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Summary: Background and aims: Sarcopaenia is associated with advanced nonalcoholic fatty liver disease (NAFLD). However, the impact of the muscle mass categorised by muscle quality on fibrosis progression remains unclear. Methods: A total of 292 patients with biopsy‐proven NAFLD who underwent serial vibration‐controlled transient elastography assessments at least 1 year from baseline were selected. The skeletal muscle area (SMA) was determined on abdominal computed tomography (CT) at the third lumbar vertebra level and categorised to normal‐attenuation muscle area (NAMA), low‐attenuation muscle area (LAMA) and intermuscular adipose tissue (IMAT) using a muscle quality map. These SMAs were normalised by the height squared to obtain the skeletal muscle index (SMI). Results: At baseline, as the histological fibrosis stage increased, SMINAMA decreased and SMILAMA increased (p for trend = 0.014 and p for trend <0.001, respectively), which was not significant after adjustment for age, sex and obesity. During a median follow‐up of 41 months, fibrosis progression was detected in 48 out of 292 patients, and higher SMILAMA quartiles independently increased the risk of fibrosis progression in a dose‐dependent manner (hazard ratio [HR] per quartile: 1.41; 95% confidence interval [CI], 1.04–1.91). The highest quartile of SMILAMA increased the risk of fibrosis progression by 3.25 times compared to the lowest quartile of SMILAMA (95% CI, 1.18–8.90). SMINAMA quartiles were not associated with the risk of fibrosis progression. Conclusion: Increased low‐quality muscle mass, but not decreased normal‐quality muscle mass, as assessed by a muscle quality map in CT, predicts fibrosis progression in patients with NAFLD. [ABSTRACT FROM AUTHOR]

Objectives: Much evidence exists that herbs have effective immunomodulatory activities. Chrysanthemi Flos (CF) is effective in clearing heat, reducing inflammation, dropping blood pressure and treating headache and is used as a pharmaceutical raw material for an immune enhancer. The purpose of this study was to investigate the modulatory effect of Chrysanthemi Flos pharmacopuncture on nitric-oxide (NO) production in activating macrophages. Methods: After a murine macrophage cell line, RAW 264.7, was cultured in the presence of lipopolysaccharide (LPS), immune-modulating abilities of CF were evaluated by using NO, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) production and phagocytic activity of macrophages. Results: CF enhanced the activities of macrophages by increasing the phagocytic activity and decreasing NO production. Especially, both LPS and CF, 200 ㎍/ml, treatment could significantly reduce the NO production, but did not change the production of IL-6 and TNF-α. Conclusion: The results of this study indicate that CF may be of immunomodulatory value, especially for adverse diseases due to increased NO production. It may have potential for use as immunoenhancing pharmacopuncture.

Objectives: This study was designed to investigate the protective effects of Atractylodis Rhizoma pharmacopuncture (ARP) against acute gastric mucosal lesions induced by compound 48/80 in rats. Methods: The ARP was injected in Joksamni (ST36) and Jungwan (CV12) 1 hr before treatment with compound 48/80. The animals were sacrificed under anesthesia 3 hrs after treatment with compound 48/80. The stomachs were removed, and the amounts of gastric adherent mucus, gastric mucosal hexosamine, thiobarbituric acid reactive substances (TBARS), xanthine oxidase (XO), and superoxide dismutase (SOD) were measured. Also, histological examination were performed. Results: Gastric adherent mucus, gastric mucosal hexosamine and histological defects of gastric mucosa declined significantly after ARP treatment. Changes in gastric mucosal TBARS were also reduced by ARP treatment, but this result was not statistically significant. ARP treatment did not change the XO and the SOD activities. Conclusions: ARP showed protective effects for acute gastric mucosal lesions induced by compound 48/80 in rats. These results suggest that ARP may have protective effects for gastritis.

Objective : This study was designed to find out the effect of seven acupoints of stroke in cerebrovascular hemiplegia patients. Methods : This study was performed on 6 patients with cerebrovascular hemiplegia (test group) and 6 health persons(control group). We measured temperature of skin surface of test and control group using digital infrared thermographic imaging(D.I.T.I.) after acupunture on seven acupoints of stroke. And we calculated difference of skin temperature between healthful and affected side for each groups. Results : There was significant difference in area 3 in both two groups between before and after acupuncture. But in general there was no significant difference between two groups on thermographic change. Conclusions : This is pilot study, so further studies are required to find out the effect of seven acupoints of stroke in cerebrovascular hemiplegia patients.

Summary: Background and Aims: Vibration‐controlled transient elastography (VCTE) has shown good diagnostic performance in predicting fibrosis stages in patients with non‐alcoholic fatty liver disease (NAFLD). However, an optimal diagnostic approach to detect advanced fibrosis in patients with NAFLD has not been established. Approach and Results: We prospectively collected data from 539 subjects who underwent liver biopsy at a single centre between January 2014 and December 2019. Diagnostic performance was estimated using the area under the receiver‐operating characteristic curve (AUROC). Several models combining the fibrosis 4 index (FIB‐4) score and liver stiffness measurement (LSM) were analysed to reduce the need for unnecessary liver biopsies. We observed significant fibrosis (≥F2), advanced fibrosis (≥F3) and cirrhosis (F4) in 173 (32.1%), 74 (13.7%) and 46 subjects (8.5%), respectively. The AUROCs (95% CI) for LSMs to diagnose ≥F2, ≥F3 and F4 were 0.82 (0.78‐0.85), 0.92 (0.89‐0.94) and 0.95 (0.93‐0.97), respectively. Optimal LSM cut‐off values were 6.7 (≥F2), 8.3 (≥F3) and 9.8 (F4) kPa. LSMs were affected by waist circumference, serum albumin and fibrosis stage (R2 = 0.315). Abdominal obesity, elevated transaminase, diabetes mellitus and high IQR/Median were associated with the discordance of ≥2 fibrosis stages between LSMs and histologic data. The sequential use of the age‐adjusted FIB‐4 and LSMs yielded the least uncertainty (5.3%) in classifying disease severity with the highest diagnostic accuracy (81%) among a variety of non‐invasive test combinations. Conclusions: The sequential approach of age‐adjusted FIB‐4 and VCTE could represent a practical diagnostic strategy to detect advanced fibrosis in NAFLD (ClinicalTrials.gov #NCT 02206841). [ABSTRACT FROM AUTHOR]

LINKED CONTENT: This article is linked to Lee et al papers. To view these articles, visit https://doi.org/10.1111/apt.17601 and https://doi.org/10.1111/apt.17618 [ABSTRACT FROM AUTHOR]