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There are gradual increases in the incidence rates of metabolic associated fatty liver disease （MAFLD） and type 2 diabetes mellitus （T2DM）， with close relationship and mutual interaction between the two diseases， but the specific mechanism is still unclear. Studies have shown that T2DM and MAFLD may cause aggravation of each other through insulin resistance， inflammation， some hepatocyte factors， and cellular senescence and protect each other through some hepatocyte factors. Further research on the association between T2DM and MAFLD and the mechanism of comorbidity is of great significance for the clinical prevention and treatment of the two diseases.
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Alcoholic hepatitis (AH) is a severe alcohol-associated liver disease with a mortality rate as high as 40%. A recent study reveals that the exotoxin (cytolysin)-secreting gut bacterium Enterococcus faecalis is a critical factor for AH, which can be eliminated by bacteriophages, and therefore, the use of bacteriophages for the treatment of AH provide a new treatment option for AH. This article introduces this pioneering study and the knowledge of bacteriophages and cytolysin, so as to provide a theoretical basis for the clinical research on AH.
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Alcoholic hepatitis (AH) is a non-infectious inflammatory injury of the liver and often occurs on the basis of chronic liver disease including fatty liver disease and liver cirrhosis. Acute exacerbation of liver disease due to heavy drinking within a short period of time is a severe manifestation of AH. The prognosis of AH depends on treatment timing and methods, and liver function can quickly recover or rapidly deteriorate into multiple organ failure. Many clinicians lack the experience in early identification and timely treatment of AH, due to a lack of typical clinical manifestations and specific auxiliary examinations, which affects clinical treatment, delays treatment, and exposes some AH patients to the risk of death. Therefore, it is imperative to conduct more clinical studies on AH, summarize real-world data, and develop expert consensus.
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Alcoholic hepatitis (AH) is a non-infectious inflammatory injury of the liver and often occurs on the basis of chronic liver disease including fatty liver disease and liver cirrhosis. Acute exacerbation of liver disease due to heavy drinking within a short period of time is a severe manifestation of AH. The prognosis of AH depends on treatment timing and methods, and liver function can quickly recover or rapidly deteriorate into multiple organ failure. Many clinicians lack the experience in early identification and timely treatment of AH, due to a lack of typical clinical manifestations and specific auxiliary examinations, which affects clinical treatment, delays treatment, and exposes some AH patients to the risk of death. Therefore, it is imperative to conduct more clinical studies on AH, summarize real-world data, and develop expert consensus.
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Objective To investigate the relationship between body mass index (BMI) and all-cause mortality in hypertensive population.Methods All participants were selected from a prospective cohort study based on a rural population from Henan province,China.Cox proportional hazards regression models were used to estimate the associations of different levels of BMI stratification with all-cause mortality.Restricted cubic spline models were used to detect the doseresponse relation.Results Among the 5 461 hypertensive patients,a total of 31 048.38 person-years follow-up was conducted.The median of follow-up time was 6 years,and 589 deaths occurred during the follow-up period.Compared to normal weight group (18.5 kg/m2＜BMI＜24.0 kg/m2) the multivariate-adjusted hazard ratios for all-cause mortality associated with BMI levels (＜ 18.5 kg/m2,24-28 kg/m2,and ≥28 kg/m2) were 0.83 (95％CI:0.37-1.87),0.81 (95％CI:0.67-0.97),and 0.72 (95％CI:0.56-0.91),respectively.The dose-response analysis showed a nonlinear,reverse "S" shaped relationship (non-linearity P＜0.001).Conclusion Overweight or obese might have a protective effect on all-cause mortality in hypertensive population,which supports the "obesity paradox" phenomenon.
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Objective To study the modification effect of age on the association between body mass index and the risk of hypertension.Methods People age ≥ 18 years old were selected by clusters,from a rural area of Henan province.In total,20 194 people were recruited at baseline during 2007 and 2008,and the follow-up study was completed from 2013 to 2014.Logistic regression model was used to assess the risk of incident hypertension by baseline BMI and age-specific BMI.Results During the 6-year follow-up period,1 950 hypertensive persons were detected,including 784 men and 1 166 women,with cumulative incidence rates as 19.96％,20.51％,and 19.61％,respectively.Compared with those whose BMI＜22 kg/m2,the RRs of hypertension were 1.09 (0.93-1.27),1.17 (1.01-1.37),1.34 (1.14-1.58) and 1.31 (1.09-1.56) for participants with BMI as 22-,24-,26-and ≥28 kg/m2,respectively.In young and middle-aged populations,the risk of hypertension gradually increased with the rise of BMI (trend P＜0.05).However,in the elderly,the increasing trend on the risk of hypertension risk was not as significantly obvious (trend P＞0.05).Conclusion The effect of BMI on the incidence of hypertension seemed to depend on age.Our findings suggested that a weight reduction program would be more effective on young or middle-aged populations,to prevent the development of hypertension.
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Objective To investigate the relationship between body mass index (BMI) and all-cause mortality in hypertensive population.Methods All participants were selected from a prospective cohort study based on a rural population from Henan province,China.Cox proportional hazards regression models were used to estimate the associations of different levels of BMI stratification with all-cause mortality.Restricted cubic spline models were used to detect the doseresponse relation.Results Among the 5 461 hypertensive patients,a total of 31 048.38 person-years follow-up was conducted.The median of follow-up time was 6 years,and 589 deaths occurred during the follow-up period.Compared to normal weight group (18.5 kg/m2＜BMI＜24.0 kg/m2) the multivariate-adjusted hazard ratios for all-cause mortality associated with BMI levels (＜ 18.5 kg/m2,24-28 kg/m2,and ≥28 kg/m2) were 0.83 (95％CI:0.37-1.87),0.81 (95％CI:0.67-0.97),and 0.72 (95％CI:0.56-0.91),respectively.The dose-response analysis showed a nonlinear,reverse "S" shaped relationship (non-linearity P＜0.001).Conclusion Overweight or obese might have a protective effect on all-cause mortality in hypertensive population,which supports the "obesity paradox" phenomenon.
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Objective To study the modification effect of age on the association between body mass index and the risk of hypertension.Methods People age ≥ 18 years old were selected by clusters,from a rural area of Henan province.In total,20 194 people were recruited at baseline during 2007 and 2008,and the follow-up study was completed from 2013 to 2014.Logistic regression model was used to assess the risk of incident hypertension by baseline BMI and age-specific BMI.Results During the 6-year follow-up period,1 950 hypertensive persons were detected,including 784 men and 1 166 women,with cumulative incidence rates as 19.96％,20.51％,and 19.61％,respectively.Compared with those whose BMI＜22 kg/m2,the RRs of hypertension were 1.09 (0.93-1.27),1.17 (1.01-1.37),1.34 (1.14-1.58) and 1.31 (1.09-1.56) for participants with BMI as 22-,24-,26-and ≥28 kg/m2,respectively.In young and middle-aged populations,the risk of hypertension gradually increased with the rise of BMI (trend P＜0.05).However,in the elderly,the increasing trend on the risk of hypertension risk was not as significantly obvious (trend P＞0.05).Conclusion The effect of BMI on the incidence of hypertension seemed to depend on age.Our findings suggested that a weight reduction program would be more effective on young or middle-aged populations,to prevent the development of hypertension.
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Only a small number of people may develop severe alcoholic liver disease after continuous or excessive drinking, which is different from the harm caused by smoking, and some people may even develop alcoholic liver disease associated with inflammation, liver cirrhosis, or primary liver cancer. There are complex risk factors for liver injury in these people; besides ethnic and genetic factors, drinking volume, and drinking duration, more important factors are involved in the pathophysiological changes of the liver, such as the type and quality of alcohol, drinking pattern, socioeconomic status, and government public policy, which may be the determining factors for the development of alcoholic liver disease. On the basis of literature review, this article proposes the concept that "liquor does not equal to alcohol" , which has important guiding significance for healthy drinking and the prevention of alcoholic liver disease.
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Nonalcoholic fatty liver disease (NAFLD) has become the most important liver disease in the world and its prevalence rate still tends to increase. However, there are still no effective drugs so far. The complex and dynamic interactions between multiple effects/mediators in the pathophysiology of NAFLD provide new insights and help with stratification and redefinition of clinical phenotypes and evaluation of disease susceptibility and multiplicity of progression. They may also provide new targets for future treatment. Therefore, research on the pathophysiology of NAFLD is imperative. Alcoholic liver disease is a great harm to health and an important cause of end-stage liver disease. Some progress has been made in the research on alcoholic liver disease around the world in 2016. This article reviews the research advances in alcoholic liver disease in 2016 from the aspects of epidemiology, pathogenesis, diagnostic and therapeutic methods, and prognosis.
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Objective To explore pathogenic bacteria distribution and drug susceptibility testing results in children with purulent meningitis in Jinan area. Methods A total of 54 children with purulent meningitis were selected from January 2010 to December 2014, the cerebrospinal fluid smear and culture, according to the national standard of clinical inspection technology for bacteria isolation and identification by disc diffusion method for drug sensitive test were retrospectively analyzed. Results A total of 54 strains of pathogenic bacteria including 36 strains of gram-positive coccus, and 17 strains of gram-negative bacillus and one strain of suspected Neisseria meningitides were found. A total of 31 strains gram positive coccus is Streptococcus pneumoniae, and most gram-negative bacilli is E. coli. In the Gram-positive coccus, 61.3% was sensitive to penicillin, and more than 90% was sensitive to ceftriaxone and cefepime, 83.3% was sensitive to meropenem, 94.7% resistant to azithromycin, and 58.1% resistant to oxazocilline. In Gram-negative bacilli, 60% was sensitive to ampicillin sulbactam 71.4% was sensitive to cephalosporin , 57.1% was sensitive to ceftriaxone , 66.6% was sensitive to cefepime. Conclusions From cerebrospinal fluid cultured of purulent meningitis, Streptococcus pneumoniae and E. coli were major pathogenic bacteria in children with purulent meningitis in Jinan area.
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Nonalcoholic fatty liver disease (NAFLD) is a clinicopathological syndrome characterized by fatty degeneration of hepatocytes due to nonalcoholic reasons. Liver cirrhosis and hepatocellular carcinoma are two important outcomes of NAFLD. Cell senescence is a relatively stable state in which cells deviate from the normal cell cycle and experience an irreversible loss of proliferative capacity, which is an objective law in cell life. Research shows that cell senescence is closely associated with the progression of liver fibrosis and the development and progression of hepatocellular carcinoma in NAFLD, and provides a new perspective for the prevention and treatment of liver fibrosis and hepatocellular carcinoma.
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Nonalcoholic fatty liver disease (NAFLD) is considered the manifestation of metabolic syndrome (MS) in the liver. Besides glucose and lipid metabolic disorders, the level of serum uric acid (SUA) is also associated with the progression of NAFLD. This article reviews the research achievements in the association between SUA and NAFLD and points out that SUA can independently predict the risks of MS, type 2 diabetes, and cardiovascular disease in both healthy people and patients. Its mechanism may be that SUA increases the expression of reactive oxygen species (ROS)/thioredoxin-interacting protein (TXNIP) through inducing ROS, and then it activates the NLR pyrin domain containing 3 inflammasome and induces the secretion of interleukin. Both basic and clinical research show that the drugs reducing SUA can inhibit the TXNIP pathway, reduce the blood glucose level, and alleviate liver ROS, inflammation, steatosis, and fibrosis. This article suggests that SUA may be a promising therapeutic method for NAFLD and needs further basic and clinical research.
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Along with the aging process, the spectrum of liver disease changes greatly. Nonalcoholic fatty liver disease (NAFLD) in elderly people lead to low liver function and is also the major cause of extrahepatic diseases, such as cardiovascular disease and malignant tumor. This review provides an overview of the morphological structure and function of the liver in aged people, and discusses the characteristics of weakness, malnutrition and limited movement in the elderly, as well as the current status of multiple diseases and multiple drug use. Finally, this article puts forward some appropriate regimens for the diagnosis and treatment of NAFLD in elderly people to provide a reference for clinical practice.
Subject(s)
Aged , Humans , Cardiovascular Diseases , Liver , Pathology , Malnutrition , Neoplasms , Non-alcoholic Fatty Liver Disease , Diagnosis , Pathology , Therapeutics , Risk FactorsABSTRACT
Objective To observe the effects of hydrogen sulfide on hepatic and renal injury induced by thioacetamide (TAA).Methods Twenty-four male SD rats were equally and randomly divided into TAA induced model group ,control group,TAA +sodium hydrogen sulfide group , and TAA +propargylglycine group .TAA was given by intraperitoneal injection to the model group , sodium hydrogen sulfide and propargylglycine groups at the dose of 600 mg/kg on the first day, and at the dose of 300 mg/kg 24 hours later.Hydrogen sulfide sodium at the dose of 0.15 mmol/kg and propargylg-lycine at the dose of 30 mg/kg were injected abdominally 1 h before TAA injection.The dose of these two agents was halved in the next 24 h.All the rats were sacrificed and specimens were collected to test hydrogen sulfide , and hepatic and renal function.Urine after the first 24 hours was collected after the administration of TAA .Results The structure of the liver in TAA group was disordered , especially in sodium hydrogen sulfide group .Liver function of TAA group was severely damaged (ALT:980.0 ±32.0 vs 38.3 ±10.6 U/L),and deteriorated with the application of sodium hydrogen sulfide (ALT:1095.6 ± 684.2 U/L), but recovered (ALT:66.3 ±8.32 U/L) with propargylglycine application.Compared with the normal group, the renal function in TAA group was significantly injured ,but the urea nitrogen and creatinine in sodium hydrosulfide group were reduced more remarkably than in TAA group (BUN:8.4 ±1.9 vs 11.62 ±6.0 mmol/L,Cr:32.6 ±8.2 vs 42.8 ±4.4 μmol/L, P<0.05).Nevertheless, creatinine was increased in propargylglycine group ( Cr 56.7 ±14.9 vs 30.8 ±4.4μmol/L, P<0.05).The urine content within 24 hours was more significantly decreased in TAA group than in the normal group (9.2 ±2.5 vs 20.5 ±6.7 ml, P<0.01), which was mildly recovered in sodium hydrogen sulfide group (11.7 ± 1.5 vs 9.2 ±2.5 , P<0.05) but further decreased (4.2 ±1.3 vs 9.2 ±2.5, P<0.01) in the propargylglycine group . Conclusion Hydrogen sulfide can alleviates renal injury while aggravating liver injury induced by thioacetamide .
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Objective To study the relationships of fatty liver with the waist to hip ratio (WHR),obesity,blood glucose,blood lipid,so as to guide clinical treatment.Methods A total of 5827 persons who underwent the following examination,including liver function,kidney function,blood lipids,blood glucose,and ultrasound imaging examination were divided into fatty liver suffering group and non-fatty liver suffering group.Results The incidences of WHR,diabetes,hyperlipidemia,and hyperuricemia in the fatty liver suffering group were significantly higher than those in the non-fatty liver suffers group(t =24.6,13.2,21.9,19.6,10.3,P ＜ 0.01).The incidence (44.3％) of fatty liver in males was significantly higher than that (31％) in females (x2 =33.6,P ＜ 0.01).Conclusions There was obvious correction between fatty liver and abdominal obesity.Patients with fatty liver should be given early prevention in order to prevent from the occurrence of cardiovascular events and metabolic syndrome.
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Objective To investigate the disease occurrence-related factors and severity of alcoholic hepatitis (AH) and alcoholic liver cirrhosis (ALC).Methods According to the clinical diagnostic criteria that were passed by the 2010 Chinese Society of Fatty Liver Hepatology and alcoholic liver disease study group,the clinical data of 241 AH and ALC patients were analyzed.Results The amount of liquor taken daily,the time limit of drinking,and total amount of liquor taken in ALC patients were significantly different from those in AH patients (P ＜0.01),respectively.In ALC patients,the proportion (48.39％)of workers,peasants,and unemployed low-income alcoholics was significantly higher than that (25.58％)in AH patients (P ＜0.01).Laboratory tests showed the AST/ALT ratio in the ALC group (2.63 ±4.74)was significantly higher than that in the AH group (1.01 ±0.52) (P ＜0.01); TG [(1.33±1.24)mmol/L] and cholesterol (CHOL) [(3.14 ± 1.25) mmol/L] in ALC group were significantly lower than TG [(2.29 ± 1.60)mmol/L] and CHOL [(4.27 ±0.79)mmol/L] in the AH group (P ＜0.01).Conclusions Alcoholic liver disease occurrence and severity were related to the amount of liquor taken,the time limit of drinking,and the work ; AST/ALT ratio,TG and CHOL values were consistent with the severity of alcoholic liver disease.