A noninvasive diagnostic model of liver fibrosis using serum markers in primary biliary cirrhosis / 中华内科杂志

Objective To verify and assess diagnostic value of noninvasive diagnostic model of liver fibrosis in primary biliary cirrhosis (PBC) based on conventional laboratory markers.Methods Seventythree patients with PBC diagnosed by liver biopsy between January 2003 and June 2011 in Beijing Friendship Hospital,Capital Medical University were recruited in this study.Correlation analysis and logistic regression analysis between the conventional laboratory markers and histology stages were assessed.A liver fibrosis diagnostic model was established based upon aforementioned biomarkers and verified by its sensitivity and specificity for predicting the liver fibrosis.Results The predictive model ( H index) consisting of five conventional laboratory markers,i.e.,platelet count,serum cholinesterase,albumin,HDL-C and prothrombin time activity,could predict advanced fibrosis ( stages Ⅲ-Ⅳ ) with an AUCROC of 0.861.The sensitivity of predicting the absence of advanced fibrosis using H index ＜ - 2.20 was 96.6％ and the specificity of predicting the presence of advanced fibrosis using H index ＞ 0.41 was 93.2％.Conclusion The established noninvasive diagnostic model consisting of five laboratory markers could accurately distinguish pathological changes of early stage PBC ( stages Ⅰ - Ⅱ ) from advanced stage PBC ( stages Ⅲ-Ⅳ).

Suppressive effect of herbal compound 861 on chemical hepatocarcinogenesis in rats / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effects of herbal compound 861 (Cpd861) on hepatocarcinogenesis induced by diethylntrosamine and 2-acetylaminofluorene (DEN-AAF) in female Sprague Dawley rats.</p><p><b>METHODS</b>Liver preneoplastic foci were induced using the DEN-AAF method in female Sprague Dawley rats, which were then treated with Cpd861. For quantitative assessment of liver preneoplastic foci, the placental form of glutathione-S-transferase (GST-P) positive foci were measured using immunohistochemical staining and image analysis. GST-P protein expression was measured by Western blotting, mRNA expression was assessed by Northern blotting.</p><p><b>RESULTS</b>Treatment using DEN-AAF caused a significant decrease in body weight and increase in liver weight compared to the control group. Oral Cpd861 administration essentially prevented DEN-AAF-induced body weight loss and liver weight increase. When 2-AAF was followed by treatment with Cpd861, there was a decrease in the number of large foci as compared to 2-AAF alone. However, there were still considerable numbers of small mixed clear/vacuolated cell foci, some of which were positive for GST-P. Significant increase in GST-P protein and mRNA expression were observed in the DEN-AAF group, while treatment with Cpd861 inhibited the increase. The effect of Cpd861 on hepatocarcinogenesis occurred in a concentration-dependent manner.</p><p><b>CONCLUSION</b>Chinese herbal compound Cpd861 prevents hepatocarcinogenesis in DEN-AAF-induced liver preneoplastic lesions in rats.</p>

Pegylated interferons in the treatment of chronic hepatitis C / 中华医学杂志(英文版)

<p><b>PURPOSE</b>To review the efficacy and safety of pegylated interferons (peginterferons) in the treatment of chronic hepatitis C.</p><p><b>DATA SOURCES</b>An English language literature search (MEDLINE 1988 - 2001) was performed and a total of 19 original articles related to the issue were selected.</p><p><b>DATA EXTRACTION</b>After careful review of the selected papers, the meaningful results and conclusions were extracted using scientific criteria. The papers reviewed pertained mainly to the efficacy and safety profiles of peginterferons in the treatment of chronic hepatitis C.</p><p><b>RESULTS</b>Peginterferon can effectively prolong the half-life of interferon and can be effectively administered conveniently as a once-a-week dose. The antiviral effect using peginterferon was enhanced compared with that of standard interferon, but the frequency and severity of adverse events were typical of those associated with interferon-alpha.</p><p><b>CONCLUSIONS</b>Based on its efficacy, safety and convenient dosing, peginterferon is more favorable than standard interferon in the treatment of chronic hepatitis C.</p>

Histopathological features of 27 cases of primary biliary cirrhosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the clinical and histopathological features of primary biliary cirrhosis (PBC).</p><p><b>METHODS</b>The clinical, laboratory, as well as histological features of 27 cases of PBC were retrospectively analyzed.</p><p><b>RESULTS</b>The male to female ratio was 1:8 (3:24), aged from 22 to 69 years. The main clinical manifestations included: fatigue (62.9%, 17/27), jaundice (59.2%, 16/27) and pruritus (29.6%, 8/27), with all of patients having markedly elevated serum alkaline phosphatase and gamma-glutamyl transpeptidase and 95.8% (23/27) of the patients being positive for anti-mitochondrial antibody (AMA). The main histopathological changes were: necroinflammation of interlobular bile ducts (100%, 27/27), lymphocyte aggregation or lymphocyte follicles (15%, 4/27), granuloma (26%, 7/27), decreased number of interlobular bile ducts and smaller bile duct proliferation (55%, 15/27), feathery degeneration of hepatocytes (59%, 16/27); bilirubinostasis in hepatocytes and/or canaliculi (52%, 14/27); fibrosis and distortion of lobules (26%, 7/27), pseudolobular formation (11%, 3/27).</p><p><b>CONCLUSIONS</b>The main clinical features of PBS are fatigue and pruritus, markedly elevated phosphatase and gamma-glutamyl transpeptidase, and positive AMA with or without jaundice. Its histopathological hallmarks are (1)necroinflammmation and ductopenia involved mainly in interlobular bile ducts; (2)lymphocyte aggregation, granuloma formation and bile ductular proliferation in the portal area; and (3)feathery degeneration of hepatocytes.</p>

Clinical features of forty patients with primary biliary cirrhosis / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To study the clinical features of patients with primary biliary cirrhosis (PBC) in order to improve the doctors' awareness of the disease.</p><p><b>METHODS</b>General status, clinical manifestations and laboratory findings of 40 patients with PBC were reviewed.Thirty-seven patients were females (37/40), and the mean age at diagnosis was 50.5 +/- 7.8 years. The time interval from initial symptoms or preliminary diagnosis to final diagnosis was 24.0 +/- 23.6 months.</p><p><b>RESULTS</b>The most frequently reported symptoms were fatigue (67.5%, 27/40), jaundice (60%, 24/40) and pruritus (32.5%, 17/40). Eight patients (20%) had associated auto-immune diseases (Sjogren's syndrome and/or rheumatoid a(c)arthritis). Serum alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (gamma-GT) levels were markedly elevated (520.3 +/- 382.3 IU/L and 648.6 +/- 529.1 IU/L, respectively) in all patients, while alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were mildly elevated (82.6 +/- 54.5 IU/L and 100.7 +/- 47.2 IU/L, respectively). Twenty-four patients (60%) had a total bilirubin level >/= 34.2 micromol/L. Thirty-five patients (87.5%) had elevated serum immunoglobin M,and 97.5% of patients (39/40 ) were anti-mitochondrial antibody (AMA)/AMA-M2 positive.</p><p><b>CONCLUSION</b>Elevated serum ALP and gamma-GT levels, together with a positive AMA/AMA-M2, can help the diagnosis of PBC. Liver biopsy is useful to confirm the diagnosis and to differentiate histopathological stages.</p>

Repair of skin defect in penis with scrotal skin flap / 中华医学美学美容杂志

Objective To explore a simple and convenient method for the treatment of penis skin defect.Methods Since Jan.1995,the scrotal skin flaps have been used to repair the defects of the penis skin in 8 patients with penis skin infection.6 of these cases lost their whole penis skin,and 2 of them lost 2/3 of their penis skin.The granulation tissues in the defective area of penis skin were cut away,and then the normal aponeurosis of corpus cavernosum or spongiosum exposed.The scrotal skin flaps were designed and shaped.The flaps were transferred to cover the defects,and the incisions were closed.Results All the flaps in 8 cases survived completely.The follow-up period was 3 to 12 months after operation.All cases obtained satisfactory results to the contour and function of the penises.Conclusion This procedure is a much better method for repairing skin defects in the penis.It can be easily operated and completed in one-stage.The postoperative results are satisfactory.

Clinical features of elderly patients with primary biliary cirrhosis / 中华老年医学杂志

Objective To evaluate clinical features and mortality of primary biliary cirrhosis (PBC) in the aged patients. Methods Clinical data of 108 patients diagnosed with PBC was reviewed. The diagnosis of PBC was made according to the 2000 practice guidelines of American Association for the study of liver Diseases (AASLD). Elderly patients (≥60 years) were compared in terms of clinical, biochemical, immunological features and mortality with younger patients (0.05). After a median follow-up of 36 months, the mortality ratio for liver diseases was higher in the elderly than in younger group (21.4% vs 2.5%, ~P