Comparison of Ablation Area and Change in Functional Liver Reserve after Radiofrequency Ablation for Hepatocellular Carcinoma Using the arfa® and VIVA® Systems

Radiofrequency ablation (RFA) is recommended in Japan for patients with hepatocellular carcinomas (HCCs) one to three in number and ≤3 cm in size. The arfa® and VIVA® RFA systems are widely used for patients with HCC and this retrospective observational study aims to compare their performances. The study included 365 patients with HCCs one to three in number and ≤3 cm in size who underwent RFA using the arfa® system (arfa® group) or the VIVA® system (VIVA® group). The total bilirubin (T-Bil) level after RFA was higher in the arfa® group than in the VIVA® group. With a 3-cm electrode needle, the longest diameter (Dmax) and the shortest diameter were analyzed and found to be greater in the arfa® group than in the VIVA® group. Furthermore, Dmax with the 2.5-cm electrode needle was greater in the arfa® group than in the VIVA® group. Statistically significant differences in the ablation area and in the T-Bil value after RFA were observed between the groups; however, these differences are not considered clinical problems because the difference in the ablation area was only slight and the Child–Pugh score was the same between the groups. Thus, hepatologists can use either of the RFA systems based on their preference.

Identification of RAGE and OSM as New Prognosis Biomarkers of Severe Pneumonia

Objective. To investigate efficiency of RAGE and OSM as new prognosis biomarkers of severe pneumonia. Methods. Eligible patients were classified into hypoxemia and nonhypoxemia groups. Meanwhile, the same cohort was divided into survival and nonsurvival groups after a post-hospital stay of 30 days. We analyzed risk factors for the hypoxia and death among these patients. Results. Compared with nonsurvival group, significant increase was noticed in PH, lymphocyte, albumin and platelet level in survival group, while significant decline was noticed in neutrophils, RBC, hemoglobin, hematocrit, creatinine, total bilirubin, CRP, PCT, OSM, RAGE and neutrophils/lymphocyte level. Oxygenation index level was related to APACHE II, LIS, SOFA, NUTRIC score, WBC, neutrophils, lymphocyte, RAGE, and albumin level ( p < 0.05 ). LIS, SOFA, NUTRIC score, lac, lymphocyte, platelet, BUN, total bilirubin, PCT, and OSM levels were associated with mortality rate ( p < 0.05 ). Conclusions. RAGE and OSM may serve as a new biomarker for poor prognosis in pneumonia patients.

Relationship of circulating total bilirubin, UDP-glucuronosyltransferases 1A1 and the development of non-alcoholic fatty liver disease: a cross-sectional study

Background This study aimed to investigate the correlation of circulating total bilirubin (TB) and UGT1A1 with NAFLD in Chinese Han population. Methods 172 adults were enrolled from the Qingdao Municipal Hospital from May 2019 to October 2020. All individuals were examined with MRI-PDFF and divided into no steatosis, mild steatosis, moderate steatosis, and severe steatosis groups according to the MRI-PDFF values. The biochemical indexes and UGT1A1 were measured. Results There was no significant difference of circulating TB and UGT1A1 levels between NAFLD group and controls. In the moderate steatosis and severe steatosis groups, the circulating TB levels were higher than that in control group (all P < 0.05). In addition, circulating TB levels were weak positively associated with liver fat fraction in NAFLD patients (ρ = 0.205, P = 0.001). There was no significant correlation between circulating UGT1A1 levels with liver fat fraction in patients with NAFLD (ρ = 0.080, P = 0.179), but positively correlation was found in patients with severe steatosis (ρ = 0.305, P = 0.026). Conclusions The circulating TB levels were significant high in patients with moderate and severe steatosis. Circulating TB levels were weakly associated with liver fat fraction in patients with NAFLD, and the circulating UGT1A1 levels were positively correlated with liver fat fraction in NAFLD patients with severe steatosis. Trial registration: ChiCTR, ChiCTR1900022744. Registered 24 April 2019 – Retrospectively registered, http://www.chictr.org.cn/edit.aspx?pid=38304&htm=4.

The Nonlinear Relationship Between Total Bilirubin and Coronary Heart Disease: A Dose-Response Meta-Analysis

Background: Evidence suggests that the total bilirubin has a protective effect on coronary heart disease (CHD), but the dose-response relationship remains controversial, and there is no meta-analysis to assess the relationship.Methods: As of October 1, 2021, relevant literature was selected from four databases (PubMed, Web of Science, Cochrane Library, and Embase) by using a retrieval strategy. The dose-response curve between the total bilirubin and CHD was fitted by a restricted cubic spline. Stata 12.0 was used for statistical analysis.Results: A total of 170,209 (6,342 cases) participants from 7 prospective studies were analyzed in our meta-analysis. We calculated the pooled relative risks (RRs) and 95% CIs for the association between serum bilirubin level and risk of CHD using random-effects models. Compared with the first quantile, the bilirubin level in the third quantile had a protective effect on the risk of CHD (RR, 0.90; 95% CI, 0.82–0.99). The restricted cubic spline functions depicted a U-type curve relationship between bilirubin (3.42–49 μmol/L) and CHD (Plinear &lt; 0.001). When the bilirubin level was in the range of 3.42–13μmol/L, the protective effect of bilirubin on CHD was enhanced with increasing bilirubin levels. When the bilirubin level exceeded 13μmol/L, the protective effect of bilirubin weakened, and a dangerous effect gradually appeared with further increases in bilirubin levels.Conclusions: Compared with a low bilirubin level, a high bilirubin level has a protective effect on the risk of CHD, and there was a U-shaped dose-response relationship between them.

Changes in serum adenosine deaminase and isoenzyme levels in addition to routine liver biochemical parameters in sheep with chronic fascioliasis

ABSTRACT: This study assessed changes in the levels of adenosine deaminase (ADA) and its isoenzymes in addition to routine liver biochemical parameters in sheep with fascioliasis. The study was conducted on 35 Akkaraman sheep. Of these, 25 sheep were diagnosed with fascioliasis based on anamnesis and clinical signs, and had endoparasites based on parasitological examinations (Fasciola-infected group). The remaining 10 sheep that were sampled from a single healthy herd (same flock) different from the infected group did not have any clinical signs or endoparasites (control group). Total protein (TP), albumin (ALB), and globulin (GLB) levels gradually increased on days after treatment compared to the values measured before treatment; the increases were statistically significant on all days for TP levels but only on day 14 after treatment for GLB levels (P < 0.05). Although, the ALB levels did not increase significantly on days after treatment, the ALB level and ALB/GLB ratio on days 7 and 14 after treatment were still lower than the values of day 21 after treatment and control group (P < 0.05). Total bilirubin (T-Bil) and direct bilirubin (D-Bil) levels on days 14 and 21 were significantly lower than that of day 0 (before treatment) and day 7 after treatment (P < 0.05). These results indicated that the increase in adenosine deaminase (ADA) and ADA1 levels may be due to possible concomitant infection of Fasciola larvae (in the parenchyma) and adults (in the bile duct).

Predictors of the development of hepatorenal syndrome

Objective. To identify the predictors of the development of hepatorenal syndrome in patients with liver cirrhosis.Materials and methods. We analyzed the medical records of 79 patients diagnosed with liver cirrhosis. The laboratory research included general and biochemical blood tests. The general blood test measured erythrocyte and leukocyte counts. The biochemical blood test measured the content of ALT (U/L), AST (E/L), total bilirubin (μmol/L), direct bilirubin (μmol/L), indirect bilirubin (μmol/L), alkaline phosphatase (U/L), albumin (g/L), urea (mmol/L), creatinine (mmol/L), cholesterol (mmol/L).Viral hepatitis markers were determined for all the patients.Results. The predictors of the development of hepatorenal syndrome were identified: increased leukocyte count, increased total and indirect bilirubin levels, urea level and decreased erythrocyte count and albumin level. The most specific predictors were the amount of indirect bilirubin (98 %) and the content of albumin in the serum (89.8 %), and the most sensitive predictors were AST (96.7 %) and the content of red blood cells and creatinine (73.3 %).Conclusion. The most significant predictors of the development obtained will contribute to the diagnosis of the development of hepatorenal syndrome in patients with liver cirrhosis.

Effect of stem bark hydroalcoholic extract of cocoa (T. Cacao) on liver function of Wistar albino rats induced with anaemia

The study investigated the effect of stem bark hydroalcoholic extract of cocoa (Theobroma cacao) on liver function of phenlyhydrazine (PHZ)-induced forty anaemic (treated) and normal albino rats divided into 8 groups of five rats each in the study. The activities of marker enzymes such as aspartate amino transferase (AST), alanine amino transferase (ALT) and alkaline phosphatase (ALP), were assayed. In addition serum total protein, total bilirubin, albumin were determined. There was a significantly (p<0.05) decrease in AST of anaemic not treated rats compared to normal control rats with the exception of serum total protein, total bilirubin, direct bilirubin, albumin, ALT and ALP where no significant (p>0.005) change was recorded. In the group (anaemic rats) treated with bark extract of Theobroma cacao at the doses of 100, 200, and 500mg/kg, AST was significantly (p<0.05) reduced while there was significant (p>0.05) increase in serum total protein, total bilirubin, albumin, ALT and ALP. In the group (non anaemic rats) treated with graded doses of the extract 200mg, 500mg and 1000mg, there was a significant (p<0.05) of total bilirubin diect bilirubin, and AST while no significant (p>0.05) change was recorded. The study illustrate that the bark extract of Theobroma cacao possess antioxidant and membrane permeability properties. Dose of Theobroma cacao at 500mg does not have antianaemic potentials.

EVALUATION OF IN VITRO ANTIOXIDANT AND IN VIVO HEPATOPROTECTIVE ACTIVITY OF BAUHINIA VARIEGATA ROOT ETHANOLIC EXTRACT AGAINST CCL4 INDUCED LIVER INJURY IN RATS

Plant derived herbal formulations and remedies provide an effective means for the treatment of various types of disease that are dogmatic and incurable in other types of systems of medicines, but it is essential to explore and establish the scientific basis for therapeutic action of herbal plant medicines. Bauhinia variegata root ethanolic extract was studied for the hepatoprotective activity against CCl4 induced liver injury in rats. For estimation of hepatoprotective role of B. variegata, total bilirubin count, serum enzymes level and finally histopathological study of liver were performed. This extract’s DPPH radical scavenging potential was also studied. The ethanolic extract of B. variegata root administered orally to animal showed significant depletion in CCL4 induced increased level of SGPT, SGOT, ALP and total bilirubin concentration. Significantly (p<0.05), hepatotoxicity is reversed by treatment with Liv 52 syrup also. For initiation of biochemical analysis, the histopathological studies are provided supportive evidence. This extract also showed better activity in quenching DPPH radical. The ethanolic extract of B. variegata root shows antioxidant property by preventing the formation of trichloromethyl peroxy radicals, and thus reduce tissue damage, which is examined and confirmed by the histopathological studies. Therefore, the hepatoprotective activity of ethanolic extract of B. variegata root may be due to its antioxidant potential. Previously studies have reported that plants containing flavonoids possess antioxidant properties. The antioxidant and hepatoprotective properties of the test plant may be attributed to the presence flavonoids. B. variegata root ethanolic extract is shown to have hepatoprotective and antioxidant action.

Alterations in Various Biochemical Parameters Among Covid-19 Patients: An Observational Retrospective Analysis

Novel coronavirus causing the pandemic infectious disease termed as COVID-19 is characterized by respiratory illness which may lead on to acute respiratory distress syndrome. Ferritin is a key mediator of immune dysregulation leading on to cytokine storm. Alterations in various biochemical parameters have been widely reported in COVID-19. Early identification of effective biomarkers to assess the severity of this disease is essential. Our study was aimed to evaluate the variations in the routinely analysed biochemical parameters and their association with ferritin levels among COVID patients. The study participants consisted of 270 members among which 149 were COVID positive and 121 were negative. Analysis of the routine biochemical parameters as well as ferritin level were carried out. Among the 149 positive cases, 84 (56.4%) were mild positive with ferritin levels <500ng/ml and 65 (43.6%) were severe positive with ferritin levels >500ng/ml. We reported significant increase in serum ferritin levels in severe positive samples (1449.84 ± 249.47) compared to mild positive samples (230.04 ± 17.41). We observed increased levels of total bilirubin in 12.7%, direct bilirubin in 16.8%, indirect bilirubin in 8.7%, AST in 65.8%, ALT in 44.3%, ALP in 9.4%, GGT in 51.7%, urea in 18.4%, creatinine in 14.3%, BUN in 18.4% and decreased levels of total protein and albumin in 23.5% positive patients compared to negative patients. Ferritin and its associated biochemical parameters act as predictors of COVID severity. These biochemical alterations suggest the significance of early risk assessment and monitoring of COVID patients.