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Objective To analyze the risk factors of repeated admissions for community-acquired pneumonia(CAP)in adults,and to build a nomogram model to predict individual risk.Methods A total of 2 306 adult hospitalized patients with CAP in Beijing Shijitan Hospital affiliated to Capital Medical University from January 2018 to Decem-ber 2020 were retrospectively selected and divided into repeated admission group and control group according to whether they were readmitted within one year after discharge.Univariate logistic analysis and multivariate logistic a-nalysis were used to determine the risk factors.The risk factors were introduced into R 3.5.3 software to construct the nomogram prediction model.The calibration curve was drawn and the Hosmer-Lemeshow goodness of fit test was performed to evaluate the accuracy of the nomogram prediction model.The receiver operating characteristic(ROC)curve was drawn to evaluate the discrimination of the nomogram prediction model.The decision analysis curve was drawn to measure patient benefits.Results The age,gender,length of stay,total score of comorbidity index,use of special grade antibiotics,history of blood transfusion,and Vaccination history were risk factors of repeated hospi-tal admissions for CAP in adults.The nomogram prediction model of adult CAP repeated admission was constructed based on the above risk factors.The Hosmer-Lemeshow goodness of fit test showed that the fitting effect of the no-mogram prediction model was good(x2=8.873,P=0.353).The ROC curve analysis showed that the area under the curve of the test dataset was 0.775.The results of the decision analysis curve showed that when the threshold was 0.21,the model could generate a net profit of 0.104.Conclusion The nomogram model established in this study has good discrimination and accuracy in predicting the risk of adult CAP repeated admissions and has high clinical application value.
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OBJECTIVE To study the components of ethyl acetate fraction in Qubai tablet ,and its pharmacodynamics on de melanocyte model ,and explore the material basis for anti-vitiligo effect of Qubai tablet. METHODS The ethyl acetate fraction of Qubai tablets was obtained by extraction ,and its components were analyzed by ultra performance liquid chromatography-mass spectrometry(UPLC-MS). Model control group ,vehicle control group and 8-methoxypsoralen(8-MOP)administration groups (10,50,100,150,200 μmol/L),ethyl acetate fraction administration groups of Qubai tablet (10,50,100,150,200 μg/mL) were set up in the experiment. By establishing the de melanocyte model ,the effects of ethyl acetate fraction of Qubai tablet on de melanocyte were studied from four aspects :cell number ,cell viability ,melanin formation and tyrosinase activity. RESULTS UPLC-MS component analysis preliminarily determined the structure of 64 compounds in the ethyl acetate fraction of Qubai tablet , of which 14 compounds were detected in positive and negative ion mode ;psoralen compounds accounted for the largest proportion , and the content of psoralen chromone chalcone was the highest in positive and negative ion mode. The results of pharmacodynamic study showed that the ethyl acetate fraction of Qubai tablet could increase the number of de melanocytes ,and significantly improve the cell proliferation rate ,the rate of promoting melanin formation and the rate of promoting tyrosinase activity in the process of melanin formation (P<0.01). CONCLUSIONS Psoralen compounds may be the material basis for the anti-vitiligo effect of ethyl acetate fraction of Qubai tablet ;good anti-vitiligo effect of ethyl acetate fraction of Qubai tablet may be related to the promotion of tyrosinase activity.
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OBJECTIVE To stud y the chemical cons tituents of n-butanol part of Qubai tablet and its pharmacodynamic effect on the model of de melanocyte. METHODS The n-butanol part of Qubai tablet was prepared. The chemical constituents were analyzed by ultra-high performance liquid chromatography-mass spectrometry (UPLC-MS). Taking mice B 16 melanoma cells as the research object ,the de melanocyte model was established and divided into model group ,positive control different concentration groups(8-methoxypsoralen 10,50,100,150,200 μmol/L),solvent group (diluted with DMSO )and Qubai tablet n-butanol part different concentration groups (10,50,100,150,200 μmol/L). The number of cells were observed by inverted microscope ,and the cell proliferation rate ,the rate of melanin production and promotion rate of tyrosinase activity were also detected. RESULTS In the positive and negative ion mode ,53 compounds in the n-butanol part of Qubai tablet were preliminarily determined (29 in the positive ion mode ,33 in the negative ion mode ,overlapping 9),of which coumarins accounted for the largest proportion , followed by flavonoids. The n-butanol part of Qubai tablet could significantly increase the number of cells ,which was positively correlated with the action time and administration concentration. It could significantly increase the proliferation rate of cells ,the rate of melanin production and promotion rate of tyrosinase activity (P<0.01). CONCLUSIONS Coumarins and flavonoids may be the material basis for the anti-vitiligo effect of n-butanol part from Qubai tablet ;anti-vitiligo effect of n-butanol part of Qubai tablet may be realized by promoting tyrosinase activity.
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OBJECTIVE:To invest igtae the rationality of drug use of pregnant women in the outpatient department of our hospital,and to promote rational drug use in the clinic. METHODS :The prescriptions of pregnant women in Beijing Shijitan Hospital Affiliated to Capital Medical University from Jan. to Dec. in 2019 were extracted by using hospital information management system ,and then analyzed statistically in respects of drug varieties ,DDDs,safety grading ,and use of Chinese patent medicine. RESULTS :The most frequently used drugs in obstetric outpatients were vitamins and microelements ,followed by blood system and hormone drugs. Grade B drugs with good safety were most used ,the use of ungraded drugs were reasonable ,and grade X drugs were not used. There were 6 kinds of Chinese patent medicines used for pregnant women ,of which 2 kinds were marked “usable”in the drug instructions ,4 kinds were not marked in the dug instructions ,and the Chinese patent medicines that were not marked“prohibited”and“cautious”in the drug instructions were not used. CONCLUSIONS :The drug use of pregnant women are generally reasonable in outpatient department of our hospital. The safety of some Chinese patent medicine used during pregnancy still needs to be further confirmed.
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OBJECTIVE:To provide reference for rational use of anticoagulant drugs in the clinic. METHODS:Medical or-ders of anticoagulant drugs were collected from hospital information system of our hospital during 2013-2015. Those medical orders were analyzed in respects of consumption sum,DDDs,DDC and drug utilization. RESULTS:During 2013-2015,the sum tatio of Low-molecular-weight heparins calcium injection(6000 AXaIU),Enoxaparin sodium injection(6000 AXaIU),Dalteparin sodium injection(5000 IU) and Rivaroxaban tablets(10 mg)were on the rise,while those of Nadroparin calcium infection(6150,4100 AXaIU)and Fondaparinux sodium injection(2.5 mg)were in the decline. DDDs of Nadroparin calcium injection(4100 AXaIU), Dalteparin sodium injection(5000 IU)and Enoxaparin sodium injection(6000 AXaIU)took up the first 3 places. DDC of Rivar-oxaban tablets was the highest,being 167.60-180.25 yuan. The utilization of Nadroparin calcium injection(6150,4100 AXaIU), Low-molecular-weight heparins calcium injection (6000 AXaIU),Fondaparinux sodium injection(2.5 mg) and Warfarin sodium tablets(3 mg)showed good synchronization within 3 years,and the values of B/A ranged 0.50-1.50. Both consumption sum and utili-zation rate of rivaroxaban took up the first place in vascular surgery department. CONCLUSIONS:Based on the spectrum of diseases, the features of drugs and ADR,the utilization of anticoagulant drugs in our hospital is rational during recent 3 years. However,the uti-lization of anticoagulant drugs should be still used as routine pharmaceutical monitoring content.
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OBJECTIVE:To compare the effects of different doses of ramipril on blood pressure and renal function of early di-abetic nephropathy patients. METHODS:A total of 108 patients with early diabetic nephropathy selected from our hospital during May 2014-Dec. 2015 as research objects were divided into group A,B,C,with 36 cases in each group. All groups were given Ramipril tablets,5 mg for group A,2.5 mg for group B,1.25 mg for group C,qd,for 8 weeks. Blood pressure(SBP,DBP)and renal function indexes(24 h urine protein,β 2-microglobulin,UAE)were compared among 3 groups before and after treatment. The occurrence of ADR was also recorded in 3 groups. RESULTS:Before treatment,there was no statistical significance in blood pressure or renal function indexes among 3 groups(P>0.05). After treatment,blood pressures 24 h urine protein,β2-microglobulin and UAE of 3 groups were decreased significantly;those indexes of group A were significantly lower than group B and C,with sta-tistical significance(P0.05). Both hypoten-sion and hypoglycemia occurred in 3 groups during treatment,but were recovered after stopping treatment. CONCLUSIONS:High dose of ramipril(5 mg,qd)shows good effects on early diabetic nephropathy and reduces urinary protein excretion,but doesn't af-fect its safety.
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OBJECTIVE:To study in vitro anticancer activity of conjugated linoleic acid-gemcitabine conjugate (CLA-GEM). METHODS:IC50 of different tumor cells (breast cancer MCF-7 cell,breast cancer MDA-MB-231 cell,lung cancer A549 cell, small cell lung cancer NCI-H446 cell,glioma C6 cell)were investigated after treated with different concentrations(0.001-100μmol/L)of CLA-GEM and gemcitabine(GEM)for 72 h;survival rates of MCF-7 cell were investigated after treated with above so-lution for 24,48 and 72 h. The dependence of 0.001-100 μmol/L CLA-GEM and GEM to nucleoside transporter was investigated (by IC50)through MCF-7 cells and MDA-MB-231 cells treated with nucleoside transporter inhibitors(NBMPR,100 μmol/L)and di-pyridamole(4 μg/ml). The change of MCF-7 cell cycle was investigated after treated with 1 μmol/L CLA-GEM and GEM for 24 h. RESULTS:Compared with GEM,IC50 of MCF-7,MDA-MB-231 and NCI-H446 cells became lower after treated with CLA- GEM (P0.05). Survival rate of MCF-7 cells de-creased significantly after treated with GEM for 48 h and CLA-GEM for 24 h. Survival rate of MCF-7 cells was the lowest,being 21% after treated with GEM for 72 h,while tumor cells were sacrificed by CLA-GEM completely. Compared with GEM or CLA-GEM,IC50 of MCF-7 and MDA-MB-231 cells increased significantly after treated with NBMPR,dipyridamole combined with GEM (P0.05). Compared with GEM,CLA-GEM could prolong 6% of S stage of MCF-7 cells (P<0.01). CONCLU-SIONS:Compared with GEM,CLA-GEM exhibits significant antitumor activity and rapid action,and it isn’t influenced by nucle-ic acid transportation.
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OBJECTIVE:To provide reference for rational utilization of antibiotics for special use. METHODS:Medical orders of antibiotics for special use in clinical departments of our hospital during 2013 to 2015 were selected from hospital information sys-tem. The consumption sum and its ratio,DDDs,DDC,DUI and the utilization of antibiotics for special use in clinical departments were calculated and analyzed. RESULTS:The consumption sum and its ratio of antibiotics for special use in our hospital during 2013 to 2015 both reduced year by year,decreasing from 21 872 200 yuan(48.00%)to 20 877 700 yuan(39.41%). The consump-tion sum ratio of carbapenems,cephalosporins and anti-deep fungal drugs showed descending tendency. The consumption sum ratio of anti-MRSA antibiotics changed slightly. DDDs of Meropenem for injection always took up the first place in recent 3 years,but the values were decreasing. DUI of Imipenem and cilastain sodium for injection was far less than 1,while those of Panipenem and betamipron for injection,Cefepime sodium for injection and Caspofungin acetate for injection(70 mg/injection)were far more than 1. The types of drug with DUI ranged 0.9-1.1 increased year by year,increasing from 3 types in 2013 (18.75%) to 10 types in 2015 (62.50%). Within 3 years, the utilization ratio of antibiotics for special use always took up the first place in ICU (86.64%-87.78%). CONCLUSIONS:The consumption sum and its ratio of antibiotics for special use in our hospital during 2013 to 2015 decreased year by year,and the utilization of antibiotics for special use become increasingly rational. But,there still are some problems,such as inadequate dose of Imipenem and cilastain sodium for injection,overdose of Panipenem and betamipron for injection,Cefepime sodium for injection and Caspofungin acetate for injection(70 mg/injection).
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<p><b>OBJECTIVE</b>To investigate the etiology of hand, foot and mouth disease (HFMD) in Beijing during 2013, and study the clinical characteristics of HFMD caused by the main serotypes of enterovirus in the study.</p><p><b>METHOD</b>Clinical data and 128 stool samples were collected from 128 hospitalized children with HFMD in Beijing Ditan Hospital during 2013. One step RT-PCR method was used for enterovirus genotyping to investigate the etiology of HFMD. Clinical characteristics of HFMD caused by the main serotypes of enterovirus were analyzed. And VP1 segments of the main virus were amplified to construct phylogenetic tree for the phylogenetic analysis.</p><p><b>RESULT</b>A total of 128 hospitalized children with HFMD were included. HFMD was more likely developed in children under 2 years of age (81.6%, 102/125); 11 different enteroviruses were genotyped, with a total enterovirus positive rate of 76.6% (98/128); the positive rate of coxsackievirus A6 (CA6), 43.0% ( 55/128), was the highest, followed by enterovirus 71 (EV71), accounting for 14.8% (19/128). HFMD caused by CA6 was atypical, the rashes of which involved the perioral, trunk, limbs, face and neck (47%, 26/55), besides the common parts. Of the 55 cases caused by CA6, 6 children had clinical manifestations of nervous system involvement, one of whom even displayed type 2 respiratory failure. Mental status change more likely to occur in EV71-infected children than in CA6-infected ones (42% (8/19) vs. 11% (6/55) (χ(2)=7.041, P=0.008)); 13 children displayed onychomadesis, including 12 CA6 cases (23%, 12/53) and 1 CA10 cases (17%, 1/6), in the convalescence of hand, foot and mouth disease, and the correlation between onychomadesis and CA6 infection was significant (χ(2)=9.297, P=0.002). Phylogenetic analysis of 33 CA6 VP1 showed that the CA6 isolates of this study were highly similar to that of Taiwan and the nucleotide similarity was 95.91%-98.89%.</p><p><b>CONCLUSION</b>CA6 was the major pathogen of hospitalized children with hand, foot and mouth disease in Beijing during 2013, followed by EV71. The rashes caused by CA6 involved a wide range of skin sites and patients with CA6 infection displayed manifestations of neurological involvement or pulmonary edema similar to EV71 infection. Mental status change more likely occurred in EV71-infected children when neurological system was involved..</p>
Subject(s)
Child, Preschool , Humans , Infant , Child, Hospitalized , Enterovirus , Classification , Enterovirus Infections , Diagnosis , Virology , Exanthema , Pathology , Genotype , Hand, Foot and Mouth Disease , Diagnosis , Virology , Hospitals , Phylogeny , Pulmonary Edema , Pathology , Skin , Pathology , TaiwanABSTRACT
Objective Biochemistry course,a professional basic course of medical students,is a challenging course,for which the traditional classroom teaching mode is not suitable,for there are many deficiencies in traditional classroom teaching,so new teaching methods need to be explored to improve the quality of teaching and learning efficiency.Method 301 students from 6 natural classes of adult medical education were selected as the object of study and were divided into the experimental group(150) and control group(151).The traditional teaching mode was adopted in the control group,while in the experimental group,the double-track teaching methods were adopted such as diagram method,the method of using body language,humor teaching method,to stimulate students' interest in scientific research and innovation.At the end of the course,students were asked to conduct online teaching evaluation while teachers were asked to conduct mutual evaluation.Examination paper analysis software was used to evaluate the examination paper.Test results were analyzed by using SPSS 15 Statistical Software for data processing.Results:mean ± standard deviation (~ ± s) ; comparison was made between groups in t test.The difference was statistically significant(P<0.05).Result The evaluation results of students and colleagues assessment show that 93.7% of the students and 90.9% of colleagues think that the experimental group uses the double-track teaching method is more popular than in the control group.At the end of the experiment,the control group grades is (66 ± 25),while the experimental group grades is (83 ± 22) ; t value is 6.2612; P value is 0.000.Conclusion Compared with traditional teaching method double-track teaching method has obvious advantages in teaching.From the result,double-track teaching enables students willing to think and have an active participation and exploration,which has significantly stimulated their learning interest and improved their performance,thus achieving good results.
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AIM: To study the change of blood lipid and difference of expressed gene in chest aorta cells of atherosclerosis model rats with or without the treatment of Taishan Ganoderma Lucidum amylose.METHODS: The concentrations of triglyceride (TG), total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) in serum were measured by automatic serum biochemical assay. Differential-display reverse transcription-PCR (DDRT-PCR) was used to analyze the differential expressed gene in chest aorta cells of atherosclerosis model rat with or without the treatment of Taishan Ganoderma Lucidum amylose. The differential expressed cDNA was confirmed by reverse Northern blotting.RESULTS: Up-regulated and down-regulated cDNA were isolated in chest aorta cells of atherosclerosis model rats with or without Taishan Ganoderma Lucidum amylose treatment. The known up-regulated genes included cytB561, ERP72, nitric oxide synthase 2 and Gpx1. The known down-regulated genes included thymosin β4, FGFRI oncogene, ICAM-1, FK506 binding protein, c-myc and TNF-α. CONCLUSION: Taishan Ganoderma Lucidum amylose decreases the level of blood lipid.
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Aim: To investigate gene expression spectra in human hepatoma cell line SMMC-7721 treated with gambogic acid (GA).Methods:Human cDNA microarray and RT-PCR technology were used to detect the changes in gene expression. Results: 31 genes in groups exposed to gambogic acid for 24 h and 56 genes for 48 h group were expessed differentially in comparison to the control group. Conclusior:The antitumor mechanism of GA might focus on apoptosis,metastasis as well as interfering with the cell cycle.
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BACKGROUND: There have been no reports available about the direct effect of beer on serum enzyme activity.OBJECTIVE: To observe the changes of the activity of various serum enzymes of the subjects in the in vivo and in vitro experiments after drinking bear.DESIGN: An observational controlled experiment.SETTING: The Institute of Basic Medicine of Taishan Medical College.PARTICIPANTS: The experiment was performed at the Institute of Basic Medicine of Taishan Medical College between March 2005 and April 2005.We selected 17 college students, aged 19 to 35 years, from Taishan Medical College, including undergraduate students and graduate students. In formed consents were obtained from the subjects before the experiment was conducted.METHODS: ① In vivo experiment: 3 mL of venous blood was collected from the subjects 3 hours after the ordinary diet as the control. Then, the subjects drank beer at an amount of 4 mL/kg according to their body mass immediately. 3 mL of blood was collected respectively 15, 30, 45, 60, 90,120, 80 minutes later to measure the changes of the activity of alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase, al kaline phosphatase, creatine kinase , lactate dehydrogenase, diastase and lipase. ② In vitro experiment: 17 fresh serum samples were added into two test tubes separately with 0.5 mL of serum in each tube. 20 μL of normal saline was added to the tube of the control and 20 μL of beer was added into the test tube. The direct effect of beer on the activity of various enzymes was observed.MAIN OUTCOME MEASURES: The changes of the activity of alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase, al kaline phosphatase, creatine kinase , lactate dehydrogenase, diastase and lipase of the serum on the in vivo and in vitro experiment .RESULTS: Totally 17 students were involved and all the students entered the stage of result analysis with no loss in the midway. ① In vivo experiment: Beer significantly decreased the activity of serum aspartate aminotransferase (418.08 ±58.68,383.41 ±63.01)nkat/L, significantly in creased the activity of serum alkaline phosphatase, (367 8.57±436.25,396 2.96±400.91)nkat/L (x2=19.00-20.00,P < 0.01). The activity of other enzymes was all increased at different degrees. ② In vitro experiment: Beer inhibited the activity of various enzymes in vitro to a certain degree.CONCLUSION: Beer has some effect on enzyme activity in vivo and in vitro, thus affecting the body metabolism. Over drinking beer can affect health. In the routine detection of serum enzymes, attention should be given to avoid the interference caused by over drinking beer to make sure the experimental results are precise and reliable.
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BACKGROUND: It is indicated in research that mildly modified low density lipoprotein (mm-LDL) is related to atherogenesis and it not only stores LDL and provides very strong biological activity, but also expresses many kinds of bioactive substances, like macrophage colony stimulating factor (MCSF) induced in cell culture and in animal body.OBJECTIVE: Differential display-PCR (DD-PCR) technique is used to study the genetic expressed difference in mm-LDL inducing vascular endothelial cells so as to lay the foundation for further explanation of the relationship between mm-LDL and arteriosclerosis.DESIGN: Repeated measurement was designed.SETTING: Taishan Medical College.MATERIALS: The experiment was performed in Basic Institute of Taishan Medical College from July 2003 to July 2004. Medium of human umbilical vein endothelial cells (HUVECs) was M199. Culture was done at 37 ℃, in 50 mL/L CO2. When cells grew to the fusion state, mm-LDL was added in the medium to the terminal concentration of 400 mg/L and then,induction was followed in 30 hours.METHODS: DD- reverse transcription (RT)-PCR technique was used to analyze genetic expression difference of human vascular endothelial cells induced with mm-LDL and reverse Northern analysis was performed to testify DD genetic fragments.mRNA in liver of mice.RESULTS: Human vascular endothelial cells induced with inm-LDL displayed some up and down-regulated genetic fragments. Up-regulated genes included thymosin 34, FGFRI protooncogene-chaperone protein, FK506 binding protein, rTSβ protein and intercellular adhesion molecule-1 (Ⅰ-CAM-1). Down-regulated genes included Apo bec-1 binding protein-l, cytochromeB561 and ERP72.CONCLUSION: DDRT-PCR testifies that mm-LDL induces changes of some genetic expression of human umbilicus vein endothelial cells in vitro and pathological changes of mm-LDL vascular endothelial cells, terminally results in atherogenesis.
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BACKGROUND: Long-term excessive intake of beer might lead to change of intra-corporal tissue or activity of serum enzyme.OBJECTIVE: Observation on relations between intake of beer and fat synthesis of rats and activity of enzyme correlated with catabolism in rats.DESIGN: Matched observations randomly of animal experiments.SETTING: Basic Medical Institute of Taishan Medical College.MATERIALS: The experiments were completed in Basic Medical Institute of Taishan Medical College from December 2004 to February 2005. Totally 60 SD rats were selected and categorized into 6 groups with 10 rats in each group. The rats were perfused with 9 mL/kg, 18 mL/kg, 27 mL/kg, 36 mL/kg, and 45 mL/kg beer respectively according to their fat; The rats in control group were fed with water in stead of beer.METHODS: All rats in each groups were narcotized and executed after continuous feeding 1 week, biochemical analysis and enzyme assay were made respectively after blood samples were adopted, and liver, subcutaneous fat, mesentery fat tissue and gastrocnemius muscle were preserved.MAIN OUTCOME MEASURES: ① The level of fat, blood glucose, insulin and blood-lipid of rats in each group after feeding 1 week . ② The enzymatic activity of liver and fat tissue of rats in each group after feeding 1 week . ③ The activity of hormone sensitive lipase and lipoprotein lipase (LPL) of rats in each group after feeding 1 week.RESULTS: Totally 60 rats were channeled into result analysis without any loss. ① Comparison of the levels of fat and biochemical specifications of rats in each group after feeding 1 week: The contents of fat, serum free fatty acid (FFA), high-density of lipoprotein (LP) cholesterol, hepar triacylglycerol and liver cholesterol in beer 36 mL/kg group were higher than those in control groups (x2=19.44-20.01, P < 0.01). ② Comparison of the levels of the enzymatic activity of liver and fat tissue of rats in each group after feeding 1 week: The activities of liver, subcutaneous fat, and liver microsome, I.e. Triacylglycerol alternation protein, phosphatidyl phosphohydrolase, malic enzyme, glucose-6-phasphate dehydrogenase (G6PD) of mesentery tissue in beer 36 mL/kg group were higher than those in control groups (x2=15.02-16.00, P < 0.05). ③ The comparison on level of the activity of hormone sensitive lipase and lipoprotein lipase (LPL) of rats in each group after feeding 1 week: The activity of gastrocnemius muscle of hormone sensitive lipase in beer 36 mL/kg group were prominently lower than those of control groups (P < 0.01), but the activity of lipoprotein lipase (LPL) (P < 0.01) of subcutaneous fat were prominently higher than those in control groups (P < 0.01). The activities of lipoprotein lipase (LPL)of mesentery fat tissue, subcutaneous fat and gastrocnemius muscle tissue in beer 36 mL/kg group were prominently higher than those in other beer groups and control groups (x2=19.00-20.00, P < 0.01).CONCLUSION: The intake of a certain amount of beer (36 mL/kg) might promote the capability of liver in synthesis and the transport of triacylglycerol in rats. The acceleration of lipid synthesis and storage of fat tissue such as mesentery fat tissue and the increase of fat decomposition and mobilization in peripheral tissue such as muscular tissue and subcutaneous fat would finally lead to the increase of fat.