators showed that serum albumin and blood phosphorus were lower in the death group than those in the control group (both P ＜ 0.05);blood albumin was significantly lower in the hemodialysis group than that in the control group (P ＜ 0.05).Conclusions The main reasons for withdrawal from PD in our center are death and transfering to hemodialysis.The cardio-cerebro-vascular disease is the leading cause of death,and inadequate dialysis is the main reason for transfering to hemodialysis.
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Objective To investigate the risk factors of all-cause mortality in diabetic patients on peritoneal dialysis (PD).Methods As a single-center retrospective cohort study,all incident PD patients who were catheterized at the First Affiliated Hospital of Nanchang University between November 1,2005 and February 28,2017 were included.Patients were divided into diabetes mellitus group (DM group) and non-diabetes mellitus group (NDM group).Outcomes were analyzed by Kaplan-Meier method.Multivariate Cox proportional hazards models were utilized to assess the risk factors of all-cause mortality.Results A total of 977 patients were enrolled.Compared with NDM group,patients in DM group were older (47.5±14.4 vs 59.3±11.3,P ＜ 0.01),had more cardiovascular disease (CVD) (7.5％ vs 20.3％,P ＜ 0.01),higher levels of serum hemoglobin (78.2±17.2 vs 82.3±14.6g/L,P ＜ 0.01),and lower levels of serum albumin (36.1±5.0 vs 32.7±5.6 g/L,P ＜ 0.01).The one-,three-and five-year patient survival rates of DM and NDM group were 89.7％,56.0％,31.9％ and 94.7％,81.3％,67.4％,respectively.Survival rate was significantly lower in DM group than in NDM group (x2=63.51,P ＜ 0.01).Stratified analysis showed that DM group had significant lower survival rate than NDM group in patients younger than 70 years old (x2=73.35,P ＜ 0.01),while survival rate was similar between the two groups patients older than 70 years old (x2=0.003,P=0.96).Multivariate Cox proportional hazards model analysis showed that DM (HR:1.74,95％CI:1.27-2.38,P ＜ 0.01),age (HR:1.05,95％CI:1.04-1.06,P ＜ 0.01),leukocyte (HR:1.06,95％CI:1.00-1.12,P=0.04) and triglyceride (HR:1.19,95％CI:1.07-1.32,P ＜ 0.01) were all independent risk factors for all-cause mortality of PD patients.However,age (HR:1.05,95％CI:1.04-1.07,P＜ 0.01) and alkaline phosphatase (HR:1.01,95％ CI:1.00-1.01,P=0.02) were independent risk factors for all-cause mortality of diabetic patients.Conclusions Long-term survival rate was lower in diabetic PD patients than in non-diabetic PD patients.DM,age,leukocyte and triglyceride were independent risk factors of mortality in PD patients.Age and alkaline phosphatase were independent risk factors of mortality in diabetic patients.
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Objective To explore the risk factors and characteristics in patients with peritoneal dialysis who died in different periods.Methods The clinical data of new peritoneal dialysis patients in the Department of Nephrology and Peritoneal Dialysis Center of the First Affiliated Hospital of Nanchang University from November 1,2005 to February 28,2017 was retrospectively analyzed.The patients were divided into two groups according to the time of death:those who died within one year and died after one year.The risk factors of mortality between the two groups were analyzed by Cox regression model.Results A total of 997 patients were enrolled and 244 patients died.There were 69 patients (28.3％) died within one year and 175 patients (71.7％) died after one year.Cardiovascular and cerebrovascular disease was the dominating reason of death in both groups,accounting for 59.4％ (died within one year group) and 51.4％ (died after one year group) respectively.Cox regression analysis showed that for died within one year group,old age (HR=1.035,95％ CI:1.016-1.055,P＜ 0.001),low blood total calcium (HR=0.167,95％ CI:0.053-0.529,P=0.002),low albumin (HR=0.899,95％CI:0.856-0.943,P ＜ 0.001) and low apolipoprotein A1 (HR=0.274,95％CI:0.095-0.789,P=0.016) were risk factors associated with mortality.However,for died after one year group,old age (HR=1.053,95％CI:1.038-1.069,P ＜ 0.001),combined with diabetes (HR=2.181,95％CI:1.445-3.291,P ＜ 0.001) and hypertriglyceride (HR=l.204,95％CI:1.065-1.362,P=0.003) were risk factors associated with mortality.Conclusions The risk factors of mortality for peritoneal dialysis patients of different periods were not exactly the same.For died within one year patients,old age,low blood total calcium,low albumin and low apolipoprotein A1 were independent risk factors for mortality.However,for died after one year patients,old age,combined with diabetes,and high triglycerides were independent risk factors for mortality.
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Objective To analyze the epidemiological characteristics and risk factors of bronchial asthma (BA) complicated with recurrent respiratory tract infection (RRTI) in children in Hebei District, Tianjin City, and to provide a reference for the prevention and treatment of children with BA complicated with RRTI. Methods The stratified cluster sampling method was adopted to randomly select 428 children with BA hospitalized in Hebei District of Tianjin as the study subjects. The routine deep sputum culture and etiological examination were carried out. The children with RRTI were included in the experimental group (n=84), and the children without RRTI (n=344) were included in the control group. A self-designed questionnaire was used to investigate gender, age, smoking proportion of family members, use of antibiotics 3 times or more a year, and family history of allergy. The risk factors of BA combined with RRTI were analyzed by logistic regression. Results RRTI occurred in 84 of 428 children with BA, and the incidence rate was 19.63% (84/428). The proportion of BA complicated with RRTI in children aged 6 months to 2 years was higher than that in other age groups (χ2=6.213, P0.05). The proportion of family smoking, the use of antibiotics 3 times or more a year, and the proportion of family allergy history in the experimental group were significantly higher than those in the control group (P<0.05). Logistic regression analysis showed that family smoking, antibiotic use 3 times or more a year and family history of allergy were independent risk factors for BA complicated with RRTI (P<0.05). Conclusion The incidence of BA complicated with RRTI in children in Hebei District, Tianjin City is high, and the age of high incidence is 6 months to 2 years old. The proportion of family smoking, the use of antibiotics three times or more a year, and the proportion of family allergy history are the high-risk factors for the occurrence of BA complicated with RRTI in children in Hebei District, Tianjin City.
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Objective To analyze the influence of intestinal trefoil factor(ITF) on Bim and Bcl-xl gene expression in neonatal rats with necrotizing enterocolitis(NEC),and to discuss the protective machanism of ITF on NEC.Methods Thirty neonatal rats were divided randomly into control group,NEC group and ITF group.NEC group were given intraperitoneal injection of saline 0.2 ml after NEC model of neonatal rats were established.ITF group were given intraperitoneal injection ITF 0.2mg after NEC model of neonatal rats were established.On the 4th day,all the subjects were put to death.We made HE stainting of the slice and made a histopathological examination and immunohistochemical method to detect Bim and Bc1-xl genes expression,and make image analysis.Results The pathological lesions indicated that intestinal tissue necrosis was severe in NEC group,which median was 3 point,but obviously lessen in ITF group,which median was 1 point,with ITF interfering.Image analysis showed the NEC group Bim gene expression (7.87 ± 0.14) higher than those in the control group (2.15±0.28) and ITF group (3.27±0.34),there were significant differences between 3 groups(P<0.05).Bcl-xl gene expression(11.23±0.22)in ITF group was higher than that in control group(1.89±0.28) and NEC group(2.51±0.13),there were significant differences between 3 groups(P<0.05).Conclusions Intestinal injury was ameliorated after ITF was injected intraperitoneally,ITF may protect the intestinal injury of neonatal rats with NEC by changing the Bim gene and Bc1-xl gene expresstion ratio.
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Objective To study the effects of intestinal trefoil factor(ITF) on inducible nitric oxide synthase(iNOS),tumor necrosis factor-?(TNF-?) and NO density in neonatal rat model of necrotizing enterocolitis(NEC). Methods Forty neonatal rats were randomly divided into five groups: Group A, NEC+ ITF 0.5 mg; Group B, NEC+ ITF 0.2 mg; Group C, NEC+ N.S 0.5 ml; Group D, NEC+ N.S 0.2 ml; Group E, normal control. NEC model was established as following method: one-day old Wistar rats were put into 100%carbon dioxide for 5 min and then 100% oxygen for 5 min before returned to their mothers. This was done once daily for 3 days. On the 4th day, all rats were sacrificed and the intestinal tissue located at the boundary of ileum and cecum was obtained for histological examination by HE staining and iNOS, TNF-? and NO level by immunohistopathology. Results iNOS was found negative in group A, B and E, but positive in group C and D. The density of TNF-? were significantly decreased in group A[(30.515?2.731) pg/mg?pro] and B[(32.229? 4.978) pg/mg?pro] than that in group C[(39.957?8.283) pg/mg?pro] and D[(39.960?8.374) pg/mg?pro, P 0.05)]. The density of NO were significantly decreased in group A[(0.37?0.07) ?mol/mg tissue] and B[(0.54?0.08) ?mol/mg tissue] than that in group C[(0.76?0.01) ?mol/mg tissue] and D[(0.82? 0.04) ?mol/mg tissue ( P 0.05)]. The TNF-? and NO expression showed no difference among group A and B, group C and D. The pathological lesions indicate that severe intestinal tissue necrosis in group C and D, and mild in group A and B. Conclusions Intestinal inflammation could be ameliorated after ITF injection hypodermically or intraperitoneally. ITF may provide a brand-new way for the management of NEC in neonatal rats.