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    Establishment of acetaminophen-induced acute hepatic failure model in mice
    MING Ya-nan, LI Chun-min, ZHANG Jing-yi, LIU Xiao-lin, MAO Yi-min
    Chinese Hepatolgy    2016, 21 (5): 351-354.  
    Abstract1585)      PDF (971KB)(808)      
    Objective To establish a stable animal model of drug-induced acute hepatic failure (AHF) with different doses of acetaminophen (APAP) by intraperitoneal injection.Methods Sixty mice, which were randomly divided into four groups (n=15), were intraperitoneally injected with saline and different doses of APAP (300 mg/kg, 500 mg/kg and 750 mg/kg), respectively. Mental status, activity and survival rates in different groups were observed within 72 hours. According to the analysis of survival rates, another 180 mice were divided into three groups randomly (n=60) with injection of saline, low (300 mg/kg) and high dose (750 mg/kg) of APAP, respectively. To detect the biochemical and pathological changes of AHF, 12 mice randomly selected from each group were sacrificed for serum and liver tissues collection at 0 h, 1 h, 3 h, 6 h and 12 h after injection, respectively.Results No mice died within 72 h in the control group, APAP (300 mg/kg and 500 mg/kg group) , while the mortality of APAP 750 mg/kg group was 100%. In control group, aminotransferase (ALT) level showed no significant increase at all time points. However, ALT levels in two APAP groups (300 mg/kg and 750 mg/kg) began to increase at 3 h, and reached to peak at 6 h (6766.5±2001.27 IU/L) or 12 h (11707.58±1882.45 IU/L) in low-dose or high-dose APAP group, respectively. Additionally, ALT level in high-dose APAP group was significantly higher than that in low-dose APAP group at 12 h (P<0.01). In view of haematoxylin-eosin (HE) staining, control group displayed normal liver structure. In APAP group, degeneration and necrosis of hepatocytes mainly occurred around central vein, and damage extent gradually expanded over time. In low-dose group, boundaries of necrotic zones were clear with normal liver cell morphology in portal areas, and visible hepatocytes proliferation around the boundaries was observed at 12 h. In high-dose group, typical acute massive hepatic necrosis was found and few of degenerated hepatocytes stayed alive at portal areas. After rapid necrosis of hepatocytes, empty fiber mesh stent remained with large red blood cells deposited in sinusoids and no proliferation of hepatocytes. At 12 h, histological activity index (HAI) score of high-dose group (7.33±1.5) was higher than that of low-dose group (5.25±2.26), which showed statistically significant differences (P<0.05).Conclusion C57BL/6 mice injected with high dose of APAP (750 mg/kg) have similar biochemical and pathological changes with AHF, which might be a reliable AHF model for investigating the role of APAP in pathogenesis and development of liver failure.
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    The expressions of CK19, Ki67 and CK7 in hepatocellular carcinoma tissues
    ZHOU Jin-hong, CHONG Yang
    Chinese Hepatolgy    2022, 27 (8): 887-890.  
    Abstract1570)      PDF (677KB)(309)      
    Objective To observe the expression of cytokeratin 19 (CK19), proliferating cell nuclear antigen (Ki67) and cytokeratin 7 (CK7) in primary hepatocellular carcinoma (HCC) tissues.Methods 65 patients with HCC hospitalized from March 2016 to March 2018 were selected as the research objects. The specimens of cancer tissue and adjacent normal tissue were taken during operation. The expressions of CK19, Ki67 and CK7 were measured by immunohistochemical staining. The positive rates of CK19, Ki67 and CK7 between cancer tissues and adjacent tissues were compared. The positive detection rates of CK19, Ki67 and CK7 in cancer tissues of HCC patients with different clinicopathological features were counted and compared. The 3-year survival of HCC patients with different expression levels of CK19, Ki67 and CK7 were analyzed.Results The positive rates of CK19, Ki67 and CK7 in cancer tissues were 40.00%, 73.85% and 70.77% respectively, which were significantly higher than those of 1.54%, 23.08% and 1.54% in adjacent tissues (χ2=29.216, 33.639, 67.483; P<0.05). The positive rates of CK19, Ki67 and CK7 were higher in HCC patients with TNM stage III~IV, poorly differentiated tissue, lymph node metastasis and capsule infiltration (P<0.05). The positive rates of CK7, CK19 and Ki67 in patients with lymph node metastasis and capsule infiltration were higher (P<0.05). The 3-year survival rates of CK19, Ki67 and CK7 positive HCC patients were 34.52%, 58.33% and 58.70% respectively, which were lower than those of 87.18%, 88.24% and 84.21% in negative HCC patients (Log-rank=19.250, 4.767, 3.910; P<0.05).Conclusion The expression levels of CK19, Ki67 and CK7 were highly correlated with TNM stage, tissue differentiation, lymph node metastasis and capsule infiltration, and have impact on the survival of HCC patients.
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    Chinese Hepatolgy    2019, 24 (12): 1335-1356.  
    Abstract1566)      PDF (1750KB)(1072)      
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    Establishment and investigation of carbon tetrachloride-induced acute liver injury model in mice
    FU Shuang-nan, GAO Da, GUO Jia-jia, MIAO Ming-san, ZHU Ping-sheng, GONG Man
    Chinese Hepatolgy    2022, 27 (9): 1036-1040.  
    Abstract1243)      PDF (1030KB)(825)      
    Objective To investigate the stable animal model of carbon tetrachloride (CCl4)-induced acute liver injury in mice, which is convenient for the research and application of new clinical drugs. Methods The Kunming (KM) mice were randomLy divided into blank group, model group, and bifendate group (5.625 mg/kg), and the acute liver injury of mice was replicated by intraperitoneal injection of 0.1% CCl4 solution. The aminotransferase level, liver index, and pathological changes of liver tissue at 3h, 6h, 12h, and 24h after modeling were detected to study the stability of the model. Results After exposure to the model group, alanine aminotransferase (ALT) increased slightly at 3 h [(45.21 ± 13.17) IU/L, P<0.01], and increased significantly at 12 h [(112.30 ± 30.54) IU/L] and 24 h [(121.98 ± 21.66) IU/L] (both P<0.01); AST increased at 3 h [(162.51 ± 28.57) IU/L], 6 h [(192.07 ± 31.05) IU/L], 12 h [(250.75 ± 90.82) IU/L] and 24 h [(274.27 ± 44.02) IU/L] (all P<0.01), but increased significantly at 12 and 24 h; liver index slightly increased at 3 h [(6.72 ± 1.90) g/100 g] and 6h [(6.72 ± 1.90) g/100 g] (both P<0.01). At 12 h [(12.41 ± 1.18) g/100 g] and 24 h [(14.90 ± 2.56) g/100 g] (both P<0.01), the liver pathological changes showed obvious hepatocyte swelling and inflammatory cell infiltration, and the injury degree was more significant at 24 h. Conclusion When the mouse acute liver injury model was prepared by intraperitoneal injection of 0.1% CCl4 solution, the modeling time between 12 h and 24 h was more appropriate.
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    Early efficacy of tenofovir amibufenamide (TMF) in the treatment of patients with chronic hepatitis B: a real-word multicenter clinical study
    LI Ya-ping, CUI Dan-dan, GOU Guo-e, LIN Yong-mei, ZU Hong-mei, XU Guang-hua, GAO Xiao-hong, DANG Shuang-suo
    Chinese Hepatolgy    2023, 28 (1): 100-104.  
    Abstract1226)      PDF (762KB)(425)      
    Objective To evaluate the efficacy and safety of tenofovir amibufenamide (TMF) in the treatment of patients with chronic hepatitis B (CHB). Methods In this multicenter, prospective, real-world cohort study, we recruited 91 patients with CHB who attended the outpatient clinic of the Department of Infection of the 4 sites from August 2021 to August 2022 and were treated with TMF antiviral therapy. We collected clinical data, and compared the changes of HBV DNA, alanine transaminase (ALT), hepatitis B virus e antigen (HBeAg) and hepatitis B virus surface antigen (HBsAg) conversion, renal function and lipid metabolism at 12W and 24W. Results A total of 91 CHB patients were enrolled at 24W, 28 patients in treatment-naïve and 63 patients in previously treated. Complete virological response was achieved in 17.4% and 47.9% of treatment-naïve patients at 12W and 24W. The proportion of treated patients achieving complete virological response at 12W and 24W was 48.4% and 58.1%, respectively. HBV DNA [(4.88±0.54) lg IU/mL vs (2.69±0.35) lg IU/mL vs (2.40±0.39 lg IU/mL)] was significantly lower compared to baseline and 12W primary patients (F=24.51, P=0.000); HBV DNA in previously treated patients[(2.67±0.31) lg IU/mL vs (1.70±0.24) lg IU/mL vs (1.49±0.09) lg IU/mL decreased from before (F=5.83, P=0.009). The ALT recurrence rates based on laboratory criteria were 64% and 92% for 12W and 24W, respectively. And the ALT recurrence rates were 38.4% and 78.9% for 12W and 24W using AASLD 2018 criteria. After 24W of antiviral therapy 4.53% of patients had HBeAg conversion, 2.17% of patients had HBeAg seroconversion, 1.09% of patients had HBsAg conversion, no patients have yet had HBsAg seroconversion. In terms of safety, there was no significant change in blood Cr, eGFR and CysC at 24 weeks of antiviral therapy in CHB patients compared with baseline. 33 treated patients who had early kidney injury switched to TMF and continued antiviral therapy for 24W had a significant decrease in urinary α1-MG and urinary NAG and urinary β2-MG compared with baseline, with P values <0.05, which were statistically significant. Compared with baseline, there was a trend of decreasing TG and increasing TC, but the difference was not statistically significant.Conclusion TMF is effective and safe in the treatment of patients with CHB.
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    Chinese Hepatolgy    2021, 26 (8): 939-942.  
    Abstract1182)      PDF (839KB)(1528)      
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    Chinese Hepatolgy    2020, 25 (8): 894-896.  
    Abstract1133)      PDF (669KB)(860)      
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    Chinese Hepatolgy    2019, 24 (9): 1049-1052.  
    Abstract1125)      PDF (1133KB)(1288)      
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    Efficacy evaluation of silybin capsule combined with fenofibrate in the treatment of nonalcoholic fatty liver
    ZHAI Yu-rong, LI Li, HUANG Ling, DUAN Hua-rong
    Chinese Hepatolgy    2020, 25 (11): 1216-1219.  
    Abstract1039)      PDF (673KB)(566)      
    Objective To explore the clinical efficacy of silybin capsules combined with fenofibrate tablets in the treatment of non-alcoholic fatty liver.Methods One hundred and eighteen patients with non-alcoholic fatty liver treated in our hospital from March 2017 to May 2019 were selected as the research subjects and randomly divided into observation group and control group,with 59 cases in each group.Fifty-nine patients in the observation group were treated with silybin capsules and fenofibrate tablets,and 59 patients in the control group were treated with silybin capsules.After treatment,the clinical efficacy,liver function,blood glucose and blood uric acid,blood lipid,inflammation index,liver and spleen CT ratio,and safety index were used as the evaluation indicators.Results The clinical effective rate of the observation group was 96.61%,which was significantly higher than that of the control group (77.97%).The difference was statistically significant (P<0.05).The serum levels of ALT,AST and GGT in the observation group and the control group were significantly lower than those in the control group,and the observation group was significantly lower than the control group,the difference was significant (P<0.05).After treatment,the FBG,FINS and the control group were compared with the control group.The level of SUA was significantly different from that before treatment,and the observation group was significantly lower than the control group,with significant difference (P<0.05).The serum levels of TC,TG and LDL-C in the observation group and the control group were significantly decreased,and the observation group decreased greater than that of the control group.HDL-C was significantly increased,and the observation group was more significant than the control group.The serum IL-6,TNF-α and NF-κB in the observation group were compared with the control group.The decrease was significantly lower in the observation group than in the control group,and the difference was significant (P<0.05).The CT ratio of the liver and spleen in the observation group and the control group was significantly higher than that before the treatment,and the increase in the observation group was greater than that in the control group,and the difference was significant (P<0.05).There was no significant difference in adverse reactions between the observation group and the control group (P>0.05).Conclusion Silybin capsules combined with fenofibrate tablets in the treatment of non-alcoholic fatty liver can significantly improve clinical efficacy,enhance liver function,improve blood glucose,blood lipid and blood uric acid levels,reduce inflammation levels,and have good safety.It is worthy of clinical promotion.
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    Correlation between blood oxygen saturation and abnormal liver function in patients with new coronavirus pneumonia
    REN Jian-feng, ZHANG Yu-ping, SHAO Jing, ZHANG Qi-sheng, GAO De-yong, WANG Xiao-jin
    Chinese Hepatolgy    2020, 25 (9): 986-989.  
    Abstract972)      PDF (835KB)(777)      
    Objective To analyze the correlation between blood oxygen saturation and liver function abnormalities and clinical treatment in patients with COVID-19 novel coronavirus pneumonia. Methods Observe the incidence of abnormal liver function in 74 patients with confirmed COVID-19 new coronary pneumonia compared with mild/normal (46 cases) and severe/critical (28 cases) patients, as well as blood oxygen saturation and liver function biochemical indicators before and after treatment. Analyze the correlation between blood oxygen saturation and changes in biochemical indicators of liver function in patients as well. Results There were significant differences in oxygen saturation(96.52±1.68 VS 87.61±2.99), ALT(39.69±25.35 VS 57.25±37.89)、AST(61.00±17.66 VS 36.83±16.30)、LDH(61.00±17.66 VS 36.83±16.30) between mild/moderate and severe/critical patients (P<0.05);In the patients with abnormal liver function, blood oxygen saturation returned to normal after treatment, and liver function was restored to different degrees in both groups. ALT(66.82±21.65 VS 42.47±18.46)、AST (61.00±17.66 VS 36.83±16.30)、LDH(309.46±58.92 VS 218.38±45.12)of mild/normal patients, and ALT (93.54±21.06 VS 49.54±19.75), AST (57.93±14.22 VS 33.80±11.28)、LDH (329.79±54.78 VS 257.50±90.59) of severe/critical patients were significantly improved (P<0.05);In the correlation analysis with oxygen saturation, ALT, AST, r-GT and LDH were negatively correlated with oxygen saturation (P<0.05). Conclusion Low blood oxygen saturation in patients with new coronary pneumonia is closely related to abnormal liver function, and the restoration of blood oxygen saturation is helpful to improving liver function.
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    Clinical features of adult patients with chronic active Epstein-Barr virus infection
    SHI Dong-mei, LIU Yun-ye, WANG Wei-jing, XIANG Xiao-gang
    Chinese Hepatolgy    2021, 26 (2): 182-186.  
    Abstract959)      PDF (678KB)(717)      
    Objective To investigat the clinical features of adult-onset chronic active Epstein-Barr virus infection(CAEBV)and to provide a basis for the diagnosis and treatment of CAEBV.Methods The clinical data of 41 adults with CAEBV from January 2008 to December 2019 was analyzed retrospectively, including onset, clinical manifestation, EBV DNA, EBV antibodies, cytokines, EBER in situ hybridization, treatment and follow-up results. Results Among the 41patients with CAEBV, the male to female ratio was 1.2∶1(22 males and 19 females), and the median age was 42 years(15-75 years). According to the analysis of the onset of the patients, 38 cases (92.7%), 36 cases (87.8%), 35 cases (85.4%) and 28 case (68.3%) of the patients presented intermittent fever, accompanied by lymph node enlargement, splenomegaly and hepatomegaly, with the most common involvement of the digestive, respiratory and blood systems. Life-threatening complications included 9 cases (21.9%) of hemophagocytic syndrome, 5 cases (12.2%) of liver failure, 4 cases (9.8%) of ARDS caused by interstitial pneumonia, and 3 cases (7.3%) of malignant lymphoma. The mean value of serum EBV DNA in 41 CAEBV patients was 104.3copy/ml. Eleven of the 41 cases (26.8%) died within 3 months. The platelet counts (53.3±29.2)×109/L vs(88.1±36.7)×109/L in death group was significantly lower than survival group (t=3.055, P ±0.01). At the same time serum TBil levels(141.4±78.5)μmol/L vs(61.3±34.4)μmol/L,AST(210.5±99.6)IU/L vs(78.8±89.2)IU/L,LDH(864.6±478.6)IU/L vs (445.2±337.5)IU/L,ferritin(1933.9±166.7)ng/mL vs(687.5±103.8)ng/mL, IL-2R(5 253.6± 736.4)U/L vs(1 989.0± 131.5)U/L,IL-10(486.1±125.7)pg/mL vs(151.2 ±232.5)pg/mL in death group were all significantly higher than survival group(t=-3.759、-3.542、-4.715、-6.672、-3.965 and -3.452,all P<0.01).Conclusion The study reveals that CAEBV in adult patients has a severe clinical course and prognosis is poor. Lower thrombocytopenia and higher TBil、AST、LDH、ferritin、IL-2R and IL-10 might potentially be risk factor for a poor prognosis. EBV loads should be measured and tissue should be stained on hybridization (EBER) if a patient presents with the known symptoms of CAEBV.
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    Efficacy and safety of tenofovir alafenamide fumarate in the treatment of CHB patients complicated with fatty liver disease
    LU Jia-hui, ZHANG Cong-nan, HE Peng-yuan, OU Meng-dang, HUANG Ming-xing
    Chinese Hepatolgy    2022, 27 (8): 858-862.  
    Abstract889)      PDF (735KB)(262)      
    Objective To explore the efficacy and safety of tenofovir alafenamide fumarate (TAF) in the treatment of chronic hepatitis B (CHB) patients complicated with fatty liver disease.Methods A total of 86 patients with CHB and fatty liver disease diagnosed and treated in our hospital from June 2019 to September 2020 were enrolled. They were divided into a the treatment-naive group (22 cases) and a treatment-experienced group (64 cases). The clinical markers of 2 groups were compared at baseline and 48 weeks after treatment.Results After 48 weeks of treatment in treatment-naive group, the undetected rate and the ratio of hepatitis B virus (HBV) DNA less than 20 IU/mL (50.0% vs 0.0%, 22.7% vs 0.0%, respectively, P<0.001) were higher than those at baseline. The levels of beta2-microglobulin (β2-MG) (median 1.82 mg/L vs 2.02 mg/L, P<0.001) and fasting blood glucose (median 5.11 mmol/L vs 5.41 mmol/L, P<0.001) at 48 weeks after treatment were lower than those at baseline, and the difference was statistically significant. In the treatment-experienced group, the undetected rate of HBV DNA at 48 weeks after treatment was higher than that at baseline, and the rate of HBV DNA more than 20 IU/mL at 48 weeks after treatment was lower than that at the baseline (64.1% vs 39.1%, 12.5% vs 35.9%, respectively, P=0.003); Total cholesterol (TC) (median 4.71 mmol/L vs 4.00 mmol/L, P<0.001), triglyceride (TG) (median 2.19 mmol/L vs 2.00 mmol/L, P<0.001), high-density lipoproteincholesterol (HDL-C) (median 1.16 mmol/L vs 1.00 mmol/ L, P<0.001) at 48 weeks after treatment were higher than those at baseline, low-density lipoprotein cholesterol (LDL-C) (median 2.61 mmol/L vs 3.00 mmol/L, P<0.001) and fasting blood glucose at 48 weeks after treatment (median 5.60 mmol/L vs 6.00 mmol/L, P<0.001) were lower than those at baseline, the differences were statistically significant.Conclusion CHB patients complicated with fatty liver disease in treatment-naive and treatment-experienced group can achieve higher virological and biochemical responses after treated with TAF, and the renal impairment of TAF is lower. However, TAF may have potential effect on increasing TCH, TG and HDL-C levels, lowering fasting blood sugar.
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    Chinese Hepatolgy    2022, 27 (7): 725-729.  
    Abstract860)      PDF (699KB)(393)      
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    Chinese Hepatolgy    2021, 26 (8): 825-831.  
    Abstract853)      PDF (868KB)(1034)      
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    Chinese Hepatolgy    2022, 27 (4): 499-501.  
    Abstract809)      PDF (839KB)(451)      
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    Evaluation of liver fibrosis stage in chronic hepatitis B patients by spleen stiffness and volume measurement with magnetic resonance elastography
    WANG Tian-bao, WEI Hai-gang, XU Xin-sheng
    Chinese Hepatolgy    2022, 27 (4): 443-446.  
    Abstract794)      PDF (667KB)(216)      
    Objective The staging of liver fibrosis in patients with chronic hepatitis B (CHB) was evaluated by spleen stiffness measurement (SSM) and spleen volume with magnetic resonance elastography (MRE).Methods A total of 92 CHB patients (70 males and 22 females) who completed MRE examination from January 2018 to April 2021 were enrolled, with an average age of (42.1±6.0) years. T test or chi-square test was used for statistical comparison according to the data type.Results When comparing the data of CHB patients (CHB group) and control group, the SSM values of CHB group and control group were (5.1±1.2)kPa and (4.4±0.9)kPa, respectively, and the difference was statistically significant (P<0.05). The volume of spleen in CHB group and control group was (210.3±37.1)cm3 and (180.6±30.8)cm3, respectively, and the difference was statistically significant (P<0.05). The levels of platelet (PLT) count, alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP) and glutamyl transpeptidase (GGT) in CHB group were (130.8±32.3) ×109/L, (55.8±18.4) U/L, (52.1±16.1) U/L, (158.2±42.1) U/L, compared with the control group [(182.5±40.6) ×109/L, (28.4±11.1) U/L, (24.6±9.6) U/L, (92.0±30.6) U/L and (36.2±12.9) U/L], respectively, the differences were statistically significant (P<0.05). The SSM values of CHB patients in F3 [(5.8±1.3) kPa] and F4 [(6.8±1.5) kPa] were significantly higher than those in F0 [(4.4±1.0) kPa], F1 [(4.5±0.9) kPa] and F2 [(4.6±1.2) kPa], respectively, with all P<0.05. The volume of spleen in patients with CHB in F3 [(246.1± 43.1) cm3] and F4 [(272.2±49.2) cm3] was significantly higher than that in F0 [(186.5±32.2) cm3], F1 [(192.3±33.5) cm3] and F2 [(198.4±35.0) cm3, respectively, with all P<0.05.Conclusion Measurement of SSM and spleen volume by MRE has important clinical value for staging liver fibrosis in CHB patients, especially for the evaluation of advanced liver fibrosis.
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    Chinese Hepatolgy    2021, 26 (12): 1303-1305.  
    Abstract786)      PDF (1235KB)(510)      
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    A study on the impact of vitamin D deficiency in patients with hepatitis B
    GAO Wen, YANG Xue, DOU Ai-hua, HUI Wei, LIU Mei, XU Bin, DUAN Zhong-ping
    Chinese Hepatolgy    2020, 25 (9): 940-942.  
    Abstract776)      PDF (659KB)(415)      
    Objective To investigate the impact of vitamin D deficiency on the clinical parameters of patients with chronic hepatitis B (CHB), liver cirrhosis and hepatocellular carcinoma (HCC). Methods Ninety-one hepatitis B patients including 14 cases of CHB, 44 cases of cirrhosis, 33 cases of HCC and 13 healthy controls were collected in this study. Vitamin D was determined by liquid chromatography-mass spectrometry with isotope dilution. Parameters such as T lymphocyte subsets, liver function and virological indexes were detected simultaneously. Univariate and multivariate analyses were performed to analysis the association between vitamin D levels and the clinical parameters. Results The prevalence of vitamin D deficiency (defined as < 20 ng/mL) in the patients with liver cancer (96.97%) and cirrhosis (93.18%) was higher than that in the healthy controls (76.92%) and the patients with chronic hepatitis B (77.83%). The content of vitamin D in the healthy controls was 16.38±5.53 ng/mL, 15.06±4.91 ng/mL in the patients with chronic hepatitis B, 11.85±2.66 ng/mL in the patients with liver cirrhosis and 10.59±3.06 ng/mL in the patients with liver cancer. The Vitamin D levels were not different in these four groups in different seasons (P> 0.05). The vitamin D levels between the healthy control and the chronic hepatitis B groups, or between the cirrhosis and HCC groups were not different (P> 0.05). However, there was a significant difference in the vitamin D levels of the cirrhosis and HCC patients when compared with the healthy controls and the chronic hepatitis B patients (P<0.05), indicating that vitamin D levels were decreased in association with hepatitis B progression. There were also correlation between the Vitamin D levels with the clinical parameters of lymphocyte, hemoglobin, platelet, PTA, albumin, prealbumin, cholinesterase, T lymphocyte subsets (CD3+, CD3+ CD8+, CD45+), suggesting that vitamin D was associated with the synthesis and immune function of the livers. Conclusion Most of the patients with chronic hepatitis B viral infection have vitamin D deficiency. Vitamin D may be involved in regulating immune function of hepatitis B patients, and its deficiency is associated with the clinical progression. These results may provide insight for the research and treatment of CHB.
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    Clinical characteristics of liver disease patients with positive anti SLA antibody
    ZHONG Yan-dan, YU Hai-ying, GUO Yin-yan, DING Qiao-yun, CAO Xing-guo, PENG Shan-shan, YANG Yong-feng
    Chinese Hepatolgy    2021, 26 (7): 795-798.  
    Abstract762)      PDF (707KB)(403)      
    Objective Anti SLA antibody is a specific serological marker of AIH. This study retrospectively evaluated the detection rate of anti SLA in AIH and various liver diseases, and analyzed the clinical characteristics, IAIHG-AIH score, treatment response and outcome of patients with anti SLA positive AIH. Methods Serum anti SLA was detected in 853 patients with liver diseases of different etiology. The presence of anti SLA was detected by Western blot. We recorded the general characteristics and test results of the patients. Results Anti SLA was detected in 18 (2%) of 853 liver disease patients. There were 11 cases of AIH (61.1%), 3 cases of AIH / PBC (16.7%), 2 cases of PBC (11.1%), 1 case of HBV (5.6%) and 1 case of DILI (5.6%). The detection rate of anti SLA in AIH patients was 6%. 11 patients with anti SLA positive AIH received immunosuppressive therapy and developed biochemical remission, but 6 of them relapsed (5 recurred after drug withdrawal and 1 relapsed in remission stage). Conclusion The detection rate of anti SLA is very low, but it has high specificity for AIH. Further studies are needed to prove the clinical significance of anti SLA in AIH.
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    Predictive value of CLIF-SOFA score for organ failure in patients with HBV-ACLF
    MA Wan-su, ZHAO Lin, LI Hong-sheng
    Chinese Hepatolgy    2020, 25 (6): 578-581.  
    Abstract742)      PDF (812KB)(423)      
    Objective To investigate the value of chronic liver failure sequential organ failure assessment (CLIF-SOFA) score in predicting organ failure in patients with hepatitis B virus associated acute-on-chronic liver failure (HBV-ACLF).Methods A total of 100 HBV-ACLF patients admitted to our hospital from August 2016 to August 2019 were divided into organ failure group and non-organ failure group according to the condition of organ involvement. The CLIF-SOFA scores were compared between the 2 groups. The receiver operator characteristic (ROC) curve was used to analyze the predictive value of CLIF-SOFA scores for organ failure. On the day of admission, 2 mL of fasting venous blood was collected. The levels of total bilirubin (TBil), total cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alpha fetoprotein (AFP) and leukocyte count (WBC) were measured. Correlation between CLIF-SOFA score and serum indexes were analyzed by Pearson correlation coefficient.Results Of the 100 cases, 21 (21.00%) had no organ failure and 79 (79.00%) had organ failure. The organ failure group had higher CLIF-SOFA score (6.19±1.04) than the non-organ failure group (4.17±1.01) (P<0.05). The area under the ROC curve of CLIF-SOFA score was 0.808 (standard error = 0.053, P=0.000, 95% confidence interval = 0.705-0.911). Serum TBil and WBC in organ failure group [(384.64±15.89) μmol/L, (7.94±1.56) × 109/L] were significantly higher than those in non-organ failure group [(189.48±17.84) μmol/L, (6.21±1.75) × 109/L] (P<0.05). TC, ALT and AST in organ failure group [(1.76±0.34) mmol/L, (384.50±96.76) U/L, (328.91±91.12) U/L] were significantly lower than those in non-organ failure group [(2.32±0.83) mmol/L , (645.41±124.64) U/L, (552.32±114.76) U/L] (P<0.05). The CLIF-SOFA score of HBV-ACLF patients with organ failure was positively correlated with serum TBil and WBC (r=0.616, 0.824, P<0.05), and negatively correlated with ALT and AST (r=-0.742, -0.574, P<0.05).Conclusion CLIF-SOFA score can predict organ failure in patients with HBV-ACLF, which is related to TBil, WBC, ALT and AST.
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