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Chronic inflammation of the liver is a risk factor that promotes the progression of hepatocellular carcinoma, and in the presence of viral infection, enhanced Fc receptor signal will further aggravate inflammatory response and participate in the process of canceration. Polymeric immunoglobulin receptor (pIgR) not only plays a critical role in first-line anti-infection immunity, but also promotes the metastasis and growth of early-stage hepatocellular carcinoma. Identifying pIgR as a predictive index for metastatic potential in patients with early-stage liver cancer can help to promote the stratification and treatment decisions for such patients, which has a positive significance in improving patient prognosis. Targeted inhibition of the pIgR/Yes signal cascade as a potential treatment option may provide more treatment options for controlling tumor size to allow resection or transplantation.
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Portal hypertensive gastropathy (PHG) has a high incidence rate in cirrhotic patients,leading to a high risk of upper gastrointestinal bleeding.Gastric mucosal injury is the major pathological change of PHG.There are few studies focusing on the clinical application of antacids in the treatment of PHG in cirrhotic patients and there are still controversies over this issue.This article reviews the influencing factors for PHG,the mechanism of gastric mucosal injury,and the application of antacids.It is pointed out that during the treatment of PHG,besides the reduction in portal venous pressure,the application of antacids such as proton pump inhibitors can improve the cure rate of PHG.Prospective randomized control trials with a large sample size are needed to further demonstrate the clinical effect and safety of antacids in the treatment of PHG in cirrhotic patients.
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Objective To analyze the virologic responses of peginterferonα‐2a plus ribavirin (Peg IFNα‐2a/RBV) for patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) coinfection by a paired study . Methods Sixteen patients with HBV/HCV coinfection and 32 patients with HCV monoinfection were allocated . The virological response and biochemical response were compared between the two groups after Peg IFNα‐2a/RBV regimen treatment .Chi‐square analysis or Fisher exact analysis was used to compare the responses .Logistic analysis was conducted to evaluate factors associated with sustained virological response (SVR) .Results The median levels of HCV RNA were 6 .54 lg IU/mL in 16 patients with HBV/HCV co‐infection and 6 .98 lg IU/mL in 32 patients of HCV monoinfection ,which was statistically different (Z= 4 .124 , P0 .05) .The relapse rate in HBV/HCV‐coinfected patients was significantly higher than that in HCV‐monoinfected patients (35 .7% [5/16] vs 8 .7% [2/32];χ2=4 .142 , P= 0 .042) .In HBV/HCV coinfection group ,7 cases were HBV DNA detectable ,7 cases were hepatitis B e antigen (HBeAg ) positive , 13 cases were abnormal alanine aminotransferase (ALT) levels and 12 cases were abnormal aspartate aminotransferase (AST ) levels . After treatment ,only 4 patients were HBV DNA detectable ,5 cases were HBeAg positive ,4 cases were abnormal ALT levels and 5 cases were abnormal AST levels (P= 0 .458 ,0 .716 ,0 .004 and 0 .032 , respectively) .The median level of hepatitis B surface antigen (HBsAg) was 780 IU/mL and decreased to 250 IU/mL after treatment ,while the difference did not reach statistical significance (Z= 1 .826 ,P=0 .068) .A total of 4 patients achieved complete virologic response for HBV ,3 achieved partial virologic response;2 achieved HBeAg seroconversion .Logistic regression analysis showed that EVR was a positive factor for achieving SVR (OR=35 .2 ,95% CI=3 .55-349 .15 , P=0 .002) .Conclusions HCV remains at low replication level in patients with HBV/HCV coinfection .Virological responses can be achieved by Peg IFNα‐2a/RBV treatment .EVR might be a positive factor associated with SVR .
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ObjectiveTo assess the efficacy of adjuvant therapy with fenofibrate for primary biliary cirrhosis (PBC). MethodsCNKI, Wanfang Data, China Biology Medicine, PubMed, Embase, and Cochrane library were searched for the pertinent literature of randomized controlled trials (RCTs) of adjuvant therapy with fenofibrate for PBC published up to December 31, 2014. Data extraction and quality assessment were carried out, and the data were statistically analyzed by Stata10.1 software. Respectively, for heterogeneity test. The fixed effect model is chosen for homogeneity, and the random effect model is chosen for heterogeneity. ResultsSix RCTs met the inclusion criteria. Treatment with fenofibrate was associated with significantly reduced levels of gamma-glutamyl transpeptidase, alanine aminotransferase, and alkaline phosphatase in PBC patients (SMD=-1.595, -0.447, and -2.125, respectively, all P＜0.05). There were no significant changes in the levels of aspartate aminotransferase and total bilirubin after adjuvant therapy with fenofibrate (both P＞0.05). Also, fenofibrate led to no significant improvement in immunoglobulin M (P＞0.05). ConclusionFenofibrate, which improves the indicators of liver function but leads to no changes in immunological indicators, appears to be an effective adjuvant therapy in PBC patients. There is a critical need for more large-scale, multi-center, high-quality RCTs to determine its effect on liver disease-related morbidity and mortality.
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ObjectiveTo assess the efficacy of adjuvant therapy with fenofibrate for primary biliary cirrhosis (PBC). MethodsCNKI, Wanfang Data, China Biology Medicine, PubMed, Embase, and Cochrane library were searched for the pertinent literature of randomized controlled trials (RCTs) of adjuvant therapy with fenofibrate for PBC published up to December 31, 2014. Data extraction and quality assessment were carried out, and the data were statistically analyzed by Stata10.1 software. Respectively, for heterogeneity test. The fixed effect model is chosen for homogeneity, and the random effect model is chosen for heterogeneity. ResultsSix RCTs met the inclusion criteria. Treatment with fenofibrate was associated with significantly reduced levels of gamma-glutamyl transpeptidase, alanine aminotransferase, and alkaline phosphatase in PBC patients (SMD=-1.595, -0.447, and -2.125, respectively, all P＜0.05). There were no significant changes in the levels of aspartate aminotransferase and total bilirubin after adjuvant therapy with fenofibrate (both P＞0.05). Also, fenofibrate led to no significant improvement in immunoglobulin M (P＞0.05). ConclusionFenofibrate, which improves the indicators of liver function but leads to no changes in immunological indicators, appears to be an effective adjuvant therapy in PBC patients. There is a critical need for more large-scale, multi-center, high-quality RCTs to determine its effect on liver disease-related morbidity and mortality.
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Objective To evaluate the relationship between long non-coding RNAs (LncRNA) in tumor tissues and clinico-pathological features of hepatocllular carcinoma (HCC).Methods Using hepatocellular carcinoma gene database GSE36376,we conducted a study on eight LncRNAs which are associated with liver diseases and analyzed the correlation between these LncRNAs and HCC clinico-pathological characteristics.We also evaluated the potential effect of LncRNAs on HCC development.Results H19 was overexpressed in non-tumorous tissues of HCC (P ＜ 0.05),while MEG3,HOXA13,KCNQ1OT1 were all upregulated in tumorous tissues (all P ＜ 0.05).HULC level in HCC tumorous tissues was negatively correlated with AJCC staging,BCLC staging and tumor size (all P ＜ 0.05).UCA1 was positively correlated with BCLC staging (r =0.135,P ＜ 0.05).Univariate analysis and multivariate logistic analyses showed that UCA1 was a risk factor of intrahepatic metastasis of HCC (OR =6.054,95％ CI =1.429 ～ 25.642,P ＜ 0.05); in contrast,HULC overexpression in tumorous tissues played a positive role in HCC tumor size (OR=0.805,95％CI=0.678 ～0.956,P＜0.05).Conclusion HULC in tumorous tissues suppressed HCC proliferation,while UCA1 was a risk factor of HCC aggressiveness.
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Objective To observe the protective effect of Xiaohuangdecotion against liver damage inα-naphthylisothiocyanate (ANIT)- induced cholestasis in rats and probe the potential mechanisms.Methods Male Wistar rats (40) were randomly divided into a normal group, a model group, aXiaohuangdecotion treatment group, and a UDCA control group (10 for each). Except for rats in the normal group, ANIT solution (6 ml/kg) was administered in other rats by gavages for cholestasis model. After ANIT treated 48 h, rats inXiaohuangdecotion group and UDCA group were treated withXiaohuangdecotion (1.73 g/kg) and UDCA (10 mg/kg) respectively for 1 week. And, rats in the normal group and the model group were given an equal volume of saline. At the end of the experiment, liver function rats were examined. Liver histology was examined by HE staining, and CD68 factor was tested by immunohistochemistry and Western blot.Results Compared with the model group, the content of ALT (164.6 ± 53.4 U/Lvs. 208.4 ± 28.5 U/L), AST (247.6 ± 76.1 U/Lvs. 341.8 ± 32.8 U/L), ALP (601.0 ± 101.1 U/Lvs. 720.6 ± 123.3 U/L), TBiL (96.5 ± 18.1μmol/Lvs. 149.6 ± 30.2μmol/L), DBiL (73.7 ± 16.6μmol/Lvs. 140.3 ± 28.6μmol/L) and TBA (93.4 ± 13.0μmol/Lvs. 146.5 ± 38.9μmol/L) were significantly reduced in the treatment group (P<0.01 orP<0.05). Compared with the model group, CD68 level (7.08 ± 0.19 vs. 17.42 ± 0.48)were significantly reduced by intervention ofXiaohuangdecotion (P<0.01).ConclusionsXiaohuangdecotion could improve liver functions and reduce CD68 expression, leading to a good hepatoprotective and jaundice-relieving effects.
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Objective This study aimed to analyze the clinical features of novel H7N9 avian influenza virus infection in human and its prognosis after integrative treatment.Methods Eighteen H7N9 infected patients were admitted to Shanghai Public Health Clinical Center from 5 April 2013 to 19 April 2013,and were divided into mild group (8 cases) and severe group (10 cases) based on their baseline disease conditions.Patients in mild group were administered modified Yinqiao powder and Shengjiang powder,while patients in severe group were administered modified Qinwen Baidu Decoction or Xuanbai Chengqi Decoction,in addition to antiviral,anti infection,glucocorticoids and human immunoglobulin treatment in both groups.Baseline characteristics and outcomes of these patients were analyzed,and factors associated with prognosis were also evaluated.Measurement data were compared by t test or rank sum test,categorical variables were compared by chi square test or Fisher exact test.Factors associated with prognosis were evaluated by Logistic regression analysis.Results Compared to mild group,patients in severe group suffered from a significantly elevated C reactive protein [(102.61± 30.80) mg/L vs (38.44± 22.31) mg/L; t=4.717,P＜0.01],and significantly lowered CD3+,CD4+,CD8+ and CD45+T cell levels (all P＜0.05).Compared to regimens with glucocorticoids and human immunoglobulin,traditional Chinese medicine (TCM) contained therapy achieved a higher recovery rate in H7N9 infected patients,but with no statistical significance (P＞0.05).Univariate Logistic regression analysis showed that myoglobin might be a risk factor associated with prognosis of H7N9 infection (P =0.029),and rnultivariable analysis showed that high levels of myoglobin might be negatively related to the prognosis of H7N9-infected patients,But with no statistical significance (P＝0.053).Conclusions Severe H7N9-infected patients suffer from active inflammation and lowered T cell mediated immune response.Integrative therapy is effective for novel H7N9 avian influenza virus infection,and helps to improve the outcomes of infected patients.
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Objective To evaluate the efficacy and influence factors of peginterferon combined with ribavirin for the treatment of elderly patients with chronic hepatitis C (CHC).Methods 34 CHC patients aged over 60 years were enrolled in this retrospective study.Virological responses,relapse rate and discontinuation rate were evaluated,and the predictive factors associated with these outcomes were analyzed.Results The proportions of rapid virological response (RVR),early virological response (EVR),end of treatment virological response(ETR),sustained virologic response (SVR) were 26.5％,41.2％,52.9％ and 35.3％,respectively in patients after peginterferon plus ribavirin theraphy,and the relapse rate was 33.3％.The relapse rate was higher in patients with the interferon treatment history than in patients with initial interferon treatment (P＜0.05).The rates of ETR and SVR were lower in CHC patients with diabetes than without diabetes (P＜0.05 or 0.01).The ratio of dose adjustment of peginterferon and ribavirin alone and in combination were 26.5％ (9/ 34),61.8％ (21/34) and 8.8％ (3/34),respectively.The discontinuation rate was 20.6％ (7/34).Multivariate Logistic regression analysis showed that SVR rate was lower in CHC patients with diabetes than in those without diabetes (P＜ 0.05).Conclusions Peginterferon plus ribavirin therapy has a better virological response,but a poor tolerance in CHC patients.Diabetes may be an important risk factor for sustained virologic response in CHC patients.
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Objective To evaluate the effects of pegylated interferon plus ribavirin on naive and retreated chronic hepatitis C (CHC) patients.Methods A total of 67 CHC patients were divided into naive group (n =35) and retreat group (n =32) based on their treatment history.And their virological responses [rapid virological response (RVR),early virological response (EVR),virological response to etravirine (ETR) and sustained virological response (SVR)] and risk factors were analyzed.Results ①RVR and EVR of naive group were 60％ (n =21) and 77％ (n =27),respectively,and the retreat group were 28％ (n =9),53％ (n =17).The differences between the two groups were significant (both P ＜ 0.05).On the contrary,CHC patients in both groups might achieve similar ETR and SVR rates (P ＞ 0.05) ; ② The relapse rate in the retreat group was higher than that in the naive group (22％ vs.10％).But the differences had no statistical significance (P ＞ 0.05) ; ③ CHC patients in the retreat group could achieve similar responses,including RVR,EVR,ETR and SVR (P ＞ 0.05) whether treated previously with standard interferon or pegylated interferon; ④ According to muhivariable logistic regression analysis,the retreated genotype 1 CHC patients has a lower SVR rate compared with naive genotype non-1 counterparts (OR =0.29 and 0.26,all P ＜ 0.05).Conclusions CHC patients in the naive group could achieve higher virological responses and a lower relapse rate compared to those in the retreat group.The previous treatment regimeu has no significant effect on virological responses of CHC patients retreated with Peg-IFN plus ribavirin.Genotype 1 and retreatment are both risk factors of achieving SVR.