【Abstract】ObjectiveTo investigate the efficacy of radiofrequency (RF) ablation comparing with percutaneous ethanol injection (PEI) in the treatment of postoperative recurrent hepatocellular carcinoma. MethodsOne hundred and thirtyseven patients with recurrent hepatocellular carcinoma excluding those with extrahepatic metastasis or Child C liver function were analyzed retrospectively. Of these patients, 74 cases with 86 lesions underwent RF therapy, while the other 63 cases with 75 lesions treated with PEI therapy. In RF group, the average size of lesions was 2.05 cm in diameter including 9 lesions were more than 3 cm in diameter (the maximum size of the lesions was 4 cm in diameter). In PEI group, all lesions were less than 3 cm in diameter, averagely 2.03 cm. Blood routine, liver function, AFP level and Doppler ultrasound were observed before and after therapy 1-year, 2-year, 3-year survival rates were calculated in two groups as well. Results①There was no serious complications in two groups. ②Complete tumor necrosis was 93.0%(80/86) in RF group and 81.3%(61/75) in PEI group. In RF group, complete tumor necrosis rate for lesions less than 3 cm in diameter was 96.1%(74/77), while that was only 66.7%(6/9) for lesions greater than 3 cm in diameter. ③The 1-year, 2-year, 3-year survival rates were 74.3%(55/74), 62.2%(46/74) and 54.8% (17/31) in RF group as well as 68.3%(43/63), 57.1%(36/63) and 45.0%(9/20) in PEI group， respectively. ④The average treatment needed to achieve tumor ablation were 1.3 for RF group, and 2.5 for PEI group，respectively. ConclusionRF is an efficient treatment for recurrent hepatocellular carcinoma.
ObjectiveTo explore the potential safety problems of acute alcohol intoxication. MethodsBetweenDecember 2009 and December 2012, 508 patients with acute alcohol intoxication were admitted to the Department ofEmergency of our hospital. We analyzed the potential safety problems of acute alcohol intoxication and made relative countermeasures. ResultsThe 508 cases of acute alcohol intoxication were treated with comprehensive measures, such as physical examination, health condition evaluation, airway patency maintaining, vein channel establishing, accelerating in vivo alcohol exclusion, maintaining consciousness, taking safety protective measures, and strengthening the communication between doctors and patients. There was no accident injury or death occurred. ConclusionWe should pay more attention to the potential safety problems of patients with acute alcohol intoxication, and take measures to ensure their safety.
ObjectiveTo summarize the epidemiology of nonalcoholic fatty liver disease (NAFLD) and the epidemiological and economic burdens of NAFLD, so as to provide a reference for hospital management decision-making. MethodThe domestic and foreign guidelines relevant to NAFLD and the literatures relevant to epidemiological investigation and disease burden researches were summarized and its research progress was reviewed. ResultsThe global prevalence of NAFLD was increasing over years. The incidence, mortality, and disability adjusted life years of liver cirrhosis and liver cancer caused by NAFLD had increased year by year. The patients relevant to NAFLD of inpatients and outpatients had increased obviously, and the overall medical expenses had also shown a rising trend. The possible reasons were health care awareness, new drug research, population aging, and excessive medical consumption. In addition, children and adolescents with NAFLD had a obviously increased risk of liver or extrahepatic diseases. ConclusionsBy understanding the epidemiological trend of NAFLD, it is a certain understanding of the disease burden of NAFLD and the related factors affecting the increase of its treatment cost. It is believed that it is necessary to further pay attention to and strengthen the genetic characteristics, pathogenesis, drug research and development, and early diagnosis of cirrhosis and liver cancer relevant to NAFLD in the future. At the same time, the NAFLD group of children and adolescents should not be ignored.
ObjectiveTo expounded the relationship between phenylalanine, tyrosine and their metabolites and non-alcoholic fatty liver disease (NAFLD). MethodThe literatures related to NAFLD in recent years were reviewed and analyzed. ResultThe levels of phenylalanine, tyrosine and their metabolites had changed significantly in the occurrence and development of NAFLD, and could lead to the progress of NAFLD by affecting the related pathways of lipid metabolism. ConclusionPhenylalanine, tyrosine and their related metabolites are associated with NAFLD, but the specific pathogenesis is still unclear.
Objective To explore the characteristics of cognitive impairment in patients with alcohol dependence, and analyze the related influencing factors. Methods The Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of 65 alcohol dependent patients hospitalized between January 1st and December 31st, 2014. The features of cognitive impairment and related influencing factors were analyzed. Results The differences of MoCA attention and delayed recall between different drinking year groups had statistical significance (P<0.05). The correlations of drinking year with MoCA attention (r=–0.250,P=0.044), and with delayed recall (r=–0.326,P=0.008) were both negative. MoCA scores, naming, attention and delayed recall were different statistically among different age groups (P<0.05). The correlations of ages with MoCA scores (r=–0.429,P<0.001), naming (r=–0.261,P=0.035), attention (r=–0.391,P=0.001) and delayed recall (r=–0.461,P<0.001) were all negative. MoCA scores, the visuoconstructional skills, language, abstraction and delayed recall were significantly different among different education level groups (P<0.05). The correlations of education level with MoCA scores (rs=0.650,P<0.001), the visuoconstructional skills (rs=0.540,P<0.001), language (rs=0.486,P<0.001), abstraction (r=0.602,P<0.001) and delayed recall (rs=0.593,P<0.001) were all positive. Ages had an effect on MoCA scores by multiple linear regression analysis (P<0.01). Conclusions For alcohol dependent patients with cognitive impairment, cognitive function is correlated with drinking year, age and education level. The cognitive function is much serious in patients with older age and longer drinking years. This kind of patients should be focused on and intervened early.
Objective To explore the relationship between alcohol induced osteonecrosis of the femoral head (ONFH) and the single nucleotide polymorphisms (SNP) of methylene tetrahydrofolate reductase (MTHFR) 677 C/T. Methods From July 2005 to May 2008, eighty-nine male patients with alcohol induced ONFH were selected as the patient group, aged from 24 to58 years old (mean 44.3 years old). The time of drinking was about 17 years, 375 mL/day. The imaging evidence showed ONFH with no other history associated to ONFH. Seventy-seven male healthy adults were selected as the control group, aged from 23 to 52 years old (mean 42.7 years old). The time of drinking was about 14 years, 335 mL/day. The imaging evidence showed no ONFH. The 2 mL blood sample was acquired from every subject. DNA was purified from leucocyte at first, then was ampl icated by PCR, the product of PCR was sequenced at last. The SNP of MTHFR 677 C/T was analyzed with SPSS 12.0 software package. Results The TT genotype and T allele frequencies of MTHFR 677 C/T were 27.2% and 52.0% (P gt; 0.05) in the control group, and the distribution of genotype was consistent with Hardy-Weinberg equil ibrium. The genotype frequencies of CC, CT and TT were 23.4% (18 cases), 49.4% (38 cases) and 27.2% (21 cases) in the control group, were 14.6% (13 cases), 36.0% (32 cases) and 49.4% (44 cases) in the patient group; showing statistically significant differences (P lt; 0.05). The allele frequencies of C and T were 48.0% (74) and 52.0% (80) in the control group, and were 32.6% (58) and 67.4% (120) in the patient group; showing statistically significant differences (P lt; 0.05). The frequencies of C, T alleles and TT genotype were higher in the patient group than in the control group, showing statistically significant differences (P lt; 0.05). The odds ratios were 0.523, 1.914 and 2.607, respectively; the 95% confidence interval were 0.335-0.816, 1.226-2.987, 1.359-5.001, respectively. Conclusion The relationship may exist between the SNP of MTHFR 677 C/T and alcohol induced ONFH.
ObjectiveTo understand the current research progress on the role of hydrogen sulfide (H2S) in liver diseases. MethodThe relevant literature on the role of H2S in the liver diseases published in recent years was retrieved and reviewed. ResultsCurrent research focused primarily on exploring the mechanisms of H2S in various liver diseases. Studies had shown that H₂S played an important role in the occurrence and development of liver diseases through mechanisms such as antioxidative stress, anti-inflammatory effects, regulation of autophagy, endoplasmic reticulum stress, angiogenesis, and cell death. ConclusionsBy supplementing exogenous H2S, adjusting the gut microbiota, or inhibiting key enzymes involved in H₂S synthesis, the concentration of H2S in the body can be modulated, providing new strategies for treating liver diseases. However, the related mechanisms are still controversial. Future research should further investigate the specific role of H2S in different liver diseases and how to precisely control its level in the body to achieve targeted drug delivery.
Objective To investigate and analyze the relationships among glucagon-like peptide-1 (GLP-1) level, chronic inflammation, and atherosclerosis in patients with non-alcoholic fatty liver disease (NAFLD). Methods From October 2016 to February 2017, using cross-sectional investigation, the GLP-1 level, chronic inflammation, and atherosclerosis were investigated in 80 subjects (40 NAFLD patients in NAFLD group, and 40 non-fatty liver disease participants in control group) who underwent physical examination at Xi’an Road Community Hospital. Results Compared with those in the control group, GLP-1 fasting level in patients with NAFLD [(9.09±1.03) vs. (9.15±1.06) pmol/L, P=0.807] and postprandial plasma GLP-1 [(15.96±3.37) vs. (17.46±4.76) pmol/L, P=0.108] had no changes. The correlations of GLP-1 level with chronic inflammation and insulin resistance (IR) were not significant either. The increased risk of carotid intima-media thickness related cardiovascular disease (CVD) in the NAFLD group was greater than that in the control group, and the difference was statistically significant [22 (55.0%)vs.13 (32.5%), P=0.043]. When the plasma lipoprotein-associated phospholipase A2 level increased, the risk of NAFLD increased [odd ratio (OR)=1.16, 95% confidence interval (CI) (1.02, 1.32), P=0.023]. Plasma ceramide kinase (CERK) in the NAFLD group was lower than that in the control group, and the difference was statistically significant [(12.36±2.45) vs. (18.33±3.71) ng/mL, P<0.001]. When the plasma CERK level of the fasting plasma was elevated, the risk of NAFLD decreased [OR=0.30, 95%CI (0.12, 0.78), P=0.014]. The homeostasis model assessment of insulin resistance (HOMA-IR) in the NAFLD group was higher than that in the control group, and the difference was statistically significant (2.46±2.53 vs. 1.11±0.66, P=0.002). The Matsuda index in the NAFLD group was less than that in the control group, and the difference was statistically significant (5.88±4.09 vs. 10.46±7.90, P=0.002). When HOMA-IR increased, the risk of NAFLD increased [OR=2.75, 95%CI (2.49, 3.12), P=0.036]. Conclusions Plasma GLP-1 level is not a sensitive indicator of chronic inflammation and IR in patients with NAFLD. Patients with NAFLD are in an increased risk of atherosclerosis and CVD. It suggests that NAFLD might be involved in chronic inflammation and IR. Chronic inflammation can cause IR, and then chronic inflammation and IR can cause NAFLD and subclinical atherosclerosis. In return for this, NAFLD increases chronic inflammation and IR.
目的:探讨使用院前指数(Prehospital Index, PHI)及格拉斯哥昏迷评分(Glasgow Coma Score, GCS)两种创伤评分法对院前急救中急性酒精中毒合并外伤性颅内出血患者的评估价值。方法: 纳入68例院前急救中酒精中毒合并头外伤患者,院前均进行PHI及GCS两种创伤评分,随访至出院,以头部CT扫描及随访结果作为标准以判断患者是否伴有颅内出血。计算两种创伤评分的敏感度、特异度、阳性似然比、阴性似然比、阳性预测值、阴性预测值及Youden指数,并作出受试者工作特征曲线(ROC曲线),以正态离差值Z检验两种评分法ROC曲线下面积的差异。 结果: 院前指数以6分作为诊断界值,敏感度为94.7%,特异度为71.4%;格拉斯哥昏迷评分以9分作为诊断界值,敏感度为98.8%,特异度为30.6%,PHI及GCS的ROC曲线下面积分别是0.881和0.678,其差异有统计学意义。结论: 在对急性酒精中毒合并头外伤患者是否伴有颅内出血的院前评估中,院前指数较格拉斯哥昏迷评分更有价值。