Investigation of jaundice

Effects of Yinzhihuang Granules on Serum Liver Enzymes in Jaundice Patients: A Real-World Study Based on HIS Data

OBJECTIVE

Our aim was to analyze the influence of Yinzhihuang granules on serum liver enzymes in jaundice patients and to provide real-world evidence for the efficacy evaluation of Yinzhihuang granules in treating jaundice.

METHODS

We constructed a data warehouse which integrates real-world electronic medical records from the hospital information system of multiple 3A hospitals in China and used a descriptive statistical method to analyze the changes in the serum liver enzymes of the jaundice patients treated with Yinzhihuang granules and then used Wilcoxon signed-rank to test the changes in the indicators caused by the treatment.

RESULTS

After being treated with Yinzhihuang granules, the jaundice patients had a decrease in the average serum levels of total bilirubin, indirect bilirubin, aspartate aminotransferase, glutamyl transpeptidase, and alkaline phosphatase, and the differences were statistically significant (P < 0.05) but had no significant changes in the average serum levels of direct bilirubin and alanine aminotransferase (P > 0.05).

CONCLUSION

The data analysis on the real-world electronic medical records demonstrate that Yinzhihuang granules help to reduce jaundice patients' serum levels of total bilirubin, indirect bilirubin, aspartate aminotransferase, glutamyl transpeptidase, and alkaline phosphatase, but there is no evidence that Yinzhihuang granules help to reduce the jaundice patients' serum levels of direct bilirubin and alanine aminotransferase.

Fiber enhanced Raman spectroscopic analysis as a novel method for diagnosis and monitoring of diseases related to hyperbilirubinemia and hyperbiliverdinemia

Fiber enhanced resonance Raman spectroscopy (FERS) is introduced for chemically selective and ultrasensitive analysis of the biomolecules hematin, hemoglobin, biliverdin, and bilirubin. The abilities for analyzing whole intact, oxygenated erythrocytes are proven, demonstrating the potential for the diagnosis of red blood cell related diseases, such as different types of anemia and hemolytic disorders. The optical fiber enables an efficient light-guiding within a miniaturized sample volume of only a few micro-liters and provides a tremendously improved analytical sensitivity (LODs of 0.5 μM for bilirubin and 0.13 μM for biliverdin with proposed improvements down to the pico-molar range). FERS is a less invasive method than the standard ones and could be a new analytical method for monitoring neonatal jaundice, allowing a precise control of the unconjugated serum bilirubin levels, and therefore, providing a better prognosis for newborns. The potential for sensing very low concentrations of the bile pigments may also open up new opportunities for cancer research. The abilities of FERS as a diagnostic tool are explored for the elucidation of jaundice with different etiologies including the rare, not yet well understood diseases manifested in green jaundice. This is demonstrated by quantifying clinically relevant concentrations of bilirubin and biliverdin simultaneously in the micro-molar range: for the case of hyperbilirubinemia due to malignancy, infectious hepatitis, cirrhosis or stenosis of the common bile duct (1 μM biliverdin together with 50 μM bilirubin) and for hyperbiliverdinemia (25 μM biliverdin and 75 μM bilirubin). FERS has high potential as an ultrasensitive analytical technique for a wide range of biomolecules and in various life-science applications.

Magnetic resonance imaging (MRI) of bruises: a pilot study

The purpose of this study was to investigate if magnetic resonance imaging (MRI) could be used to image the presence of hemosiderin in bruises and if there was the potential for this technique to be applied as a non-invasive method to estimate the age of bruises. To achieve this aim an animal model to produce lesions resembling bruises was created by injecting blood obtained from the tail vein subcutaneously into an area of the abdominal wall. The animals were euthanized at 3, 6, 12 h, 1, 2, 3, 5, and 7 days post injection and the skin of the abdominal wall was excised for MRI scanning and histological examination. The injected blood appeared as hypointense (dark) areas on the T2* MRI at 3 and 6 h. The image of the injected areas became indistinct at 12 h and continued to be indistinct at 1 and 2 days, although there appeared to be transitioning from hypointensity to hyperintensity (light). The magnetic resonance image appeared to better correspond to the histological appearance at 3 and 5 days, with the "bruise" appearing hyperintense (white); however, some hypointense (darker) areas at 3 day possibly corresponded to the development of hemosiderin. At 7 day the injected blood had been converted to hemosiderin with possible correlation between areas of blue staining in Perls' stained histologic sections and areas of extreme hypointensity in the T2* magnetic resonance image. This study has shown that a series of changes occur on MRI of bruises in an animal model that may relate to histological changes. Although variability in the intensity of the MRI signal and considerable soft tissue artifact currently make interpretations difficult, this may be a technique worth pursuing in the non-invasive evaluation of bruises.