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Ghrelin has been discovered as a kind of gastrointestinal hormone in recent years, which poses a variety of biological functions and has a wide range of functional effects on the body. Numerous studies have revealed that ghrelin are actively engaged to protect the liver by improving inflammatory response, reducing oxidative stress, and apoptosis in acute and chronic liver injury. This article summarizes the research progress of the protective effect of ghrelin for acute and chronic liver injury.Objective To retrospectively analyze the clinical efficacy, safety and the main factors affecting the prognosis of anlotinib hydrochloride in the treatment of advanced primary liver cancer. Methods Fifty-five cases with advanced primary liver cancer who received anlotinib hydrochloride were enrolled. The baseline data of the patients, such as prothrombin time, total bilirubin, albumin, Child-Pugh score, procalcitonin, alpha fetoprotein, extrahepatic metastasis, cirrhosis, portal hypertension, whether or not combined surgery, pathological staging, etc before treatment were recorded. Hematological and imaging results of the patients were reviewed. Adverse events that appeared in patients at any time until the end of follow-up or loss- to- follow-up or death were recorded. The survival curve was plotted by Kaplan-Meier method, and the difference of survival time between groups was examined by log-rank test. DMOG purchase Cox regression model of single and multiple factor were used to analyze the factors affecting the prognosis. Results As of the last follow-up, 2 patients were lost-to-follow-up, 30 died, and 23 survived. The median survival time was 6.5 months (196 days). Grade 3 or higher adverse events included hypertension (12.73%), leukopenia (3.64%), absolute neutropenia (1.82%), thrombocytopenia (9.09%), fatigue (3.64%), anemia (1.82%), and diarrhea (1.82%). Adverse events were effectively controlled. One case had fatal ruptured esophageal varices, which were not medically related. Multivariate Cox regression analysis showed that total bilirubin (HR = 0.247, P = 0.003), albumin (HR = 0.279, P = 0.003) and procalcitonin (HR = 0.105, P = 0.012) were independent factors affecting the prognosis of advanced HCC. Conclusion Anlotinib hydrochloride therapy is safe, effective and well tolerated in patients with advanced liver cancer, and total bilirubin, albumin, and procalcitonin are independent factors that affect the prognosis of patients with advanced liver cancer.Objective To investigate the mechanism of action of peroxisome proliferator-activated receptor α (PPARα)-mediated CCAAT/enhancer binding protein homologous protein (CHOP) signaling molecule with response to inflammation in mice with acute liver failure. Methods C57BL/6 mice were used as the research subjects, and D-galactose (D-GalN) combined with lipopolysaccharide (LPS) was injected intraperitoneally to establish a mouse model of acute liver failure. PPARα was activated by Wy-14643. CHOP expression was promoted by plasmids. Liver pathological changes and serum transaminases (ALT and AST) were detected in mice to evaluate liver function. The mRNA expression level of inflammatory factors in liver tissue was detected by real-time fluorescence quantitative PCR. LPS-stimulated macrophage was used to establish an inflammation model. PPARα and CHOP expression was inhibited by siRNA. The mRNA expression level of inflammatory factors in the cells was detected by real-time fluorescence quantitative PCR. Results Promoted PPARα activation had inhibited liver hemorrhage and inflammation in mice with acute liver failure induced by D-GalN/LPS. In addition, the serum level of transaminases and genetic level of inflammatory factors in liver tissues were reduced (P less then 0.01). CHOP accelerated expression had reversed the hepatoprotective effect of PPARα activation, aggravated liver injury, and increased inflammatory factors expression (P less then 0.01). At the cellular level, the inhibition of PPARα activation had accelerated the increase of inflammatory factors (P less then 0.01), while the inhibition of CHOP activation had all over again decreased the inflammatory factors (P less then 0.01). Conclusion PPARα and CHOP are important signaling molecules to regulate the inflammatory response in acute liver failure and liver injury. PPARα acceleration can down-regulate CHOP to inhibit inflammatory factors, which might play a protective role in mice with acute liver failure.Objective To understand the clinical features and outcomes of chronic liver diseases overlapping with CMV infection. Methods Clinical characteristics, treatment and outcome of patients of chronic liver diseases overlapping with CMV infection were analyzed retrospectively. T-test was used for measurement data and χ (2) test was used for count data. All measurement data were expressed by (x ± s). P > 0.05 was not determined as significant. P 0.05). However, when TBIL was compared with three (156.58 ± 147.461) μmol/L and four weeks (103.39 ± 102.218) μmol/L) of treatment, the decrease was significant (P less then 0.05, P less then 0.01). Alanine aminotransferase (ALT) after one week (293.57 ± 467.438) U/L (P less then 0.01) of treatment was significantly lower than before treatment (782.34 ± 828.801) U/L. Gamma-glutamyl transferase (GGT) after treatment (202.52 ± 155.174)U/L was significantly lower than before treatment(280.69 ± 205.619)U/L). Total bile acid (TBA) was increased after treatment (198.04 ± 155.174)μmol/L, when compared with that of before treatment (62.93 ± 178.944)μmol/L. Biochemical indicators of liver diseases had shown typical features of cholestasis, and the slow and reduced flow of bile acid was tracked and observed. Compared with the advanced group (182.45 ± 214.169) umol/L, the total bilirubin in inflammation group (50.36 ± 26.282) umol/L was decreased (P less then 0.05). Moreover, advanced group (122.18 ± 106.780) umol/L (P less then 0.05) had elevated total bile acid normalization rate than that of bile acid group (54.82 ± 56.123) umol/L, and the inflammatory phase had significantly better outcome than those with advanced-stage. Conclusion Chronic liver diseases overlapping with cytomegalovirus infection has a good therapeutic outcome in the inflammatory phase, but in the advanced-stage; the therapeutic efficacy and outcome is poor and perilous.
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