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Objective To establish a new model of indocyanine green (ICG) clearance test combined with total bilirubin actual resident rate (TBARR) for predicting the short-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) treated with artificial liver support system (ALSS) therapy. Methods A retrospective analysis was performed for the clinical data of 136 patients with HBV-ACLF who underwent ALSS therapy in Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, from June 2017 to July 2021, and according to the prognosis at 3-month follow-up, they were divided into survival group with 92 patients and death group with 44 patients. Related indicators were measured at the time of the confirmed diagnosis of ACLF, including biochemical parameters, coagulation, indocyanine green retention rate at 15 minutes (ICGR 15 ), and effective hepatic blood flow (EHBF), and related indices were calculated, including Model for End-Stage Liver Disease (MELD) score, MELD difference (ΔMELD), Child-Turcotte-Pugh (CTP) score, total bilirubin clearance rate (TBCR), total bilirubin rebound rate (TBRR), and TBARR. The Mann-Whitney U test was used for comparison of continuous data with skewed distribution between two groups; the chi-square test was used for comparison of categorical data between groups. A binary logistic regression analysis was used to establish a combined predictive model for the prognosis of HBV-ACLF after ALSS therapy. The area under the ROC curve (AUC) was used to compare the accuracy of various models in judging the short-term prognosis of patients with HBV-ACLF after ALSS therapy, and the Z test was used for comparison of AUC. Results There were significant differences between the death group and the survival group in MELD score, ΔMELD, CTP score, ICGR 15 , EHBF, TBRR, TBARR, neutrophil count, percentage of neutrophils, lymphocyte count, platelet count, alkaline phosphatase, gamma-glutamyl transpeptidase, total bilirubin, albumin, prothrombin time, international normalized ratio, prothrombin time activity, prealbumin, fibrinogen, serum sodium, age, and the incidence rate of hepatic encephalopathy (all P 80%. Conclusion The combined predictive model established by ICGR 15 and TBARR has a good value for in predicting the short-term prognosis of patients with HBV-ACLF after ALSS therapy, and the combined predictive model has a better accuracy than the single model in judging prognosis.
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Objective To evaluate the effect of different techniques of hepatic artery reconstruction on postoperative hepatic artery complications and clinical prognosis in liver transplantation. Methods Clinical data of 140 liver transplant recipients were retrospectively analyzed. All recipients were divided into the conventional hepatic artery reconstruction group (n=123) and special hepatic artery reconstruction group (n=17) according to hepatic artery reconstruction methods. Intraoperative and postoperative clinical indexes, the incidence of postoperative hepatic artery complications and survival rate were compared between two groups. Results The alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at postoperative 1 d, total bilirubin (TB) at postoperative 7 d and prothrombin time international normalized ratio (PT-INR) at postoperative 30 d in special hepatic artery reconstruction group were higher than those in conventional hepatic artery reconstruction group, and the differences were statistically significant (all P < 0.05). There were no significant differences in the operation time, anhepatic phase, intraoperative blood loss, intraoperative transfusion volume of red blood cells, cold or warm ischemia time, the length of intensive care unit (ICU) stay, the length of hospital stay and postoperative blood flow of liver allograft between two groups (all P > 0.05). In the conventional hepatic artery reconstruction group, 5 recipients developed hepatic artery complications, whereas no hepatic artery complications occurred in the special hepatic artery reconstruction group, with no significant difference between two groups (P > 0.05). In the special hepatic artery reconstruction group, the 1-, 3- and 5-year cumulative survival rates were equally 82.4%, compared with 85.0%, 78.9% and 75.6% in the conventional hepatic artery reconstruction group, respectively. There was no significant difference between two groups (all P > 0.05). Conclusions When hepatic artery variations and (or) lesions are detected in donors and recipients, use of special hepatic artery reconstruction may effectively restore the hepatic arterial blood flow of liver allograft after liver transplantation, and will not affect the incidence of hepatic artery complications and survival rate of the recipients following liver transplantation.
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Objective:To assess the predictors of outcomes for different subtypes of liver failure, and the effectiveness of artificial liver support systems in the treatment of liver failure.Methods:The clinical data of 112 patients with hepatitis B virus (HBV)- and non-HBV-related liver failure admitted to the intensive care unit (ICU) of the Fifth People's Hospital of Wuxi were collected from January to December 2020. The relevant etiologies of acute, subacute, acute-on-chronic, subacute-on-chronic, chronic subtype liver failure were analyzed. The efficacies of artificial liver support systems in the treatment of various subtypes of liver failure were also compared. The correlation of various indicators was analyzed by Spearman correlation analysis, the risk factors affecting the prognosis of patients with liver failure were analyzed by multivariate Logistic regression equation, and receiver operator characteristic curve (ROC curve) of subjects was plotted to evaluate the predictive value of each risk factor for the prognosis of patients with liver failure.Results:Among the 112 liver failure patients, 63 were caused by hepatitis B and 49 were caused by non-hepatitis B. The liver failure caused by hepatitis B was 6 times higher than for men than for women, which was higher than that of non-HBV liver failure group (1.33 times). Antithrombin Ⅲ (AT Ⅲ) and total bilirubin (TBil) levels of subacute liver failure were higher than those of pre-liver failure in the HBV liver failure group [AT Ⅲ: (59.33±14.57)% vs. (35.66±20.72)%, TBil (μmol/L): 399.21±112.94 vs. 206.08±126.96, both P < 0.05]. The levels of AT Ⅲ in patients with pre-liver failure and chronic liver failure in the non-HBV liver failure group were significantly higher than those with acute liver failure [(58.33±15.28%), (44.00±19.10)% vs. (31.33±7.57)%, both P < 0.05], patients with acute liver failure had significantly lower level of TBil than pre-liver failure (μmol/L: 107.83±49.73 vs. 286.20±128.92, P < 0.05), the TBil levels in patients with subacute and acute-on-chronic liver failure were also significantly higher than that in pre-liver failure group (μmol/L: 417.27±118.60, 373.00±187.00 vs. 286.20±128.92, both P < 0.05). Patients with subacute liver failure, subacute-on-chronic liver failure and chronic liver failure in the non-HBV failure group were significantly longer than those in acute liver failure (days: 36.00±8.31, 27.52±11.71, 27.72±22.71 vs. 11.00±1.41, all P < 0.05). There was no statistically significant difference in the case fatality rate of using the artificial liver support system between the HBV failure group and the non-HBV failure group (55.6% vs. 50.0%, P < 0.05), the levels of AT Ⅲ in the two groups of surviving patients were significantly higher than that of the dead [HBV liver failure group: (36.20±6.26)% vs. (27.33±8.87)%, non-HBV liver failure group: (41.06±4.16)% vs. (28.71±12.35)%, both P < 0.01]. Correlation analysis showed that there was a clear positive correlation between AT Ⅲ and TBil in the dead patients of HBV liver failure group and the survival and death patients of non-HBV liver failure group ( r values were 0.069, 0.341, 0.064, and P values were 0.723, 1.196 and 0.761, respectively); there was a significant inverse correlation between AT Ⅲ and TBil in the HBV liver failure group ( r = -0.105, P = 0.745). Multivariate Logistic regression analysis showed that AT Ⅲ was an independent risk factor affecting the prognosis of patients with non-HBV liver failure [odd ratio ( OR) = 1.023, 95% confidence interval (95% CI) was -0.001 to 0.001, P = 0.007]. TBil was an independent risk factor affecting prognosis of patients with HBV liver failure ( OR = 1.005, 95% CI was -0.002 to -7.543, P = 0.033). The analysis of ROC curve showed that AT Ⅲ had a predictive value for the prognosis of patients with non-HBV liver failure, the area under the ROC curve (AUC) = 0.747, the 95% CI was 0.592-0.902, P = 0.009. When the optimal truncation value was 39.5%, its sensitivity and specificity were 83.33% and 56.25%, respectively. Conclusions:Artificial liver support system treatment of liver failure was difficult to effectively reduce the mortality of patients with end-stage liver failure. In addition to AT Ⅲ, TBil also could be used as an indicator to assess liver compensatency and predict prognosis in liver failure patients.
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Objective:To investigate the changes in myocardial enzyme spectrum, procalcitonin, and C-reactive protein levels in neonates with hyperbilirubinemia.Methods:A total of 150 neonates with hyperbilirubinemia who received treatment in the 1 st Affiliated Hospital of Wenzhou Medical University during January-December 2019 were included in this study. They were allocated to mild (total bilirubin level 221-256.5 μmol/L, n = 68) and moderate-to-severe hyperbilirubinemia (total bilirubin level > 256.5 μmol/L, n = 82) groups according to different serum total bilirubin levels. An additional 70 healthy neonates who were born concurrently served as controls. Myocardial enzyme spectrum (creatine kinase, creatine kinase-MB, lactate dehydrogenase, alpha-hydroxybutyrate dehydrogenase), procalcitonin, and C-reactive protein levels were compared among groups. The correlation between myocardial enzyme spectrum, procalcitonin, and C-reactive protein levels and the severity of hyperbilirubinemia was investigated. The factors related to hyperbilirubinemia in neonates were analyzed using logistic regression analysis. Results:Serum levels of creatine kinase, creatine kinase-MB, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase were (1130.23 ± 385.42) U/L, (194.82 ± 60.33) U/L, (993.45 ± 271.46) U/L, and (493.76 ± 105.65) U/L, respectively in the moderate-to-severe hyperbilirubinemia group, which were significantly higher than those in the mild hyperbilirubinemia and control groups [(682.23 ± 258.53) U/L, (82.67 ± 24.43) U/L, (486.38 ± 112.57) U/L, (252.63 ± 38.73) U/L; (368.13 ± 104.20) U/L, (27.90 ± 8.29) U/L, (402.13 ± 102.20) U/L, (228.53 ± 34.30) U/L; F = 67.12, 56.23, 66.57, 44.34, all P < 0.01]. Serum levels of creatine kinase, creatine kinase-MB, lactate dehydrogenase, and alpha-hydroxybutyrate dehydrogenase were significantly higher in the mild hyperbilirubinemia group than those in the control group (all P < 0.05). Premature infants, intrauterine distress, neonatal asphyxia, amniotic fluid pollution, sepsis, omphalitis, erythrocyte glucose-6-phosphate dehydrogenase defect, and delayed passage of meconium are the risk factors for neonatal hyperbilirubinemia ( OR = 6.13, 5.40, 5.29, 4.26, 7.79, 6.99, 5.79, 5.44, all P < 0.05). Breastfeeding is an independent protective factor for the development of neonatal hyperbilirubinemia ( OR = 5.87, P < 0.05). Conclusion:Myocardial enzyme, procalcitonin, and C-reactive protein levels increase in neonates with hyperbilirubinemia with the aggravation of the disease. Close monitoring of high-risk factors of neonatal hyperbilirubinemia (including preterm infants, intrauterine distress, neonatal asphyxia, amniotic fluid pollution, sepsis, omphalitis, erythrocyte glucose-6-phosphate dehydrogenase defect, and delayed passage of meconium) and strengthening perinatal health care and high-risk pregnancy management can reduce the incidence of pathological jaundice.
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Objective To explore the value of ultrasound elastography in the non-invasive monitoring of liver elasticity of stable recipients at different stages after liver transplantation. Methods Clinical data of 73 stable recipients after liver transplantation were collected. According to the time after liver transplantation, all patients were divided into the early group (n=25) and medium-to-long group (n=48). In addition, 38 healthy subjects were assigned into the control group. The ultrasound indexes and liver function indexes were statistically compared among each group. The ultrasound elastography indexes of liver and spleen were analyzed, and their correlation with liver function indexes was analyzed. Results Compared with the control group, the ultrasound indexes, alanine aminotransferase (ALT), γ-glutamyl transferase (GGT) and alkaline phosphatase (ALP) levels were significantly increased in the early group (all P < 0.05), and the ultrasound indexes in the medium-to-long group were significantly increased, whereas the GGT level was significantly decreased (all P < 0.05). Compared with the early group, the right oblique diameter of liver, ALT, GGT and ALP levels were significantly decreased in the medium-to-long group (all P < 0.05). Compared with the control group, the sound touch elastography (STE) and sound touch quantify (STQ) values of liver and STE value of spleen in the early group and medium-to-long group were significantly increased (all P < 0.05). Compared with the early group, the ultrasound elastography indexes of liver and spleen in the medium-to-long group were remarkably decreased (all P < 0.05). The ultrasound elastography indexes of liver were weakly correlated with the ALT, aspartate aminotransferase (AST) and GGT levels, significantly correlated with ALP level. The STE value of spleen was weakly correlated with the ALP level. The STE value of liver was significantly correlated with the STQ value of liver. The STE and STQ values of liver were weakly correlated with the STE value of spleen. Conclusions The characteristics of liver elasticity in stable recipients after liver transplantation are various among different stages. Persistent monitoring of liver elasticity may provide a novelnon-invasive monitoring method during follow-up after liver transplantation.
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Background: Coffee has a number of bioactive compounds that have beneficial effects on human health in general and more importantly is the fact that coffee consumption has positive impact on the liver function. The present study investigated the effect of coffee consumption on liver enzymes: alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase (ALP), total bilirubin (TB) and conjugated bilirubin (CB) levels among student in Nnewi.Methods: A total of twenty-five (25) apparently healthy participants aged between 18 and 30 years which were randomly recruited from College of Health Sciences’ students to serve as both test and control group. Each participant was advised to abstain from coffee and similar beverages for a period of three weeks prior to the commencement of the study. Subsequently, in addition to their normal diet, each of the subjects was given 2 gm of coffee dissolved in 150 ml of hot water in which 50 mg of non-dairy creamer was added before breakfast daily for 28 consecutive days. 6 ml each of baseline and test samples (after an overnight fast) were collected at day 0 and 29 respectively from each participant. Liver enzymes such as ALT, AST, and ALP activity as well as TB and CB levels was determined using standard laboratory methods.Results: This showed significant reductions in the mean serum AST and ALT activity, TB and unconjugated bilirubin (UB) levels with no significant alterations in the mean ALP activity and CB level in participants studied after short-term coffee consumption.Conclusions: This study revealed the hepatoprotective effect of coffee intake at short term basis.
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A new multi-component spectrophotometric method was developed experimentally and theoreticallyto determine the accurate serum concentrations of the total bilirubin (TB), oxyhemoglobin (HbO2), andmethemalbumin (Mha) in healthy human adults and neonates with hemolytic jaundice. With respect to theexperimental technique, the method of preparation of serum solution has been developed, like the use ofdistilled water as a solvent and centrifugation of serum solutions to clear the sample turbidity. The resultsof TB were compared to the diazo-assay. Theoretically, the formulas used for the calculation of the majorcomponents (TB, HbO2, and Mha) in human sera have been derived based on the theory of multi-componentspectrophotometric analysis and the mathematical Gaussian elimination method for matrix calculation. Themethod of multi-component spectrophotometry, suggested in this study for determination of TB, showed% error (3.1%–4.9%), indicating the high accuracy of the method. The small coefficients of variation(CV = 3.65%–5.1%) indicate the high precision of the method. The results showed higher values of serum TB(p < 0.00005), HbO2 (p < 0.001), and Mha concentrations (p < 0.00005) in neonates, when compared to adults.The method is highly sensitive and accurate. It is inexpensive, precise, reproducible, and has the advantages ofsimplicity, speed, and can be computerized.
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Objective To explore the clinical efficacy of marginal liver from elderly donors in liver transplantation. Methods According to the inclusion and exclusion criteria, the clinical data of 127 donors and recipients were retrospectively analyzed. According to the age of donors, 127 donors were divided into the elderly group (n=27) and control group (n=100). The recovery of liver function, the occurrence of postoperative complications and survival rate of the recipients after transplantation were statistically analyzed between two groups. Results The incidence of primary nonfunction (PNF) and initial poor graft function (IPGF) did not significantly differ between the elderly and control groups (both P > 0.05). Within postoperative 2 weeks, the average levels of alanine aminotransferase (ALT) and serum total bilirubin (TB) of liver transplant recipients in the elderly group was not significantly different from those in the control group (both P > 0.05). There was no significant difference in the incidence of postoperative complications in the postoperative elderly group compared with the control group (all P > 0.05). The 1-and 3-year survival rates of the recipients in the elderly group were 84% and 78% respectively, which did not significantly differ from 89% and 79% in the control group (both P > 0.05). Conclusions Strict and sufficient quality evaluation and functional maintenance should be done for elderly donor livers. It can achieve good transplantation results by intraoperative fine operation, reducing bleeding and trauma, shortening the time of cold ischemia and operation, strengthening postoperative monitoring and implementing enhanced recovery after surgery.
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Objective To establish a rat liver transplantation model under direct vision of single operator and to explore the effect of different perfusion methods on the quality of the donor liver. Methods On the basis of the "two-cuff method" established by Kamada, the operation details were improved to established the rat liver transplantation model. The recipient rats were divided into two groups according to different perfusion methods, group A (perfusion via abdominal aorta) and group B (perfusion via portal vein). The perfusion effect, operation time, operation success rate, postoperative liver function, liver graft pathological manifestations and survival were compared between the two groups. Results There were more residual red blood cells in sinus hepaticus in group B than in group A after perfusion. Both the donor liver perfusion time and donor operation time were longer in group A than those in group B, and the differences were statistically significant (both P < 0.01). The success rate of operation in group A and group B was 77% and 71%, respectively. At 3 d after liver transplantation in rats, the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TB) of the rats in the two groups were significantly higher than normal. At 7, 30 d after operation, compared with group A, the levels of ALT, AST and TB in group B were significantly increased, and the differences were statistically significant (all P < 0.01-0.05). The liver pathological examination showed that the degree of inflammatory reaction in the liver and degree of destruction of liver tissue in group B were more severe than those in group A, but there was no significant difference in long-term survival rate between the two groups. Conclusions Although the perfusion time and donor operation time of rat liver transplantation model were slightly prolonged by means of abdominal aorta perfusion, the perfusion effect was better, which can reduce liver tissue damage after operation and restore liver function to normal levels more quickly.
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@#Objective To explore the clinical efficacy of liver transplantation for severe liver disease. Methods The clinical data of 51 patients who underwent liver transplantation for severe liver disease were retrospectively analyzed. The general intraoperative conditions were observed, including operation duration, warm ischemia time, cold ischemia time, anhepatic phase, bleeding volume, blood transfusion volume, plasma transfusion volume and so on. The changes in indexes such as total bilirubin (TB), prothrombin time activity (PTA), and prothrombin time international normalized ratio (PT-INR) were observed before operation and at 3 d, 1 week and 2 weeks after operation. The postoperative survival and occurrence of complications were analyzed. The indexes that might affect the prognosis of patients with severe liver disease were analyzed by Cox regression analysis. Results For the 51 patients, operation duration, warm ischemia time and cold ischemia time was 8 (7, 9) h, 3 (2, 3) min and 6 (5, 8) h respectively, intraoperative anhepatic phase was 80 (70, 100) min, intraoperative bleeding volume was 1 000 (550, 1 500) mL, and intraoperative blood transfusion volume was 1 200 (200, 1 600) mL. Postoperative TB, PTA, PT-INR and other indexes improved significantly compared to those preoperatively. Among the 51 patients, 10 cases died, with the death causes of multiple organ failure and severe infection(7 cases), renal insufficiency (2 cases), and cardiovascular complications (1 case). Survival rates at 1 month and 1 year post-transplantation for patients with severe liver disease were 82% and 80%, respectively. Cox regression analysis suggested that abnormal preoperative PTA and PT-INR were the risk factors for post-transplantation death in patients with severe liver disease. Conclusions Liver transplantation significantly improves the survival rate for patients with severe liver disease, perioperative infection prevention and treatment as well as multiple organ function management play key roles in improving post-transplantation survival rate in patients with severe liver disease.
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Objective To summarize the therapeutic effects of living related donor liver transplantation for Crigler-Najjar syndrome type Ⅰ (CNS type Ⅰ). Methods A 3-month-old male infant had appeared a progressive xanthochromia of the skin and sclera 4 d after birth without obvious cause. Other causative factors were eliminated after relevant tests were completed, and identified as CNS type Ⅰ by genetic testing. Living related donor liver transplantation was performed with his mother as the donor. An immunosuppression regimen was routinely applied postoperatively and tacrolimus doses were adjusted according to biochemical indicators and cytochrome P450 (CYP) 3A5 genotype of the recipient. Results The liver enzymes of the recipient returned to normal at 7 d postoperatively, and bilirubin decreased daily and fell to the normal range at 22 d postoperatively. Followed up to the submission date, the recipient's xanthochromia of skin and scleral faded with normal bilirubin and stable liver enzymes. The condition of the recipient was generally good with high quality of life. Conclusions Living donor liver transplantation can treat unconjugated hyperbilirubinemia and other diseases caused by CNS type Ⅰ, which greatly improve the quality of life of patients.
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Metabolic syndrome is closely related to target organ injury such as heart, brain, and kidney. And bilirubin is an effective antioxidant. At present, there is a lack of research data on metabolic syndrome and serum total bilirubin in longevity elderly people. This study aimed to study the prevalence of the metabolic syndrome and its correlation with serum total bilirubin level in nonagenarians and centenarians living in Hubei Zhongxiang Province. According to the demographic information provided by Zhongxiang Civil Affairs Bureau, 128 elderly people were interviewed and 11 of them were excluded. A total of 117 population were included in the study. Questionnaires, physical examination, and blood test were made. 117 subjects aged 90-113 years with an average age of (98.6±4.8) years old were analysed. The prevalence of metabolic syndrome and its diagnostic components were obesity 19.7%, hyperglycemia 29.9%, hypertension 94.0%, hypertriglyceridemia 33.3%, low high density lipoprotein-cholesterol (HDL-C) levels 17.1%, and metabolic syndrome 23.9%. Logistic regression analysis found that the total bilirubin level was negatively correlated with metabolic syndrome and triglyceride levels(P<0.05), but not with obesity, hyperglycemia, hypertension, and total cholesterol (P>0.05). The nonagenarians and centenarians have a low prevalence of metabolic syndrome in Zhongxiang, Hubei Province, total bilirubin was negatively correlated with metabolic syndrome and triglyceride.
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This study developed a population pharmacokinetic model for sodium tanshinone IIA sulfonate (STS) in healthy volunteers and coronary heart disease (CHD) patients in order to identify significant covariates for the pharmacokinetics of STS. Blood samples were obtained by intense sampling approach from 10 healthy volunteers and sparse sampling from 25 CHD patients, and a population pharmacokinetic analysis was performed by nonlinear mixed-effect modeling. The final model was evaluated by bootstrap and visual predictive check. A total of 230 plasma concentrations were included, 137 from healthy volunteers and 93 from CHD patients. It was a two-compartment model with first-order elimination. The typical value of the apparent clearance (CL) of STS in CHD patients with total bilirubin (TBIL) level of 10 μmol(L was 48.7 L(h with inter individual variability of 27.4%, whereas that in healthy volunteers with the same TBIL level was 63.1 L(h. Residual variability was described by a proportional error model and estimated at 5.2%. The CL of STS in CHD patients was lower than that in healthy volunteers and decreased when TBIL levels increased. The bootstrap and visual predictive check confirmed the stability and validity of the final model. These results suggested that STS dosage adjustment might be considered based on TBIL levels in CHD patients.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Bilirubin , Blood , Coronary Disease , Drug Therapy , Metabolism , Drugs, Chinese Herbal , Pharmacokinetics , Metabolic Clearance Rate , Models, Biological , Phenanthrenes , Blood , PharmacokineticsABSTRACT
Objective Newborn bilirubin encephalopathy seriously threatens the life and health of newborns, Both the mortality and morbidity are high.Cerebrospinal fluid bilirubin concentration can better reflect the blood-brain barrier function and brain bilirubin levels, which can help the diagnosis of bilirubin encephalopathy.Methods In order to meet the clinical needs, we confirmed the detection performance of the existing serum bilirubin detection system for cerebrospinal fluid bilirubin, including precision, accuracy and analysis of measurement range.Results The results showed that the detection system was linear at 1.0-25.1μmol/L, and the daytime CVat normal and pathological values was less than the precision requirement (6％) .The bias of each sample and the average bias are less than the allowable bias (5％) , the total error is less than the total allowable error (15％) .Conclusion Therefore, the performance of the detection system meet the industry standards, can be used for neonatal cerebrospinal fluid bilirubin detection.
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Metabolic syndrome is closely related to target organ injury such as heart, brain, and kidney. And bilirubin is an effective antioxidant. At present, there is a lack of research data on metabolic syndrome and serum total bilirubin in longevity elderly people. This study aimed to study the prevalence of the metabolic syndrome and its correlation with serum total bilirubin level in nonagenarians and centenarians living in Hubei Zhongxiang Province. According to the demographic information provided by Zhongxiang Civil Affairs Bureau, 128 elderly people were interviewed and 11 of them were excluded. A total of 117 population were included in the study. Questionnaires, physical examination, and blood test were made. 117 subjects aged 90-113 years with an average age of (98.6 ± 4.8) years old were analysed. The prevalence of metabolic syndrome and its diagnostic components were obesity 19. 7％, hyperglycemia 29. 9％, hypertension 94. 0％, hypertriglyceridemia 33. 3％, low high density lipoprotein-cholesterol ( HDL-C) levels 17.1％, and metabolic syndrome 23. 9％. Logistic regression analysis found that the total bilirubin level was negatively correlated with metabolic syndrome and triglyceride levels(P<0.05), but not with obesity, hyperglycemia, hypertension, and total cholesterol ( P>0.05) . The nonagenarians and centenarians have a low prevalence of metabolic syndrome in Zhongxiang, Hubei Province, total bilirubin was negatively correlated with metabolic syndrome and triglyceride.
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Objective To explore the diagnostic efficacy of combined detection of serum midkine (MK) and total bilirubin (TBIL)levels of diabetic retinopathy(DR),and determine the value in diagnosis of DR.Methods Clinical data of 215 cases of patients with type 2 diabetes mellitus (T2DM) treated in our hospital from July 2014 to December 2016 were collected,and diabetes mellitus without retinal lesions (NDR) in 79 cases,non-proliferative diabetic retinopathy (NPDR) in 81 cases,proliferative diabetic retinopathy (PDR) in 55 cases.Another 70 cases of physical examination persons in the same period were as the control group.Serum MK and TBIL levels were detected in the four groups,and the relationship between indexes and DR was done by Person correlation analysis and Logistic regression analysis,and diagnostic efficacy of Midkine and TBIL was evaluated in DR.Results Serum MK and TBIL levels were compared between the four groups,with statistically significant differences (P ＜ 0.05).MK level increased in normal control group,NDR group,NPDR group and PDR group,while TBIL levels decreased in each group.MK was positively correlated with DR (r =0.779,P =0.005),and TBIL was negatively correlated with DR (r =-0.657,P =0.012),and both were independent factors influencing DR (OR =2.257,0.681,P ＜ 0.05).The sensitivity of combined detection of MK and TBIL in diagnosis of DR was higher than that of each index detected separately (P ＜ 0.05).Conclusion Serum MK and TBIL levels are closely related to the occurrence of DR and severity of the disease,and the combined detection has high diagnostic efficacy for DR.
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We evaluated serum total bilirubin levels as a predictor for metabolic syndrome (MetS) and investigated the relationship between serum total bilirubin levels and MetS prevalence. This cross-sectional study included 1728 participants over 65 years of age from Eastern China. Anthropometric data, lifestyle information, and previous medical history were collected. We then measured serum levels of fasting blood-glucose, total cholesterol, triglycerides, and total bilirubin, as well as alanine aminotransferase activity. The prevalence of MetS and each of its individual component were calculated per quartile of total bilirubin level. Logistic regression was used to assess the correlation between serum total bilirubin levels and MetS. Total bilirubin level in the women who did not have MetS was significantly higher than in those who had MetS (P<0.001). Serum total bilirubin quartiles were linearly and negatively correlated with MetS prevalence and hypertriglyceridemia (HTG) in females (P<0.005). Logistic regression showed that serum total bilirubin was an independent predictor of MetS for females (OR: 0.910, 95%CI: 0.863–0.960; P=0.001). The present study suggests that physiological levels of serum total bilirubin might be an independent risk factor for aged Chinese women, and the prevalence of MetS and HTG are negatively correlated to serum total bilirubin levels.
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Humans , Male , Female , Aged , Bilirubin/blood , China/epidemiology , Metabolic Syndrome/blood , Biomarkers/blood , Cross-Sectional Studies , Metabolic Syndrome/epidemiology , Prevalence , Risk FactorsABSTRACT
Objective To study reaction principle of bilirubin vanadate oxidation method and bilirubin oxidase method through comparison of the determination results,and discuss similarities and difference between the two methods .Methods 310 ca-ses were measured and analyzed with each method.Abnormal samples were further investigated.Results Fortotal bilirubin, the regression equation obtained wasY=1.065 1X+1.197 2,the correlation coefficientr=0.997 0.For direct bilirubin of a-dults and children greater than 30 days,the regression equation wasY=0.945 9X+0.599 5 and the correlation coefficient r=0.994 4.For neonatal direct bilirubin,the regression equation wasY=0.410 4X+2.756 3 and the correlation coefficient r=0.883 5.The results from vanadate oxidation method were unacceptable for abnormal neonatal serum measurement after serial dilution.Conclusion The overall conclusions were that for the measurement of total bilirubin,and direct bilirubin for adults and children older than 30 days.The correlation between these two methods is in an acceptable range,for measure-ment of neonatal direct bilirubin,the correlation between thesetwo methods was not acceptable.It is not recommended to measure neonatal direct bilirubin by vanadate oxidation method.
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Objective To discuss the incidence,clinical characteristics of sepsis-associated liver injure in pediatric patients and risk factors that may affect the prognosis.Methods A retrospective analysis was made on the data of patients with sepsis-associated liver injure that had been hospitalized in Shanghai Children′s Hospital from January 2011 to December 2015.The cases were divided into the survival group and the death group.Logistic regression analysis was made to screen out risk factors of patients with sepsis-associated liver injure that influence the prognosis.Results The incidence of sepsis associated liver dysfunction was 9.7%(120/1242),the mortality rate was 35.8%(43/120).The most common focus of infection was respiratory tract infection(50.0%),followed by abdominal cavity infection(33.3%) and central nervous system infection(6.7%).The pathogenic microorganisms were mainly gram-negative bacilli(51.3%),followed by virus(26.5%) and gram-positive bacterium(17.7%).The main manifestations of the liver injure were elevated glutamic-pyruvic transaminase(117 cases,97.5%),prolonged prothrombin time(PT)(93 cases,77.5%),hypoproteinemia(83 cases,69.2%) and hyperbilirubinemia(70 cases,58.3%).The total bilirubin(TBIL),PT,activated partial thromboplastin time and total bile acid of the death group were higher than thoes of the survival group.Logistic regression analysis indicated that elevated TBIL(OR=2.937,95%CI 1.179-7.315,P=0.021) was the independent risk factor for death.The area under receiver operating characteristic curve for TBIL(cut off was 64.5μmol/L)was 0.736 with sensitivity 57.7% and specificity 84.8%.Conclusion The incidence rate of sepsis-associated liver injure among pediatric patient is high.Gram-negative bacilli are the main pathogenic microorganisms.This disease is manifested as the elevated glutamic-pyruvic transaminase,hypoproteinemia,prolonged PT and hyperbilirubinemia.Hyperbilirubinemia is the independent risk factor that influences the prognosis.
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Objective To explore the factors that affect the prognosis of extensive small cell lung cancer by analyzing the association between lab-oratory indicators before treatment of extensive small cell lung cancer patients and the initial evaluation results with disease progression and overall survival. Methods This study retrospectively analyzed 96 cases of hospitalized patients in the medical oncology department of The First Hospital of China Medical University from March 2008 to September 2014. Kaplan-Meier method and Cox proportional hazards models were adopted to ana-lyze the relevant factors affecting the prognosis of extensive small cell lung cancer. P<0.05 was considered statistically significant. Results There was no obvious correlation between HB level before treatment with PFS of patients(P=0.179),but there was obvious significant correlation be-tween HB level and OS of patients(P=0.041). Our results showed that the TBIL level of patients before chemotherapy was significantly associated with the PFS(P=0.039)and OS(P=0.026)of patients. Conclusion HB and TBIL levels are the influencing factors that affect the prognosis and survival of patients with extensive small cell lung cancer.