ABSTRACT
@#【Objective】To investigate the effects of Tc17 cells on disease severity and elimination of HBV-DNA in patients with HBV related acute-on-chronic liver failure（HBV-ACLF）.【Methods】Forty-three patients with HBV- ACLF were enrolled. Twenty patients with chronic hepatitis B（CHB）and 12 healthy subjects（NC）were enrolled as controls. Flow cytometry was used to detect the expression of peripheral Tc17 cells. HBV-DNA loads were measured，and the MELD，MELD-Na，CLIF-C ACLF and AARC scores were used to evaluate the disease severity. The effects of Tc17 cells on disease severity and decline of HBV-DNA were analyzed.【Results】Compared with NC group and CHB group， the expression of Tc17 cells in HBV-ACLF patients was significantly increased（P < 0.001 and P = 0.017）. Correlation analysis showed that Tc17 cells were positively correlated with AARC score，MELD score and MELD-Na score（r = 0.504，P = 0.001；r = 0.417，P = 0.005 and r = 0.382，P = 0.012），and a correlated trend was found with CLIF-C ACLF score（r = 0.294，P = 0.055）. And as the disease progressed，the expression of Tc17 cells gradually increased.In addition，Tc17 cells were positively correlated with HBV-DNA levels（r = 0.339，P = 0.026）at baseline，and the HBV-DNA levels were significantly decreased in patients with higher expression of Tc17 cells than in lower group after 4 weeks of treatment（P < 0.001）. Furthermore，it was found that baseline Tc17 cells and AST levels were associated with the HBV-DNA decline by multivariate linear regression analysis.【Conclusion】Tc17 cells-mediated inflammatory response helps clear the HBV-DNA，but excessive inflammatory response may aggravate the disease severity.
ABSTRACT
@# 【Objective】To study the correlation between hepatocellular jaundice and liver stiffness measurement and reflect the changes in patients with acute-on-chronic liver failure（ACLF）.【Methods】Between January 2015 and March 2016，a total of 150 patients with ACLF-HBV infection were enrolled to collect clinical data，2D-SWE and biochemical variables. According to data distribution，correlation of total bilirubin with LSM by 2D-SWE was assessed by Pearson correlation analysis.【Results】One hundred and twenty-one patients were analyzed and divided into two groups：descended TB group and elevated TB group. For descended TB group，LSM decreased 5.1（2.2～6.6）kPa. For elevated TB group， LSM increased 6.2（1.2～12.8）kPa. A significant parallel correlation between TB and LSM value either the descended TB group or the elevated TB group. For descended TB group，accompanied with the decrease of LSM，patients reached clinical improvement standard and their average hospitalization time was 30 ± 15 days. Six patients underwent liver trans⁃ plantation in the elevated TB group，and showed TB level higher than twenty ULN（the upper limit of normal），ac⁃ companied with increased LSM value. Histological characteristics of these patients showed submassive hepatic necrosis. 【Conclusion】The degree of hepatic necrosis aggravation in patients with ACLF，which results in the continuous increase of TB and LSM，reflects the aggravation of patients′ condition；on the contrary，the decline in value of LSM reflects the improvement of patients′ condition.