Background: Eicosanoid and related docosanoid polyunsaturated fatty acids (PUFAs) and their oxygenated derivatives have been proposed as noninvasive lipidomic biomarkers of nonalcoholic steatohepatitis (NASH). Therefore, we investigated associations between plasma eicosanoids and liver fibrosis to evaluate their utility in diagnosing and monitoring NASH-related fibrosis. Methods: Our analysis used baseline eicosanoid data from 427 patients with biopsy-confirmed nonalcoholic fatty liver disease (NAFLD), and longitudinal measurements along with liver fibrosis staging from 63 patients with NASH and stage 2/3 fibrosis followed for 24 weeks in a phase II trial. Results: At baseline, four eicosanoids were significantly associated with liver fibrosis stage: 11,12-DIHETE, tetranor 12-HETE, adrenic acid, and 14, 15-DIHETE. Over 24 weeks of follow up, a combination of changes in seven eicosanoids [5-HETE, 7,17-DHDPA, adrenic acid, arachidonic acid (AA), eicosapentaenoic acid (EPA), 16-HDOHE, and 9-HODE) had good diagnostic accuracy for the prediction of ⩾1 stage improvement in fibrosis (AUROC: 0.74; 95% CI: 0.62–0.87), and a combination of four eicosanoids (7,17-DHDPA, 14,15-DIHETRE, 9-HOTRE, and free adrenic acid) accurately predicted improvement in hepatic collagen content (AUROC: 0.72; 95% CI: 0.50–0.77). Conclusion: This study provides preliminary evidence that plasma eicosanoids may serve as noninvasive biomarkers of liver fibrosis and may predict liver fibrosis improvement in NASH.

The aim of this study was to analyse the management of Gartland type III supracondylar humerus fractures in children older than 10 years at our paediatric orthopaedics and to determine the clinical and radiographic long-term effects following open reduction by the small medial approach and cross-fixation with three kirschner wires. Eighty-three cases of Gartland type III supracondylar humerus fractures in children older than 10 years were treated by open reduction by the small medial approach and cross-fixation with three kirschner wires from January 2010 to December 2015. All patients were followed up from 12 to 15 months (mean: 13 months). Assessments after 1 year included neurovascular examination, Flynn’s criteria (elbow function and carrying angle), pain and complications (infections, growth disturbances or iatrogenic nerve injuries). All fractures healed within 2 months. According to Flynn’s criteria, 80 (96.4%) patients achieved satisfactory outcomes, whereas three (3.6%) were graded as unsatisfactory because of limited elbow motion. The mean carrying angle measured 9.4° (1°–16°) compared with 10.8° on the contralateral side (5°–16°). No case of cubitus varus was noted. No wound infection and displacement of bone fracture occurred. No case of iatrogenic ulnar nerve injury and vascular deficits was noted. There were no cases of myositis ossificans or Volkmann’s ischaemic contracture. It is safe and effective to treat Gartland type III paediatric supracondylar humerus fractures in older children with open reduction by the medial approach and crossed K-wires fixation.