Administration of silymarin in NAFLD/NASH: A systematic review and meta-analysis.

INTRODUCTION AND OBJECTIVES: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease with a high prevalence worldwide and poses serious harm to human health. There is growing evidence suggesting that the administration of specific supplements or nutrients may slow NAFLD progression. Silymarin is a hepatoprotective extract of milk thistle, but its efficacy in NAFLD remains unclear. MATERIALS AND METHODS: Relevant studies were searched in PubMed, Embase, the Cochrane Library, Web of Science, clinicaltrails.gov, and China National Knowledge Infrastructure and were screened according to the eligibility criteria. Data were analyzed using Revman 5.3. Continuous values and dichotomous values were pooled using the standard mean difference (SMD) and odds ratio (OR). Heterogeneity was evaluated using the Cochran's Q test (I2 statistic). A P<0.05 was considered statistically significant. RESULTS: A total of 26 randomized controlled trials involving 2,375 patients were included in this study. Administration of silymarin significantly reduced the levels of TC (SMD[95%CI]=-0.85[-1.23, -0.47]), TG (SMD[95%CI]=-0.62[-1.14, -0.10]), LDL-C (SMD[95%CI]=-0.81[-1.31, -0.31]), FI (SMD[95%CI]=-0.59[-0.91, -0.28]) and HOMA-IR (SMD[95%CI]=-0.37[-0.77, 0.04]), and increased the level of HDL-C (SMD[95%CI]=0.46[0.03, 0.89]). In addition, silymarin attenuated liver injury as indicated by the decreased levels of ALT (SMD[95%CI]=-12.39[-19.69, -5.08]) and AST (SMD[95% CI]=-10.97[-15.51, -6.43]). The levels of fatty liver index (SMD[95%CI]=-6.64[-10.59, -2.69]) and fatty liver score (SMD[95%CI]=-0.51[-0.69, -0.33]) were also decreased. Liver histology of the intervention group revealed significantly improved hepatic steatosis (OR[95%CI]=3.25[1.80, 5.87]). CONCLUSIONS: Silymarin can regulate energy metabolism, attenuate liver damage, and improve liver histology in NAFLD patients. However, the effects of silymarin will need to be confirmed by further research.

Depression and NAFLD risk: A meta-analysis and Mendelian randomization study.

BACKGROUND: Both depression and nonalcoholic fatty liver disease (NAFLD) have a high global prevalence. Growing evidence suggests an association between depression and NAFLD, while the association remains unclear. Thus, in this study, we aimed to explore the effect of depression on the risk of developing NAFLD. METHODS: The meta-analysis examined the association between depression and the risk of NAFLD by including observational studies. Relevant studies were searched in PubMed, Embase, the Cochrane Library, and Web of Science. Then a two-sample Mendelian randomization (MR) analysis was performed to explore causal association using genetic instruments identified from a genome-wide association study. RESULTS: Six eligible studies were included in the meta-analysis, involving 289,22 depression cases among 167,554 participants. Meta-analysis showed a significant association between depression and a higher risk of developing NAFLD (OR = 1.14, 95 % CI: [1.05, 1.24], P = 0.002). However, we found no convincing evidence supporting a causal role of genetically predicted depression with NAFLD risk (OR = 0.861, 95 % CI: [0.598, 1.238], P = 0.420). LIMITATIONS: The insufficient number of included studies, the use of summary-level data, and restrictions on population sources are the major limiting factors. CONCLUSIONS: Meta-analysis and MR analysis demonstrated inconsistent results on the relationship between depression and a high risk of developing NAFLD. Specifically, meta-analysis confirmed that depression increases the risk of developing NAFLD, while MR analysis did not support a causal association between genetically determined depression and the risk of NAFLD.

Kinetics, mechanism, and application of sodium persulfate activated by sodium hydroxide for removing 1,2-dichloroethane from groundwater.

1,2-Dichloroethane (1,2-DCA) is a common compound found in groundwater contaminated with organics. This compound is difficult to remove from groundwater and has the potential to inflict significant harm on human health and the environment. This study used sodium persulfate (Na2S2O8) activated by sodium hydroxide (NaOH) to remove 1,2-DCA from aqueous solutions. Density functional theory was employed to calculate the potential energy surface of the reactants, intermediates, transient states, and products to thoroughly analyze the degradation pathways. The computations were performed in combination with in situ remediation of a 1,2-DCA plume from a point source to verify the industrial applicability of the technology. The results showed the 1,2-DCA removal efficiency was impacted considerably by the Na2S2O8 dosage and the dosing sequence of Na2S2O8 and NaOH, with the mean removal ratio reaching 96.24%. A free radical reaction was the main pathway of 1,2-DCA degradation; superoxide radical (O2•-) existed stably and played a key role in the reaction, and the main transformation proceeded via a vinyl chloride intermediate. The maximum removal of 1,2-DCA reached 91.79% in the in situ remediation. The developed technology exhibits important advantages in enabling flexible control over chemical dosages, long durations of effective activity, and rapid full-cycle remediation.

The promising role of probiotics/prebiotics/synbiotics in energy metabolism biomarkers in patients with NAFLD: A systematic review and meta-analysis.

Background: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease with a high prevalence worldwide, seriously harming human health, and its pathogenesis remains unclear. In recent years, increasing evidence has indicated that intestinal microbiota plays an important role in the occurrence and development of NAFLD. The regulation method of probiotics/prebiotics/synbiotics can alter the intestinal microbiota and has been suggested as an option in the treatment of NAFLD. Methods: Five databases of PubMed, Embase, the Cochrane Library, clinicaltrails.gov, and China National Knowledge Infrastructure were searched initially, and then the eligible studies were screened. Finally, the data of included studieswere extracted, combined and analyzed. Results: A total of 29 randomized controlled trials involving 2,110 patients were included in this study. The results showed that using probiotics/prebiotics/synbiotics in the intervention group could reduce the levels of glucose (SMD = -0.23, 95% CI [-0.45, -0.01], P = 0.04), HOMA-IR (SMD = -0.47, 95% CI [-0.63, -0.31], P < 0.00001) and insulin (SMD = -0.46, 95% CI [-0.76, -0.16], P = 0.002) in sugar metabolism; in terms of lipid metabolism, the levels of TC (SMD = -0.62, 95%CI [-0.87, -0.36], P < 0.00001), and LDL-C (SMD = -0.57, 95%CI [-0.85, -0.28], P < 0.00001) were decreased; and the level of ALB was decreased in protein metabolism (SMD = -0.34, 95%CI [-0.61, -0.06], P = 0.02). Conclusions: Based on the current evidence, probiotics/prebiotics/synbiotics may improve energy metabolism biomarkers in the NAFLD population, but these effects still need to be confirmed by further research. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/#aboutpage.

[Mechanism of Gynostemma pentaphyllum in treatment of metabolism associated fatty liver disease based on network pharmacology and molecular docking].

The present study explored the mechanism of action of Gynostemma pentaphyllum in the treatment of metabolism associa-ted fatty liver disease(MAFLD) by network pharmacology and molecular docking. The main active components and action targets of G. pentaphyllum were collected from TCMSP. Disease-related targets were obtained from GeneCards, OMIM and TTD, and the common targets of the three databases were screened out, which were converted to the genes with standard names by UniProt. The drug-disease common target genes were obtained through Venn tool and uploaded to STRING for the construction of the protein-protein interaction(PPI) network. Cytoscape was used to construct and analyze the drug-active component-common target-disease network. The gene ontology(GO) analysis and Kyoto encyclopedia of genes and genomes(KEGG) pathway enrichment analysis were performed on the common targets by DAVID. Pymol was adopted to perform molecular docking of active components and the common targets and predict their binding ability. Twenty-four active components(such as gypenosides, quercetin and sitosterol) of G. pentaphyllum were screened out. Ninety-two targets were obtained and 54 common targets were identified. Key targets included TNF, IL6, PTGS2, TP53, CCL2 and VEGFA. GO analysis on biological processes, molecular functions and cellular components and KEGG pathway analysis were performed, and the results indicated that NF-κB, PI3 K-Akt, TNF and HIF-1 signaling pathways were mainly involved. Molecular docking results showed that gypenosides and quercetin had a strong binding ability to TNF, IL6 and PTGS2. The findings of this study revealed that the therapeutic efficacy of G. pentaphyllum on MAFLD might be achieved by resisting inflammation and oxidative stress and improving insulin resistance, providing ideas and a theoretical basis for the development and application of G. pentaphyllum in the treatment of MAFLD.

Forecasting and Evaluating Multiple Interventions for COVID-19 Worldwide.

As the Covid-19 pandemic surges around the world, questions arise about the number of global cases at the pandemic's peak, the length of the pandemic before receding, and the timing of intervention strategies to significantly stop the spread of Covid-19. We have developed artificial intelligence (AI)-inspired methods for modeling the transmission dynamics of the epidemics and evaluating interventions to curb the spread and impact of COVID-19. The developed methods were applied to the surveillance data of cumulative and new COVID-19 cases and deaths reported by WHO as of March 16th, 2020. Both the timing and the degree of intervention were evaluated. The average error of five-step ahead forecasting was 2.5%. The total peak number of cumulative cases, new cases, and the maximum number of cumulative cases in the world with complete intervention implemented 4 weeks later than the beginning date (March 16th, 2020) reached 75,249,909, 10,086,085, and 255,392,154, respectively. However, the total peak number of cumulative cases, new cases, and the maximum number of cumulative cases in the world with complete intervention after 1 week were reduced to 951,799, 108,853 and 1,530,276, respectively. Duration time of the COVID-19 spread was reduced from 356 days to 232 days between later and earlier interventions. We observed that delaying intervention for 1 month caused the maximum number of cumulative cases reduce by -166.89 times that of earlier complete intervention, and the number of deaths increased from 53,560 to 8,938,725. Earlier and complete intervention is necessary to stem the tide of COVID-19 infection.