During the past 42 months, a total of 53 patients with primary hepatic carcinoma (PHC) had been treated by fine needle percutanous ethanol intratumor infiltration (group P) and ethanol infiltration combined with intrahepatoportal chemotherapy around carcinoma, using adriamycin (group PA) or using adriamycin, carboplytin mitomycin and 5-Fu (group PC) for two courses. Result showed that 16cases were complete remission and 21 cases were part remission. The overall response rate was 69.8%, with a median survival duration of 10.1 months. After clinical contrast among three groups, the response rate in PA group exceeded P and PC group and adverse reactions was lower than PC group. The authors belive that this method might be a remedial measure for patients who are unsuitable for major surgery.
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.
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.
ObjectiveTo investigate the surgical strategies and clinical efficacy of transmitral septal myectomy in the treatment of recurrent left ventricular outflow tract obstruction (LVOTO) after alcohol septal ablation. MethodsThe clinical data of patients with recurrent LVOTO after alcohol septal ablation from July 2020 to July 2021 in the Department of Cardiac Surgery, Guangdong Provincial People's Hospital were retrospectively analyzed. Patients were preoperatively evaluated by echocardiography, cardiac magnetic resonance imaging, cardiac computed tomography, 3D modeling and printing technology. A personalized surgical strategy was preoperatively developed according to multimodality imaging assessment, while visual exploration was performed on the digital model and simulated surgical resection was performed on the printed model. Results Two female patients were enrolled, aged 62 years and 64 years, respectively. Totally endoscopic transmitral extended myectomy was successfully performed on both patients with aortic cross-clamping time of 96 min and 85 min, respectively. LVOTO was relieved immediately (subaortic peak pressure gradient decreased from 100 mm Hg to 4 mm Hg and from 84 mm Hg to 6 mm Hg, respectively) and the mitral regurgitation significantly improved after the procedure. No patient had complete atrioventricular block or required permanent pacemaker implantation. The patients were discharged uneventfully without postoperative complications. ConclusionPersonalized totally endoscopic transmitral extended myectomy combined with multimodality imaging assessment and 3D modeling and printing has an acceptable clinical effect in patients with recurrent LVOTO after alcohol septal ablation. The procedure can precisely resect the hypertrophic septal myocardium while avoiding serious complications such as septal perforation or complete atrioventricular block.
Objectives To compare umbilical cord daily care protocol in the current clinical setting in which 75% alcohol sterile is used daily for the umbilical and surrounding skins with the WHO-recommended method (dry and clean). Methods A total of 283 full-term newborns were randomly divided into two groups: the trial group (n=181) receiving WHO “dry and clean” protocol that the umbilical cord was open to air (with losing clothes), cleaned by clear water instead of alcohol. The control group (n=102) used the traditional method that after the newborns’ bathing, the umbilical cord and surrounding skins were sterilized with 75% alcohol. The basic condition of the newborns, umbilical departure time and complications around the navel were assessed. And bacterial culture from the newborns’ skins was observed. Results There were no significant differences in departure time of the umbilical cord (7.64±3.29 day vs. 8.50±3.45 days t=1.82, Pgt;0.05), complications (6 patients with slight omphalitis in the trial group and 2 patients with slight omphalitis in the control group), and the skin flora culture between the two groups. The umbilical cord of the newborns dropped off safely. And no fever was found. Conclusion This study does not support that 75% alcohol can prevent the umbilical cord from being infected. Keeping the umbilical cord and surrounding skins dry is important for infection control.
Objective To analyze the disease burden of liver cancer caused by nonalcoholic steatohepatitis (NASH) among the Chinese population by utilizing the latest global burden of disease (GBD) 2021 data, and conduct a comparative analysis with the global situation, so as to provide references and lessons for the formulation of public health policies and disease management plans in China. Methods GBD 2021 database publicly released in May 2024 was searched and relevant disease burden data of liver cancer caused by NASH in China and globally from 1990 to 2021 was sorted out. Joinpoint regression model was employed to calculate the average annual percentage change (AAPC) of the age-standardized rates of various burden indicators in order to evaluate the changing characteristics of disease epidemiology over time. Meanwhile, Bayesian method was used to predict the number of incidences and deaths of liver cancer caused by NASH in China and globally from 2022 to 2045. Results Compared with 1990, in 2021, the number of incidences, prevalence, deaths, disability-adjusted life years, age-standardized incidence rate and age-standardized prevalence rate of liver cancer caused by NASH in the overall, male and female populations in China and globally all increased. Moreover, in 1990 and 2021, all the burden indicators of the Chinese male population were higher than those of the female population in the corresponding years. The overall trend analysis showed that during the 32 years from 1990 to 2021, the age-standardized incidence rate [AAPC=0.44%, 95%CI (0.35%, 0.53%), P<0.001] and the age-standardized prevalence rate [AAPC=0.92%, 95%CI (0.73%, 1.11%), P<0.001] of liver cancer caused by NASH in the overall population in China both showed a significant upward trend. In addition, in 1990 and 2021, the age-standardized rates of all the burden indicators of the overall population in China were higher than the global levels in the corresponding years. The prediction results of the Bayesian model showed that from 2022 to 2045, the number of incidences and deaths of liver cancer caused by NASH in the overall, male and female populations in China and globally will generally show an upward trend. Conclusions The disease burden of liver cancer caused by NASH in China and globally is generally on the rise. In order to curb the increasing disease burden, it is necessary to formulate relevant public health policies and disease management plans in a timely manner.
ObjectivesTo systematically review the association between serum high sensitivity C-reactive protein (HS-CRP) and nonalcoholic fatty liver disease (NAFLD).MethodsPubMed, EMbase, The Cochrane Library, CNKI, SinoMed and WanFang Data databases were electronically searched to collect case-control studies on the association between HS-CRP and NAFLD from inception to October, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 22 case-control studies involving 5 825 subjects were included. The results of meta-analysis showed that HS-CRP levels in NAFLD group were higher than non-NAFLD group (SMD=1.25, 95%CI 0.81 to 1.68, P<0.000 01). The results of subgroup analysis showed that, HS-CRP levels in NAFLD group were higher in Asian region (SMD=1.32, 95%CI 0.82 to 1.83, P<0.000 01), however not in American region (SMD=0.48, 95%CI ?0.02 to 0.98, P=0.06). HS-CRP levels in NAFLD group were higher in BMI≥30 kg/m2 group (SMD=0.37, 95%CI 0.19 to 0.54, P<0.000 1), however not in BMI<30 kg/m2 group (SMD=1.19, 95%CI ?0.28 to 2.66, P=0.11). Additionally, HS-CRP levels in NAFLD group were higher with or without diabetes (SMD=0.86, 95%CI 0.49 to 1.24, P<0.000 01; SMD=1.47, 95%CI 0.84 to 2.10, P<0.000 01).ConclusionsCurrent evidence shows that NAFLD patients have higher levels of HS-CRP than non-NAFLD patients, and are affected by high levels of BMI and geographical regions. Therefore, HS-CRP may play important roles in the non-invasive field of NAFLD detection. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
