Table of Content

30 May 2017, Volume 22 Issue 5

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Original Articles

Clinical study on CLIF-C OFs for distinguishing acute-on-chronic liver failure from HBV-related chronic liver disease with acute decompensation

ZHOU Hui-juan, TANG Wei-liang, LU Xiao-bo, HU Pei, JIANG Shao-wen, XU Yu-min, CAO Zhu-jun, LAI Rong-tao, WANG Hui, CAI Wei, XIE Qing, YU Min-jie

2017, 22(5):  396-399. 

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Objective To investigate the applicability of chronic liver failure consortium organ failure score (CLIF-C OFs) in diagnosing hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF), which was initially proposed by European association for the study of the liver (EASL) for diagnosing alcoholic ACLF.Methods A total of 854 consecutive HBV-related chronic liver disease patients with acute decompensation (AD) from January 2005 to December 2010 in our hospital were enrolled. Patients were divided into ACLF group and non-ACLF group according to CLIF-C OFs, whose clinical data, biochemistry characteristics, disease severity and short-term mortality rate were analyzed, respectively.Results Among the 854 patients, there were 262 in ACLF group and 592 in non-ACLF group. Compared with non-ACLF group, patients in ACLF group were older with higher incidence of liver, renal, cerebral, coagulation, circulatory and respiratory failure, respectively (P<0.01). Moreover, 28-day mortality and 90-day mortality in ACLF group were also higher than that in non-ACLF group (27.1% vs 3.1% and 39.6% vs 4.9%, P<0.01).Conclusion CLIF-C OFs can help distinguish a severe ACLF subgroup with high mortality from HBV-related chronic liver disease patients with AD, which is benefit for clinical management.

A meta-analysis of comparison of efficacy of tenofovir or entecavir in nucleos(t)ide analogue-naive patients with chronic hepatitis B

DING Rong-rong, SHI Guang-feng, ZHANG Zhan-qing, ZHOU Xin-lan

2017, 22(5):  400-403. 

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Objective To compare treatment efficacy and safety of tenofovir (TDF) or entecavir (ETV) in nucleoside-nave chronic hepatitis B (CHB) patients using meta-analysis.Methods Published data relevant to TDF or ETV treated CHB patients from January 2006 to October 2016 was enrolled and meta-analyzed. The rate of Hepatitis B virus (HBV) DNA suppression, alanine transaminase (ALT) normalization, and hepatitis B e antigen (HBeAg) seroconversion at week 48 and 96 were reviewed, respectively. Drug safety and resistance were also discussed.Results There were 6 articles involved. The meta-analysis showed no significant differences in HBV DNA suppression rate between the two drugs innave treated CHB patients (TDF vs. ETV: RR= 1.19, 95% CI = 1.09~1.30 and RR=1.08, 95% CI=1.02~1.14 for week 48 and week 96, respectively). Moreover, there were also no differences in ALT normalization rate (4 studies for 48 weeks), HBeAg seroconversion rate (3 studies for 96 weeks) and long-term safety between TDF and ETV, respectively.Conclusion TDF and ETV show similar efficacy in treating nucleoside-nave chronic HBV patients. Nevertheless, the long-term efficacy and safety should be monitored in prolonged therapy.

Clinical and pathological features of Dubin-Johnson syndrome in 21 cases

YU Si-miao, ZHU Yun,GAO Han-jia,DU Ning,WANG Li-fu, SUN Yong-qiang,JING Jing,WANG Li-ping, ZHANG Fan,WANG Rui-lin

2017, 22(5):  404-405. 

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Objective To investigate the clinical and pathological features of Dubin-Johnson syndrome (DJS) in 21 cases.Methods Clinical data of 21 inpatients diagnosed of DJS from January 2006 to April 2016 was collected and retrospectively analyzed.Results There were 17 male patients and 4 female patients enrolled with average age of 28.7±8.1-year old. The average levels of total bilirubin (TBil) and direct bilirubin were 59.2±11.1 mol/L and 40.9±9.3 mol/L, respectively. Macroscopic observation shown liver tissues with pathognomonic black including gray-brown, yellow-green and gray-black. Microscopically, there were a large number of dark brown coarse granules depositing in the hepatocytes, especially around the central veins. A few of hydropic degeneration of hepatocytes was detected with little perisinuitis. There was no or slight enlargement in the portal areas with little inflammatory cells infiltration.Conclusion DJS occurs mainly in men during the phase of adolescence. Total bilirubin is increased in DJS, especially the direct bilirubin. Liver biopsy is the golden index for diagnosis of DJS, which is shown as grossly dark liver specimen and microscopically numerous brownish pigment deposits in hepatocytes.

Expression of HNF4a gene and its prognostic value in hepatocellular carcinoma

ZHANG Wei, DONG Zheng, KONG Hui-fang, ZHANG Bai-long, MAO Wei, GAO Xu-dong, RONG Yi-hui

2017, 22(5):  406-409. 

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Objective To investigate the expression of hepatocyte nuclear factor 4 alpha (HNF4a) in hepatocellular carcinoma (HCC), and explore its prognostic value in metastasis and recurrence of HCC by analyzing its relationships with disease-free survival (DFS) and overall survival (OS).Methods Expressions of HNF4a in 172 HCC tissues was detected using immunohistochemistry. To establish the regression model of HNF4a protein expression with clinical pathological parameters, DFS and OS in HCC patients.Results The positive rate of HNF4a was 81.98% in 141/172 HCC patients. Moreover, HNF4a gene expression was significantly correlated with alpha fetal protein (AFP) and pathologic grading of cancer (P<0.05), while showed no significantly correlations with sex, age, hepatitis B surface antigen (HBsAg), liver cirrhosis, tumor size, tumor node metastasis (TNM) stage, metastasis and recurrence, respectively (all P>0.05). The DFS was 22.0 months in patients with high HNF4a protein expression and 4.0 months in patients with low HNF4a expression (P<0.05). OS analysis showed that HNF4a protein expression was a risk factor (P<0.05).Conclusion HNF4a expression was significantly positively correlated with the survival in HCC patients, which might be a reference index for the recurrence and prognosis of HCC.

Isolation and cryopreservation of human hepatocytes from adult whole liver with steatosis

LI Tao, TONG Hui, SHEN Chuan, ZHU Zhe-cheng

2017, 22(5):  410-413. 

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Objective To isolate and cryopreserve human hepatocytes from adult whole liver with heavy steatosis to provide human hepatocytes source for bio-artificial liver. Methods Primary human hepatocytes were isolated using a modified two-step collagenase retrograde perfusion via hepatic vein from adult whole livers with heavy steatosis. The isolated hepatocytes were under programmed and standard cryopreservation, respectively. The viability, adhesion rate, lactate dehydrogenase (LDH) releasing level and albumin synthesis ability were compared between the thawed hepatocytes with the 2 different cryopreservation methods.Results The average yield and viability of hepatocytes from livers perfused with N-acetylcysteine (NAC) was significantly higher than that without NAC [(7.4±0.5)×10⁶ cells/g vs. (5.6±0.8)×10⁶ cells/g and (81.4±3.4)%vs. (67.3±5.0)%, both P<0.05], respectively. Compared with hepatocytes under standard cryopreservation, hepatocytes under programmed cryopreservation showed significantly higher in the viability, adhesion rate, LDH release level and albumin synthesis ability (all P<0.05), respectively.Conclusion A modified two-step retrograde perfusion using collagenase with the NAC via hepatic vein could improve the yield and viability of isolated hepatocytes from adult whole livers with heavy steatosis. Besides, the programmed cryopreservation program could improve the quality of the isolated hepatocytes to meet the grossing need of hepatocyte for the bio-artificial liver.

Role of DKK3 in non-alcoholic fatty liver disease of mice model

XIE Lan-feng, SHEN Ting-ting, ZHENG Ce, WANG Pi-xiao, WEI Qiao-fang, YANG Chang-qing, ZHANG Qin

2017, 22(5):  414-417. 

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Objective To investigate the role of Dickkopf-3 (DKK3) in mice with non-alcoholic fatty liver disease (NAFLD).Methods Male C57BL/6 mice were applied to establish NAFLD model with high fat diet (HFD), which was validated using detections of hepatic function, glucose metabolism, lipid content and liver pathology. DKK3 expression in liver were measured using western blot.Results In HFD group, NAFLD-related parameters were significantly elevated, while hepatic DKK product was significantly decreased compared with that in control group.Conclusion Decreased expression of hepatic DKK3 in NAFLD mice model suggests that DKK3 might play a role in the development of NAFLD.