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Una de las principales preocupaciones para la mayoría de las Instituciones de Educación Superior radica en cumplir con los requerimientos de calidad que les demandan diversos organismos de evaluación y de acreditación. Los exámenes generales de egreso de licenciatura (EGEL) aplicados por el Centro Nacional de Evaluación para la Educación Superior (CENEVAL) tienen la intención de evaluar e informar públicamente el nivel de conocimientos y habilidades

Introduction and objectives: Decompensated cirrhosis is defined by the onset of complications and is associated with immune dysfunction. This is the result of two processes: systemic inflammation and damage made by the immune system. Our objective was to determine the profile of pro and anti inflammatory cytokines in patients with chronic liver disease: alcoholic (OH), non-alcoholic steatohepatitis (NASH), autoimmune liver disease (AILD) and hepatitis C (HCV), in the phases of compensation, inflammation and immunosuppression, based on functional classifications and prognosis with the CHILD- PUGH, MELD and D'Amico scales. Methods and materials: Prospective, observational, and cross-sectional study, made in the University Hospital, Dr. Jose E. Gonzalez during 2019-2020. A total of 108 patients were included: 28 OH, 27 NASH, 25 HCV and 27 AILD. The diagnosis and functional classification was made according to international guidelines. Inclusion criteria: over 18 years of age, signed informed consent. Exclusion criteria: hepatocellular carcinoma, other autoimmune pathologies. Blood samples (10 ml) were collected to quantify TNF-a, IL-8, IL-10, IL-1, IL-6. The protocol was approved by the ethics committee with registration MI20-0002. A one-way ANOVA was used to determine the differences between groups and stages Results: In OH, there is an increase in IL-6 and IL-8 in the decompensation phase, Child-Pugh stage C, D'amico stage 5 and MELD from 25 to 34 points. NASH patients had an increase in IL-8 in the inflammation phase as assessed by Child-Pugh B and D'amico 3 and 4. There was an increase in IL-6 in the immunosuppression phase. In patients with HCV and AILD, increased serum levels of IL-8 and IL-6 were shown in decompensation stages (Figure 1). Discussion: In this study, we demonstrated a significant increase in the pro-inflammatory cytokine profile in patients in the inflammation and immunosuppression phases. Fischer J et al. reported that a greater understanding of

Introduction and aims: Primary liver cancer is a public health problem in Mexico and the world. Liver transplantation (LT) is the ideal treatment for early hepatocellular carcinoma (HCC). Our aim was to evaluate the characteristics of patients with HCC and cholangiocarcinoma (CC) at two centers and identify transplantation candidates. Materials and methods: A retrospective observational study was conducted at the Hepatology Center (HC) and the University Center Against Cancer (UCAC), within the time frame of 2012---2018. HCC or intrahepatic CC was confirmed in 109 patients. Staging classifications, transplant selection models, and a predictive model for post-LT recurrence were applied to the HCC patients. Results: Of the total population, 93% (n = 102) presented with cirrhosis, 86% (n = 94) had HCC (HC: 58%, UCAC: 42%), and 14% (n = 15) had intrahepatic CC (HC: 40%, UCAC: 60%). Of the HC patients with HCC, Okuda I---II, BCLC A---B, and AFP levels <100 ng/m predominated, whereas Okuda II-III, BCLC C-D, and AFP levels >1000 ng/mL predominated in the UCAC patients. Half of the HC population with HCC met the criteria for LT, in contrast to 23% of the UCAC patients. Fifteen patients were evaluated for LT, and at present, six have undergone transplantation.

Introducción y objetivos: El cáncer primario de hígado es un problema de salud pública en México y en el mundo. El trasplante hepático (TH) es el tratamiento ideal para el carcinoma hepatocelular (CHC) temprano. El objetivo fue evaluar las características de los pacientes con CHC y colangiocarcinoma (CC) en dos centros e identificar a los candidatos a trasplante. Material y métodos: Estudio retrospectivo, observacional del 2012 al 2018 en el Centro de Hepatología (CH) y el Centro Universitario contra el Cáncer (CUCC). Se confirmó CHC o colangiocarcinoma intrahepático (CCi) en 109 pacientes, a los CHC se les aplicaron clasificaciones de estadiaje, modelos de selección para trasplante y modelo pronóstico de recidiva post-TH. Resultados: De la población total, 93% (n = 102) eran cirróticos. El 86% (n = 94) tuvo CHC (58% CH y 42% CUCC) y 14% (n = 15) CCi (40% CH y 60% CUCC). En los pacientes con CHC del CH predominó Okuda I-II, clasificación de Barcelona Clinic Liver Cancer (BCLC) A-B y niveles < 100 ng/mL de alfafetoproteína (AFP), mientras que en el CUCC predominó Okuda II-III, BCLC C-D y niveles > 1,000 ng/mL de AFP. La mitad de la población del CH con CHC cumplía con los criterios para TH, en cambio, en el CUCC solo lo hizo el 23%. Se valoraron 15 pacientes para TH y, a la fecha, se trasplantaron seis.

nIntroducción: Los métodos de diagnóstico actuales son poco sensibles para detectar las eta-pas iniciales de la nefropatía diabética tipo 2. En este trabajo se hace una revisión de estudiosde aproximación metabolómica para la identificación de biomarcadores de esta enferme-dad con potencialidad para diferenciar entre etapas tempranas, evaluar y direccionar eltratamiento y coadyuvar a ralentizar el da˜no renal.Métodos: Utilizando bases de datos públicas (Pubmed y Google Scholar) y privadas (Scopus yWeb of Knowledge), se realizó una búsqueda sistemática de la información que se ha publi-cado de metabolómica de la nefropatía diabética en distintos bioespecímenes (orina, suero,plasma y sangre). Posteriormente, se utilizó el programa MetaboAnalyst 4.0 para evidenciarlas vías metabólicas que están asociadas con estos metabolitos.Resultados: Con los datos de la literatura se identificaron grupos de metabolitos potencialespara la monitorización de la nefropatía diabética. Destacan en la orina: el óxido-3-hidroxiisovalerato, TMAO, aconitato y citrato y derivados del hidroxipropionato; en el suero:el citrato, la creatinina, la arginina y sus derivados; y en el plasma: aminoácidos como his-tidina, metionina y arginina. Utilizando el programa MetaboAnalyst 4.0 se detectaron lasrutas metabólicas que están relacionadas con estos metabolitos.Conclusiones: La búsqueda de biomarcadores relacionados con la progresión de la nefropatíadiabética junto con estrategias analíticas para su detección y cuantificación son el puntode partida para el dise˜no de nuevos métodos de análisis químico-clínico. La correlacióncon la disfunción de vías metabólicas podría ser utilizada para la evaluación integral deltratamiento y seguimiento clínico de este padecimiento.

Introduction and Objectives: Chronic liver inflammation may lead to hepatic cirrhosis, limiting its regenerative capacity. The clinical standard of care is transplantation, although stem cell therapy may be an alternative option. The study aim was to induce endogenous hematopoietic stem cells (HSCs) with granulocyte colony stimulating factor (G-CSF) and/or intravenous administration of adipose tissue-derived mesenchymal stem cells (MSCs) to decrease hepatic fibrosis in an experimental model. Material and methods: A liver fibrosis model was developed with femaleWistar rats via multiple intraperitoneal doses of carbon tetrachloride. Three rats were selected to confirm cirrhosis, and the rest were set into experimental groups to evaluate single and combined therapies of G-CSF-stimulated HSC mobilization and intravenous MSC administration. Results: Treatment with MSCs and G-CSF significantly improved alanine amino transferase levels, while treatment with G-CSF, MSCs, and G-CSF + MSCs decreased aspartate amino transferase levels. Hepatocyte growth factor (HGF) and interleukin 10 levels increased with MSC treatment. Transforming growth factor levels were lower with MSC treatment. Interleukin 1 and tumor necrosis factor alpha levels decreased in all treated groups. Histopathology showed that MSCs and G-CSF reduced liver fibrosis from F4 to F2. Conclusions: MSC treatment improves liver function, decreases hepatic fibrosis, and plays an antiinflammatory role;it promotes HGF levels and increased proliferating cell nuclear antigen when followed by MSC treatment mobilization using G-CSF. When these therapies were combined, however, fibrosis improvement was less evident.