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Nevin Manimala Statistics

Study on the comparative analysis of the efficacy of transmesenteric vein extrahepatic portosystemic shunt and transjugular intrahepatic portosystemic shunt in the treatment of cavernous transformation of portal vein

Zhonghua Gan Zang Bing Za Zhi. 2023 Jan 20;31(1):90-95. doi: 10.3760/cma.j.cn501113-20221002-00485.

ABSTRACT

Objective: To compare the safety and efficacy of transmesenteric vein extrahepatic portosystemic shunt (TEPS) and transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of cavernous transformation of the portal vein (CTPV). Methods: The clinical data of CTPV patients with patency or partial patency of the superior mesenteric vein treated with TIPS or TEPS treatment in the Department of Vascular Surgery of Henan Provincial People’s Hospital from January 2019 to December 2021 were selected. The differences in baseline data, surgical success rate, complication rate, incidence rate of hepatic encephalopathy, and other related indicators between TIPS and TEPS group were statistically analyzed by independent sample t-test, Mann-Whitney U test, and Chi-square test. Kaplan-Meier survival curve was used to calculate the cumulative patency rate of the shunt and the recurrence rate of postoperative portal hypertension symptoms in both groups. Results: The surgical success rate (100% vs. 65.52%), surgical complication rate (6.67% vs. 36.84%), cumulative shunt patency rate (100% vs. 70.70%), and cumulative symptom recurrence rate (0% vs. 25.71%) of the TEPS group and TIPS group were statistically significantly different (P < 0.05). The time of establishing the shunt [28 (2141) min vs. 82 (51206) min], the number of stents used [1 (12) vs. 2 (15)], and the length of the shunt [10 (912) cm vs. 16 (1220) cm] were statistically significant between the two groups (t = -3.764, -4.059, -1.765, P < 0.05). The incidence of postoperative hepatic encephalopathy in the TEPS group and TIPS group was 6.67% and 15.79% respectively, with no statistically significant difference (Fisher’s exact probability method, P = 0.613). The pressure of superior mesenteric vein decreased from (29.33 ± 1.99) mmHg to (14.60 ± 2.80) mmHg in the TEPS group and from (29.68 ± 2.31) mmHg to (15.79 ± 3.01) mmHg in TIPS group after surgery, and the difference was statistically significant (t = 16.625, 15.959, P < 0.01). Conclusion: The best indication of TEPS is in CTPV patients with patency or partial patency of the superior mesenteric vein. TEPS improves the accuracy and success rate of surgery and reduces the incidence of complications.

PMID:36948855 | DOI:10.3760/cma.j.cn501113-20221002-00485

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Nevin Manimala Statistics

MiR-340 mediates the involvement of high mobility group box 1 in the pathogenesis of liver fibrosis

Zhonghua Gan Zang Bing Za Zhi. 2023 Jan 20;31(1):77-83. doi: 10.3760/cma.j.cn501113-20210302-00100.

ABSTRACT

Objective: To explore the pathogenic mechanism of the miR-340/high mobility group box 1 (HMGB1) axis in the formation of liver fibrosis. Methods: A rat liver fibrosis model was established by injecting CCl(4) intraperitoneally. miRNAs targeting and validating HMGB1 were selected with gene microarrays after screening the differentially expressed miRNAs in rats with normal and hepatic fibrosis. The effect of miRNA expressional changes on HMGB1 levels was detected by qPCR. Dual luciferase gene reporter assays (LUC) was used to verify the targeting relationship between miR-340 and HMGB1. The proliferative activity of the hepatic stellate cell line HSC-T6 was detected by thiazolyl blue tetrazolium bromide (MTT) assay after co-transfection of miRNA mimics and HMGB1 overexpression vector, and the expression of extracellular matrix (ECM) proteins type I collagen and α-smooth muscle actin (SMA) was detected by western blot. Statistical analysis was performed by analysis of variance and the LSD-t test. Results: Hematoxylin-eosin and Masson staining results showed that the rat model of liver fibrosis was successfully established. Gene microarray analysis and bioinformatics prediction had detected eight miRNAs possibly targeting HMGB1, and animal model validation had detected miR-340. qPCR detection results showed that miR-340 had inhibited the expression of HMGB1, and a luciferase complementation assay suggested that miR-340 had targeted HMGB1. Functional experiments results showed that HMGB1 overexpression had enhanced cell proliferation activity and the expression of type I collagen and α-SMA, while miR-340 mimics had not only inhibited cell proliferation activity and the expression of HMGB1, type I collagen, and α-SMA, but also partially reversed the promoting effect of HMGB1 on cell proliferation and ECM synthesis. Conclusion: miR-340 targets HMGB1 to inhibit the proliferation and ECM deposition in hepatic stellate cells and plays a protective role during the process of liver fibrosis.

PMID:36948853 | DOI:10.3760/cma.j.cn501113-20210302-00100

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Nevin Manimala Statistics

Changes of intestinal wall barrier function and its correlation with susceptibility to infection in patients with cirrhotic portal hypertension

Zhonghua Gan Zang Bing Za Zhi. 2023 Jan 20;31(1):70-76. doi: 10.3760/cma.j.cn501113-20220118-00031.

ABSTRACT

Objective: To investigate the changes of intestinal wall barrier function and its correlation with infection occurrence in patients with cirrhotic portal hypertension. Methods: 263 patients with cirrhotic portal hypertension were split into: the clinically evident portal hypertension (CEPH) combined with infection group (n = 74); CEPH group (n = 104); and Non-CEPH group (n = 85). Among them, 20 CEPH patients and 12 non-CEPH patients in non-infection status were subjected to sigmoidoscopy. Immunohistochemical staining was used to detect the expression of trigger receptor-1 (TREM-1), CD68, CD14, the inducible nitric oxide synthase molecule, and Escherichia coli (E.coli) in the medullary cells of the colon mucosa. An enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of soluble myeloid cell trigger receptor-1 (sTREM-1), soluble leukocyte differentiation antigen-14 subtype (sCD14-ST) and intestinal wall permeability index enteric fatty acid binding protein (I-FABP). Fisher’s exact probability method, one-way ANOVA, Kruskal-Wallis-H test, Bonferroni method, and Spearman correlation analysis were used for statistical analysis. Results: The serum sTREM-1 and I-FABP levels were higher in CEPH patients than those of non-CEPH patients in the non-infectious state (P < 0.05), but the difference in blood sCD14-ST levels was not statistically significant (P > 0.05). Serum levels of sTREM-1, sCD14-ST, and I-FABP in infected patients were higher than those in patients without a concurrent infection (P < 0.05). Serum sCD14-ST levels were positively correlated with serum sTREM-1, C-reactive protein (CRP), and procalcitonin (PCT), and sTREM-1 levels were also positively correlated with CRP and PCT (r > 0.5, P < 0.001). The rates of CD68, inducible nitric oxide synthase, CD14-positive cells, and E.coli-positive glands were higher in the intestinal mucosa of the CEPH group than those of the control group (P < 0.05). Spearman’s correlation analysis showed that the rate of E.coli-positive glands in CEPH patients was positively correlated with the expression of molecular markers CD68 and CD14 in the lamina propria macrophages. Conclusion: Patients with cirrhotic portal hypertension have increased intestinal permeability and inflammatory cells, accompanied by bacterial translocation. Serum sCD14-ST and sTREM-1 can be used as indicators to predict and evaluate the occurrence of infection in patients with cirrhotic portal hypertension.

PMID:36948852 | DOI:10.3760/cma.j.cn501113-20220118-00031

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Nevin Manimala Statistics

Comparison of three different measurement methods to determine resting energy expenditure in patients with decompensated hepatitis B cirrhosis

Zhonghua Gan Zang Bing Za Zhi. 2023 Jan 20;31(1):65-69. doi: 10.3760/cma.j.cn501113-20210906-00455.

ABSTRACT

Objective: To compare the differences to determine resting energy expenditure (REE) measured with indirect calorimetry and REE predicted by formula method and body composition analyzer in patients with decompensated hepatitis B cirrhosis, so as to provide theoretical guidance for the implementation of precision nutrition intervention. Methods: Patients with decompensated hepatitis B cirrhosis who were admitted to Henan Provincial People’s Hospital from April 2020 to December 2020 were collected. REE was determined by the body composition analyzer and the H-B formula method. Results: were analyzed and compared to REE measured by the metabolic cart. Results A total of 57 cases with liver cirrhosis were included in this study. Among them, 42 were male, aged (47.93 ± 8.62) years, and 15 were female aged (57.20 ± 11.34) years. REE measured value in males was (1 808.14 ± 201.47) kcal/d, compared with the results calculated by the H-B formula method and the measured result of body composition, and the difference was statistically significant (P = 0.002 and 0.003, respectively). REE measured value in females was (1 496.60 ± 131.28) kcal/d, compared with the results calculated by the H-B formula method and the measured result of body composition, and the difference was statistically significant (P = 0.016 and 0.004, respectively). REE measured with the metabolic cart had correlation with age and area of visceral fat in men (P = 0.021) and women (P = 0.037). Conclusion: Metabolic cart use will be more accurate to obtain resting energy expenditure in patients with decompensated hepatitis B cirrhosis. Body composition analyzer and formula method may underestimate REE predictions. Simultaneously, it is suggested that the effect of age on REE in H-B formula should be fully considered for male patients, while the area of visceral fat may have a certain impact on the interpretation of REE in female patients.

PMID:36948851 | DOI:10.3760/cma.j.cn501113-20210906-00455

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Nevin Manimala Statistics

Diagnostic value of novel hepatic fibrosis markers in assessing cirrhosis in patients with chronic hepatitis C

Zhonghua Gan Zang Bing Za Zhi. 2023 Jan 20;31(1):56-64. doi: 10.3760/cma.j.cn501113-20220329-00149.

ABSTRACT

Objective: To investigate the efficacy of chitinase-3-like protein 1 (CHI3L1) and Golgi protein 73 (GP73) in the diagnosis of cirrhosis and the dynamic changes of CHI3L1 and GP73 after HCV clearance in patients with chronic hepatitis C (CHC) treated with direct-acting antiviral drugs (DAAs). The comparison of continuous variables of normal distribution were statistically analyzed by ANOVA and t-test. The comparison of continuous variables of non-normal distribution were statistically analyzed by rank sum test. The categorical variables were statistically analyzed by Fisher’s exact test and χ(2) test. Correlation analysis was performed using Spearman correlation analysis. Methods: Data of 105 patients with CHC diagnosed from January 2017 to December 2019 were collected. The receiver operating characteristic curve (ROC curve) was plotted to study the efficacy of serum CHI3L1 and GP73 for the diagnosis of cirrhosis. Friedman test was used to compare CHI3L1 and GP73 change characteristics. Results: The areas under the ROC curve for CHI3L1 and GP73 in the diagnosis of cirrhosis at baseline were 0.939 and 0.839, respectively. Serum levels of CHI3L1 and GP73 in the DAAs group decreased significantly at the end of treatment compared with baseline [123.79 (60.25, 178.80) ng/ml vs. 118.20 (47.68, 151.36) ng/ml, P = 0.001; 105.73 (85.05, 130.69) ng/ml vs. 95.52 (69.52, 118.97) ng/ml, P = 0.001]. Serum CHI3L1 and GP73 in the pegylated interferon combined with ribavirin (PR) group were significantly lower at the end of 24 weeks of treatment than the baseline [89.15 (39.15, 149.74) ng/ml vs. 69.98 (20.52, 71.96) ng/ml, P < 0.05; 85.07 (60.07, 121) ng/ml vs. 54.17 (29.17, 78.65) ng/ml, P < 0.05]. Conclusion: CHI3L1 and GP73 are sensitive serological markers that can be used to monitor the fibrosis prognosis in CHC patients during treatment and after obtaining a sustained virological response. Serum CHI3L1 and GP73 levels in the DAAs group decreased earlier than those in the PR group, and the serum CHI3L1 levels in the untreated group increased compared with the baseline at about two years of follow-up.

PMID:36948850 | DOI:10.3760/cma.j.cn501113-20220329-00149

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Nevin Manimala Statistics

Demographic characteristics and associated influencing factors in treated patients with chronic hepatitis B with hypoviremia : a single-center retrospective cross-sectional study

Zhonghua Gan Zang Bing Za Zhi. 2023 Jan 20;31(1):42-48. doi: 10.3760/cma.j.cn501113-20220121-00039.

ABSTRACT

Objective: To investigate the demographic characteristics and clinical influencing factors which associates with the occurrence probability of persistent or intermittent hypoviremia (LLV) in patients with chronic hepatitis B (CHB) treated with nucleos(t)ide analogues (NAs). Methods: A single-center retrospective analysis was performed on patients with CHB who received outpatient NAs therapy for≥48 ± 2 weeks. According to the serum hepatitis B virus (HBV) DNA load at 48±2 weeks treatment, the study groups were divided into LLV (HBV DNA < 20 IU/ml and < 2 000 IU/ml) and MVR group (sustained virological response, HBV DNA < 20 IU/ml). Demographic characteristics and clinical data at the start of NAs treatment (considered as baseline) were retrospectively collected for both patient groups. The differences in the reduction of HBV DNA load during treatment was compared between the two groups. Correlation and multivariate analysis were further conducted to analyze the associated factors influencing the LLV occurrence. Statistical analysis was performed using the independent samples t-test, c2 test, Spearman analysis, multivariate logistic regression analysis, or area under the receiver operating characteristic curve. Results: A total of 509 cases were enrolled, with 189 and 320 in the LLV and MVR groups, respectively. Compared to patients with MVR group at baseline: (1) the demographics characteristics of patients showed that LLV group was younger in age (39.1 years, P = 0.027), had a stronger family history (60.3%, P = 0.001), 61.9% received ETV treatment, and higher proportion of compensated cirrhosis (20.6%, P = 0.025) at baseline; (2) the serum virological characteristics of patients showed that LLV group had higher HBV DNA load, qHBsAg level, qHBeAg level, HBeAg positive rate, and the proportion of genotype C HBV infection but decreased HBV DNA during treatment (P < 0.001) at baseline; (3) the biochemical characteristics of patients showed that LLV group had lower serum ALT levels (P = 0.007) at baseline; (4) the noninvasive fibrosis markers of patients showed that LLV group were characterized by high aspartate aminotransferase platelet ratio index (APRI) (P = 0.02) and FIB-4 (P = 0.027) at baseline. HBV DNA, qHBsAg and qHBeAg were positively correlated with LLV occurrence (r = 0.559, 0.344, 0.435, respectively), while age and HBV DNA reduction were negatively correlated (r = -0.098, -0.876, respectively). Logistic regression analysis showed that ETV treatment history, high HBV DNA load at baseline, high qHBsAg level, high qHBeAg level, HBeAg positive, low ALT and HBV DNA level were independent risk factors for patients with CHB who developed LLV with NAs treatment. Multivariate prediction model had a good predictive value for LLV occurrence [AUC 0.922 (95%CI: 0.897 ~ 0.946)]. Conclusion: In this study, 37.1% of CHB patients treated with first-line NAs has LLV. The formation of LLV is influenced by various factors. HBeAg positivity, genotype C HBV infection, high baseline HBV DNA load, high qHBsAg level, high qHBeAg level, high APRI or FIB-4 value, low baseline ALT level, reduced HBV DNA during treatment, concomitant family history, metabolic liver disease history, and age < 40 years old are potential risk factors for developing LLV in patients with CHB during the therapeutic process.

PMID:36948848 | DOI:10.3760/cma.j.cn501113-20220121-00039

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Nevin Manimala Statistics

Broken bond models, magic-sized clusters, and nucleation theory in nanoparticle synthesis

J Chem Phys. 2023 Mar 21;158(11):114306. doi: 10.1063/5.0132601.

ABSTRACT

Magic clusters are metastable faceted nanoparticles that are thought to be important and, sometimes, observable intermediates in the nucleation of certain faceted crystallites. This work develops a broken bond model for spheres with a face-centered-cubic packing that form tetrahedral magic clusters. With just one bond strength parameter, statistical thermodynamics yield a chemical potential driving force, an interfacial free energy, and free energy vs magic cluster size. These properties exactly correspond to those from a previous model by Mule et al. [J. Am. Chem. Soc. 143, 2037 (2021)]. Interestingly, a Tolman length emerges (for both models) when the interfacial area, density, and volume are treated consistently. To describe the kinetic barriers between magic cluster sizes, Mule et al. invoked an energy parameter to penalize the two-dimensional nucleation and growth of new layers in each facet of the tetrahedra. According to the broken bond model, barriers between magic clusters are insignificant without the additional edge energy penalty. We estimate the overall nucleation rate without predicting the rates of formation for intermediate magic clusters by using the Becker-Döring equations. Our results provide a blueprint for constructing free energy models and rate theories for nucleation via magic clusters starting from only atomic-scale interactions and geometric considerations.

PMID:36948834 | DOI:10.1063/5.0132601

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Comparison of Matsubara dynamics with exact quantum dynamics for an oscillator coupled to a dissipative bath

J Chem Phys. 2023 Mar 21;158(11):114106. doi: 10.1063/5.0138250.

ABSTRACT

We report the first numerical calculations in which converged Matsubara dynamics is compared directly with exact quantum dynamics with no artificial damping of the time-correlation functions (TCFs). The system treated is a Morse oscillator coupled to a harmonic bath. We show that, when the system-bath coupling is sufficiently strong, the Matsubara calculations can be converged by explicitly including up to M = 200 Matsubara modes, with the remaining modes included as a harmonic “tail” correction. The resulting Matsubara TCFs are in near-perfect agreement with the exact quantum TCFs, for non-linear as well as linear operators, at a temperature at which the TCFs are dominated by quantum thermal fluctuations. These results provide compelling evidence that incoherent classical dynamics can arise in the condensed phase at temperatures at which the statistics are dominated by quantum (Boltzmann) effects, as a result of smoothing of imaginary-time Feynman paths. The techniques developed here may also lead to efficient methods for benchmarking system-bath dynamics in the overdamped regime.

PMID:36948794 | DOI:10.1063/5.0138250

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Development and Effectiveness of the School-Based Education Program for Coping With Particulate Matter

J Sch Health. 2023 Mar 22. doi: 10.1111/josh.13329. Online ahead of print.

ABSTRACT

BACKGROUND: Adolescents are considered to be vulnerable to particulate matter (PM). This study aims to develop and verify the effectiveness of the “school-based education program for coping with particulate matter (SEPC_PM).” This program was designed by employing the health belief model.

METHODS: High school students between the ages of 15 and 18 in South Korea participated in the program. This study employed a nonequivalent control group pretest-posttest design. A total of 113 students participated in the study; of these, 56 students participated in the intervention group, and 57 in the control group. The intervention group received 8 intervention sessions the SEPC_PM over the course of 4 weeks.

RESULTS: After the completion of the program, the intervention group’s knowledge about PM showed a statistically significant increase (t = 4.79, p < .001). The practice of engaging in health-managing behaviors to protect against PM also showed statistically significant improvement in the intervention group, with the greatest progress in practicing precaution when outdoors (t = 2.22, p = .029). No statistically significant changes were observed regarding other dependent variables. However, a subdomain of the variable of perceived self-efficacy for engaging in health-managing behaviors to protect against PM (degree of body cleansing after returning home) demonstrated a statistically significant increase in the intervention group (t = 1.99, p = .049).

CONCLUSIONS: The SEPC_PM may be proposed for incorporation into regular high school curricula to improve students’ health by encouraging them to take necessary actions against PM.

PMID:36948789 | DOI:10.1111/josh.13329

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Assessment of the Effectiveness of Knee Joints Treatment With the Use of 90Y: Prospective Ultrasound and Clinical Analysis

Clin Nucl Med. 2023 Mar 22. doi: 10.1097/RLU.0000000000004618. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this prospective study was to assess the effectiveness of knee joints treatment by radiosynoviorthesis with the use of 90Y based on ultrasound and clinical analysis.

MATERIALS AND METHODS: Ninety-seven patients were qualified for treatment from October 2016 to June 2017, and observation period lasted until December 2017. Bioethics Committee of the Medical University of Silesia approved this study. The effectiveness of knee joints treatment with the use of 90Y was based on 927 ultrasound measurements of fluid and 927 synovial thickness in 3 sites of the suprapatellar recess, 309 assessments of patient’s disability documented in Lequesne questionnaire, 309 assessments of pain on visual analog scale, as well as 103 overall self-assessment. Statistical methods were used to process the results.

RESULTS: A reduction in fluid was found in 62.14% of the knees; synovial thickness reduction was observed in 97.09% of all knees. The greatest benefit from the therapy was experienced by patients complaining of morning stiffness lasting more than 15 minutes (in 85.71% of joints). There was reduction in pain at rest in 94.52% of knee joints and in 80.39% of joints with pain while walking. At the second follow-up visit after treatment, the percentage of improvement in self-assessment was 74.76%.

CONCLUSIONS: Statistically significant decreases in the amount of fluid and thickness of the synovial membrane as well as the level of disability and the intensity of pain after radiosynoviorthesis 90Y treatment were demonstrated.

PMID:36947794 | DOI:10.1097/RLU.0000000000004618