GPT and Shock: In a pilot experiment with a lower dose of APAP (250 mg/kg) administration, the ALT level could rapidly decrease to about 100 u/L at 48 h, however, the pathology at 48 h looked much worse than the liver injuries with similar ALT/AST levels caused by hemorrhagic shock and sepsis, therefore, we think ALT/AST concentrations alone can not accurately predict the severity of APAP hepatotoxicity.