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Table of Content

    15 August 2017, Volume 22 Issue 8
    Cardiovascular risk analysis in nonalcoholic fatty liver disease patients complicated with hyperuricemia
    LI Shao-feng, YE Jun-zhao, LI Rui, HU Xuan, Zhao Wen-wen, ZHONG Bi-hui. Department of Gastroenterology, The First Affiliated Hospital of Sun Yat Sen University, Guangzhou 510080, China
    2017, 22(8):  675-679. 
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    Objective To investigate the risk of hyperuricemia on cardiovascular disease in patients with non-alcoholic fatty liver disease (NAFLD).Methods Patients diagnosed of NAFLD in both outpatient and inpatient in our hospital from 2009 to 2015 were enrolled, who were ≥ 18-year old and without the other liver diseases or excessive drinking history. Framingham scoring system and carotid artery ultrasonography were applied for assessing cardiovascular risk.Results A total of 678 NAFLD patients were enrolled, including 410 patients with normal uric acid and 268 patients with hyperuricemia (HUA).Among the 678 NAFLD patients, 233 received carotid artery ultrasonography. Compared to normal uric acid group, HUA group showed higher levels of waist-hip ratio, body mass index (BMI), diastolic blood pressure, triglyceride (TG), fasting plasma glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR) and prevalence rate of metabolic syndrome, but lower level of high-density lipoprotein cholesterol (HDL-C) (P<0.05), respectively. Male and female patients were divided into four groups by uric acid level, respectively. Framingham risk showed significantly positive correlation to uric acid level (P=0.012), while no significant differences were observed in carotid intima media thickness (CIMT), incidence of thickening carotid artery and carotid artery plaque among the 4 groups with different uric acid levels (P=0.691, 0.384 and 0.936, respectively). Further analysis revealed that uric acid was not associated with Framingham risk and CIMT.Conclusion Metabolic disorder was more noticeable in NAFLD patients with HUA than that in NAFLD patients with normal uric acid. Ten-year cardiovascular risk exerts a positive correlation with uric acid level.
    Feasibility, safety and efficacy of ultrasound-guided percutaneous microwave ablation for giant hepatic hemangioma
    QI Xing-xing, TANG Xiao-yin, WANG Zhi, WANG Tao, CUI Dan, ZHAI Bo
    2017, 22(8):  680-684. 
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    Objective To investigate the feasibility, safety and efficacy of microwave ablation (MWA) guided with ultrasound in the treatment of giant hepatic hemangioma (≥ 10 cm in diameter).Methods A total of 13 tumors (≥ 10 cm in diameter) in 12 patients with giant hepatic hemangioma received ultrasound-guided percutaneous MWA in our hospital from December 2013 to June 2016. MWA-related complications were observed. The effcacy of MWA for all patients was assessed using magnetic resonance imaging or enhanced computed tomography within one month after treatment.Results Four male and 8 female patients were enrolled with average age of 41 ± 10 years old (31-65 years old). Besides 1 patient had two hepatic hemangiomas (≥ 10 cm in diameter), the other 11 patients had one hepatic hemangioma (≥ 10 cm in diameter). The average diameter of hemangiomas was 11.7 ± 1.6 cm, ranging from 10 to 14.5 cm. The 13 giant hemangiomas underwent 17 MWA treatments, including 4 received treatment twice. The mean time of single hemangioma ablation was 39.0 ± 14.4 minutes (20-62 minutes). After treatment, 2 patients experienced acute non-oliguric renal dysfunction without other complications, such as intra-abdominal hemorrhage and liver failure. With average follow-up of 20.7 months (5-36 months), 10 giant hemangiomas in 9 patients achieved complete ablation with significant reduction in volume. The primary complete ablation rate was 76.9% (10/13). One patient who failed to the primary treatment received a second MWA treatment 5 months later, and then achieved complete ablation. So the overall complete ablation rate was 84.6% (11/13). Two patients were reviewed regularly without further therapies for small residual tumors.Conclusion Ultrasound-guided percutaneous MWA is a safe, feasible and effective treatment for giant hepatic hemangiomas.
    Efficacy comparison between resveratrol and ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy
    LIAO E, SHAO Yong
    2017, 22(8):  685-689. 
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    Objective To compare the efficacy between resveratrol (RES) and ursodeoxycholic acid (UDCA) in the treatment of intrahepatic cholestasis of pregnancy (ICP).Methods Seventy Sprague-Dawley (SD) rats on day 13 of pregnancy were induced ICP using 17-α ethinyl estradiol, and divided into control group, ICP group and 5 treatment groups [low-dosage RES (LRES) group, middle-dosage RES (MRES) group, high-dosage RES (HRES) group, UDCA group and UDCA combined with MRES (UDCA-MRSV) group]. Livers were collected for histological analysis using hematoxylin and eosin (HE) staining. Serum levels of total bile acid (TBA) and alanine aminotransferase (ALT) were measured before and after treatment in all 5 treatment groups. Stillbirth rate of each group was counted. Immunohistochemistry and western blot were applied for determining intrahepatic levels of silent information regulator 1 (SIRT1) and tumor necrosis factor-α (TNF-α).Results Compared with ICP group, LRES could obviously decrease TBA (31.81±15.19 umol/L, P<0.05), and MRES could obviously decrease the stillbirth rate (14.29%, P<0.05). UDCA-MRSV might synergistically reduce TBA level (27.77±7.43 umol/L, P<0.05), but with a higher rate of stillbirth (36.26%, P<0.05) than the single drug treatment. RES could enhance SIRT1 expression (P<0.05) and decrease TNF-α expression (P<0.05).Conclusion RES might be a potential option in treatment of ICP, of which effective dosage needs further investigation.
    Hepatitis C virus core protein induces dysfunction of liver sinusoidal endothelial cell by down-regulation of silent information regulator
    SUN Li-jie, SHI Yu-guang, ZHANG Xiao-yu, SHU Meng-ni, CHEN Mo-yang, YU Jian-wu.
    2017, 22(8):  690-694. 
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    Objective To investigate the effect of hepatitis C virus (HCV) core protein on expression of silent information regulator 1 (SIRT1) and function of liver sinusoidal endothelial cell (LSEC).Methods LSEC was co-cultured with HepG2 cells with/without expressing HCV core protein, respectively. After co-culture, the activity and expression levels of SIRT1 in LSEC were detected by scintillation counter in mRNA and protein levels, using real-time polymerase chain reaction (RT-PCR) and western blot, respectively. Levels of adiponectin receptor 2 (AdipoR2), endothelial nitric oxide synthase (eNOS), von Willebrand factor (vWf), cluster of differentiation (CD) 31, vascular endothelial growth factor (VEGF) and CD14 were measured using western blot. Level of reactive oxygen species (ROS) was assayed using flow cytometry. Levels of malondialdehyde (MDA), superoxide dismutase (SOD), adiponectin, nitric oxide (NO) and endothelin-1 (ET-1) in the supernatant were measured. The quantitative data was analyzed using t-test.Results Compared with co-culture cells without expressing HCV core protein, the co-culture cells with expressing HCV core protein showed lower activity (0.3±0.1 vs 1.0±0.3, t=5.422, P<0.01), mRNA (0.4±0.1 vs 1.0±0.2, t=6.573, P<0.01) and protein (0.3±0.08 vs 1.0±0.3, t=5.613, P<0.01) of SIRT1; vWf protein (0.8±0.3 vs 0.4±0.1, t=3.098, P<0.01), CD31 protein (0.9±0.2 vs 0.3±0.1, t=6.573, P<0.01) and VEGF protein (0.9±0.3 vs 0.5±0.1, t=3.873, P<0.01); lower levels of adiponectin (3.41±0.61 vs 5.82±0.87μg/mL, t=5.556, P<0.01), AdipoR2 protein (0.3±0.1 vs 0.8±0.2, t=5.477, P<0.01), eNOS protein (0.4±0.1 vs 0.9±0.3, t=3.873, P<0.01) and CD14 protein (0.4±0.1 vs 0.9±0.3, t=3.873, P<0.01), respectively. Additionally, compared to those in the supernatant of co-culture cells without expressing HCV core protein, NO and SOD levels were decreased in co-culture cells with expressing HCV core protein, whereas ET-1 and MDA levels were increased.Conclusion HCV core protein may down-regulate the activity and expression of SIRT1, decrease adiponectin and AdipoR2, subsequently induce LSEC contraction and hepatic sinusoidal capillarization, as well as increase oxidative stress, ultimately lead to liver microcirculation disturbance.
    Three methods to identify hepatitis B virus strains with C/D recombinant
    LI Ji-jie, BAO Cheng-lan, GAMA Cai-pei, WANG Yun, LI Wei, ZHOU Bin, WANG Zhan-hui, LI Hua
    2017, 22(8):  695-699. 
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    Objective To investigate accurate method for identifying hepatitis B virus strains with C/D recombinant.Methods A total of 25 patients with chronic hepatitis B from western China were enrolled in this study. Three methods, containing polymerase chain reaction (PCR) of fragment length analysis, phylogenetic analysis based on S and preC/C gene, and full genome precise analysis, were compared.Results On account of the 33bp deletion in preS1 of genotype D, a PCR fragment spanning the preS1 region could identify C/D recombinant from genotype D, which was easy to perform and suitable for large sample screening. Phylogenetic analysis based on S and preC/C gene could identify C/D recombinant with high accuracy. Full genome precise analysis could identify C/D recombinant precisely and accurately which was the most reliable method.Conclusion For various research purposes, the application of the 3 methods should be performed comprehensively to improve the efficiency and reliability in identification of C/D recombinant.
    Establishment and evaluation of a mice model for non-alcoholic fatty liver disease induced using fructose
    ZHANG Cheng-liang, HE Wen-xi, XU Yan-jiao, CHANG Mu-jun, XIANG Dong, YANG Jin-yu, LIU Dong
    2017, 22(8):  700-704. 
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    Objective To investigate the features of the mice model for non-alcoholic fatty liver disease (NAFLD) induced using fructose.Methods C57BL/6 mice in NAFLD group were continuously fed with 30%(w/v)fructose solution for 8 weeks, while mice in normal control group were fed with distilled water. Body weight of mice in both groups was recorded. Liver was weighted and liver index was calculated after mice were sacrificed at week 2, 4, 6 and 8. Serum levels of glucose and insulin were measured and fasting insulin resistance index (FI-IR) was calculated. Indexes of lipid metabolism in serum were detected using corresponding kits. The histopathology of livers was analyzed using oil red staining and hematoxylin and eosin (HE) staining.Results Compared with those in normal control group, the body weight, liver weight and liver index of mice in NAFLD group increased obviously (P<0.05). FI-IR in NAFLD group increased continuously and was up to 4.7 times of that in normal control group at week 8 (P<0.05). Compared with normal control group, NAFLD group showed significantly higher serum levels of triglyceride, total cholesterol, low density lipoprotein and free fatty acid, while markedly lower level of high density lipoprotein (P<0.05). The histopathological results displayed small lipid droplets in liver of NAFLD group at week 2 and obvious diffused macro-vesicular lipid droplets and fat infiltration at week 8.Conclusion Thirty percent fructose diet could successfully establish NAFLD mice model, which shows similar pathological features and biochemical indices with NAFLD patients. This model can be used for the study of pathogenesis and therapy of fructose-induced NAFLD.