Table of Content

31 December 2018, Volume 23 Issue 12

Previous Issue    Next Issue

Original Articles

A clinical study on the predictors for esophageal variceal rebleeding in patients with liver cirrhosis after endoscopic variceal ligation treatment

LIU Jin-jin, DING Rui, OU Xiao-juan, WU Xiao-ning, JIA Ji-dong

2018, 23(12):  1065-1068. 

Asbtract ( 240 )   PDF (684KB) ( 507 )  

References | Related Articles | Metrics

Objective The aim of the study was to investigate predictive factors of esophageal variceal rebleeding (EVRB) within 12 months after initial endoscopic variceal ligation (EVL) treatment in patients with cirrhosis. Methods A total of 120 cirrhotic patients with esophageal variceal bleeding (EVB) treated with EVL treatment for the first time were retrospectively analyzed, who were admitted to our hospital between January 2009 and January 2012. The 120 patients were followed up for 12 months. Among these patients, 73 (60.83%) patients without rebleeding and 47 (39.17%) patients with recurrent hemorrhage within 12 months were enrolled as the non-rebleeding group and rebleeding group, respectively. Differences between 2 groups were estimated using independent samples t-test and non-parametric test for continuous variables, and χ² test for categorical variables, respectively. COX regression was used to identify independent risk factors and establish a COX model. Results The average age was 51.7 and 55.5 years old in non-rebleeding and rebleeding group, respectively. Mean hemoglobin (HGB) and mean albumin (Alb) level were 82.2 g/L and 30.9 g/L in non-rebleeding group, and 74.0 g/L and 29.0g/L in rebleeding group, respectively. Parameters including age, HGB, Alb, Child-Pugh (CTP) classification, ascites, non-neoplastic splanchnic vein thrombosis (SVT), requirement of blood transfusion and the width of portal vein were significant different between 2 groups (P<0.05). COX regression revealed that age and CTP classification were independent predictors for variceal rebleeding within 12 months of initial treatment. Besides, a COX regression equation was established: h(t, X)=h0(t)exp(0.053X₁+0.888X6) (X₁=age, X₂=CTP classification), which was statistically significant (χ²=21.417, P<0.001). Conclusion The study indicates that recurrent hemorrhage within 12 months after initial EVB and EVL treatment in cirrhotic patients is significantly associated with age, HGB, Alb, CTP classification, ascites, SVT, requirements of blood transfusion and the width of portal vein. Furthermore, age and CTP classification are the independent predictors of EVRB.

The role of Tfh cells and its transcription factor achaete-scute homologue 2 in chronic infection of hepatitis B virus

WANG Ya-ning, FAN Chao, SHEN Huan-jun, HAO Chun-qiu, JIA Zhan-sheng

2018, 23(12):  1069-1072. 

Asbtract ( 217 )   PDF (1611KB) ( 307 )  

References | Related Articles | Metrics

Objective To investigate the significance of achaete-scute homologue 2 (Ascl2) expression in T follicular helper (Tfh) cells during chronic hepatitis B virus infection. Methods Frequencies of CD4⁺CXCR5⁺ Tfh cells and CD4⁺CXCR5⁺PD-1⁺ Tfh cells in peripheral blood mononuclear cells (PBMC) were analyzed by flow cytometry, respectively. The expression of Ascl2 in Tfh cells was determined by quantitative real-time polymerase chain reaction. The levels of serum interleukin-21 (IL-21) and interleukin-17 (IL-17) were measured using enzyme-linked immunosorbent assay. Results The frequencies of CD4⁺CXCR5⁺ and CD4⁺CXCR5⁺PD-1⁺ Tfh cells were significantly higher in PBMC from chronic hepatitis B (CHB) patients than that from healthy controls (t=4.786, P<0.05). The expression of Ascl2 was significantly higher in Tfh cells of CHB patients (t=4.655, P<0.05). Furthermore, the levels of serum IL-21 and IL-17 were significantly higher in CHB patients (t=4.896 and t=3.764, P<0.05). Conclusion It was implied that transcription factor Ascl2 plays an important role in the differentiation and development of Tfh cells in CHB patients.

Correlations between serum IL-35, IL-17 and HBeAg clearance in chronic hepatitis B patients treated with entecavir

ZHANG Cao-geng,ZHANG Zhi-feng, ZHANG Hong-yun, GU Hai-wei, LIU Hong, NI Ju-ping, SHI Yan-fen, XU Rui-fang

2018, 23(12):  1073-1077. 

Asbtract ( 149 )   PDF (953KB) ( 332 )  

References | Related Articles | Metrics

Objective To study the dynamic changes of serum levels of interleukin-35 (IL-35) and interleukin-17 (IL-17) during the 48-week entecavir (ETV) treatment and to investigate their relationship with hepatitis B e antigen (HBeAg) clearance. Methods A total of 48 HBeAg-positive chronic hepatitis B (CHB) patients receiving antiviral treatment of ETV were followed up. Laboratory indicators including HBeAg titer, hepatitis B virus (HBV) DNA load, alanine aminotransferase (ALT), serum IL-35, IL-17 and the ratio of IL-35/IL-17 were detected at baseline, week 12, week 24, week 36 and week 48, respectively. According to the HBeAg status at week 48, the patients were divided into HBeAg-negative and HBeAg-positive group for comparative analysis. Results At week 48, 41 out of 48 (85.42%) patients achieved ALT normalization, 46 (95.83%) patients achieved complete virological response, and 2 (4.17%) patients achieved partial virological response. No patient had a virological breakthrough. A total of 11 (22.92%) patients achieved HBeAg clearance. At baseline, serum levels of IL-35, IL-17 and IL-35/IL-17 ratio in HBeAg-negative and HBeAg-positive groups were higher than those of healthy controls (P<0.05). However, there was no significant difference between these 2 groups (P>0.05). During treatment, serum IL-35 level in 2 groups significantly decreased (P<0.05), and was significantly different between 2 groups at week 48 (P=0.0421). Compared with that at baseline, serum IL-17 level showed no significant changes in 2 groups (both P>0.05), and no significant differences between 2 groups during treatment (P>0.05). Compared with those at baseline, the IL-35/IL-17 ratios and HBeAg titers of 2 groups showed different degrees of decline (P<0.05), with statistically significant differences between 2 groups (P<0.05). Conclusion ETV antiviral therapy can reduce the serum IL-35 level of CHB patients. The dynamic changes of serum levels of IL-35, IL-17 and IL-35/IL-17 ratio may predict HBeAg clearance during antiviral treatment.

Preliminary exploration of the relationship between IgG4 and immunological liver injury

WANG Lan, QIU Hong, YANG Rui-ning

2018, 23(12):  1078-1080. 

Asbtract ( 299 )   PDF (673KB) ( 322 )  

References | Related Articles | Metrics

Objective To analyze the level of immunoglobulin G4 (IgG4) in serum from patients with 3 types of immunological liver injury, and to investigate its correlation with different types of immunological liver injury and the clinical significance. Methods A total of 220 patients with immunological liver injury in our hospital were enrolled, including 80 patients with chronic hepatitis B (CHB), 60 patients with autoimmune hepatitis (AIH) and 80 patients with primary biliary cirrhosis (PBC). The serum biochemical index, serum IgG4 level and autoantibodies of the 3 groups were retrospectively analyzed for comparative analysis of the relationship between IgG4 and diseases. Results The median level of IgG4 in AIH group was 3.24 (1.78~4.53), which was significantly higher than that in other 2 groups (P<0.05). The median level of IgG4 in PBC group was 2.19 (0.69~3.01), which was higher than that in CHB group (1.40) (0.55~3.05). Within the group, serum IgG4 levels showed a certain correlation with liver function and autoantibody positive rate. Conclusion The correlation between AIH and IgG4 is the most relevant among the 3 groups. Thus, detection of IgG4 content is of great significance in the diagnosis of immunological liver injury, such as AIH, and the evaluation of therapeutic effect.