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Objective To explore the correlation between serum lipoprotein-related phospholipase A2 (Lp-PLA2), cystatin C (Cys-C) levels and disease severity in patients with hepatitis B cirrhosis (HBC). Methods Clinical data of 110 HBC patients in the hospital from October 2017 to May 2019 were retrospectively analyzed. According to Child-Pugh classification criteria of liver cirrhosis, they were divided into grade A (n=42), grade B (n=37) and grade C groups (n=31). Another 30 healthy controls during the same period were enrolled as control group. The levels of serum Lp-PLA2 and Cys-C were detected. And their correlation with disease severity was analyzed. Results Levels of serum Lp-PLA2 and Cys-C in HBC group were higher than those in control group (P<0.05). The levels of serum Lp-PLA2 and Cys-C were the highest in grade C group, followed by grade B group and grade A group (P<0.05). The areas under the ROC curve (AUC) of serum Lp-PLA2 combined with Cys-C for evaluating grade A and B, grade B and C HBC were 0.875 and 0.837, which were higher than those of Lp-PLA2 (0.772, 0.750) and Cys-C (0.750, 0.691) alone (P<0.05). Spearmann rank correlation analysis showed that levels of serum Lp-PLA2 and Cys-C were positively correlated with disease severity (r=0.659, 0.561, P<0.05). Conclusion The levels of serum Lp-PLA2 and Cys-C are significantly increased in HBC patients, which are gradually increased with the aggravation of HBC. The two indexes are positively correlated with disease severity, which are of diagnostic efficiency for the classification of liver cirrhosis.
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OBJECTIVE@#To construct and validate an individualized nomogram to predict the probability of occurrence of portal vein thrombosis (PVT) after splenectomy in patients with hepatitis B cirrhosis.@*METHODS@#We retrospectively collected the clinical data from 180 patients with hepatitis B cirrhosis undergoing splenectomy with postoperative anticoagulation therapy during the period from January, 2014 to January, 2020 in our hospital. The patients were randomized into modeling group (= 120) and validation group (=60), and the former group was further divided into PVT group (=49) and non-PVT group (=71) according to the occurrence of PVT occurred within 1 month after splenectomy. The independent risk factors of PVT after splenectomy were screened in the modeling group using univariate and multivariate binary logistic regression analyses and were used for construction of the nomogram prediction model. The area under the receiver-operating characteristic (AUROC) curve (C-index), GiViTI calibration belt and Hosmer-Lemeshow test, and the DCA curve were used to estimate the discrimination power, calibration and clinical efficiency of the prediction model in both the model construction group and validation group.@*RESULTS@#Univariate and multivariate logistic regression analyses showed that a history of hemorrhage, portal vein diameter, spleen vein diameter, spleen volume, varicose, postoperative platelet change, and postoperative D-dimer differed significantly between PVT group and non-PVT group ( < 0.05), and portal vein diameter, spleen vein diameter, and postoperative platelet change were independent risk factors of PVT after splenectomy ( < 0.05). The prediction model had a good discrimination power with AUROC (C-index) of 0.880 (95% : 0.818-0.942) in the modeling group and 0.873 (95% : 0.785-0.960) in the validation group. The 80% and 95% region of GiViTI calibration belt did not cover the 45-degree diagonal bisector line (=0.965 and 0.632, respectively), and the P-values of the Hosmer-Lemeshow test were 0.624 and 0.911, respectively, suggesting a high reliability of the predicted probability by the model. DCA curve analysis showed a threshold probability of 30.5%, with a net benefit of 30% in the modeling group and 34% in the validation group, indicating a good clinical efficiency of the model.@*CONCLUSIONS@#The model for predicting the risk of PVT after splenectomy in patients with hepatitis B cirrhosis can help in early identification of patients having high risks of PVT.
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@#Primary hepatic carcinoma（PHC）is the second leading cancer that caused death in the world. The morbidity of PHC is increasing year by year,which threaten people's lives and health. Chronic hepatitis B is considered to be an independent risk factor for PHC,and the incidence of PHC is higher in patients who have progressed to liver cirrhosis. We reviewed the domestic and abroad literatures about the risk factors for hepatitis B cirrhosis progressing to PHC from the year of 1992 to 2018,and concluded that HBV-DNA,HBsAg,HBeAg expression,antiviral treatment time,different antiviral drugs,degree of cirrhosis,alanine transaminase and family history were related to the development of PHC from cirrhosis.
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OBJECTIVE@#To explore the action mechanisms of Huangqi Decoction Granules (, HQDG) on hepatitis B cirrhosis.@*METHODS@#A total of 85 patients with hepatitis B cirrhosis were randomly divided into HQDG group (42 cases) and control group (43 cases) by a random number table and were treated with HQDG or placebo for 48 weeks (6 g per times and orally for 3 times a day), respectively. After RNA-sequencing of serum samples extracted from the patients, the differentially expressed genes (DEGs) in HQDG and control groups before and after treatment were separately screened. The DEGs were then performed pathway enrichment analysis and proteinprotein interaction (PPI) network analysis. The expression levels of key genes were detected by quantitative realtime polymerase chain reaction (qRT-PCR).@*RESULTS@#After the investigation, 4 and 3 cases were respectively excluded from HQD and control groups because of the incomplete data. Additionally, 3 and 5 cases were lost to follow up in HQD and control groups respectively. Finally, a total of 70 cases with good compliance were included for further DEGs analysis. A total of 1,070 DEGs (including 455 up-regulated genes and 615 down-regulated genes) in HQDG group and 227 DEGs (including 164 up-regulated genes and 63 down-regulated genes) in the control group were identified after treatment. Compared with the control group, 1,043 DEGs were specific in HQDG group. Besides, 1 up-regulated transcription factor (TF, such as GLI family zinc finger 1, GLI1) and 25 down-regulated TFs (such as drosophila mothers against decapentaplegic proteinfamily member 2, SMAD2) were identified. Pathway enrichment analysis showed that down-regulated Ras homolog gene family member A (RHOA) was enriched in pathogenic Escherichia coli infection. In the PPI network, up-regulated epidermal growth factor receptor (EGFR), and down-regulated cell division cycle 42 (CDC42) as well as v-akt murine thymoma viral oncogene homolog 1 (AKT1) had higher degrees. Moreover, long non-coding RNAs (lncRNA) growth arrest-specific 5 (GAS5) was involved in the lncRNA-target regulatory network. Furthermore, qRT-PCR revealed that expression levels of CDC42 and GLI1 had significant differences in HQDG group before and after treatment (P<0.05).@*CONCLUSIONS@#CDC42 and GLI1 may be the targets of HQDG in patients with hepatitis B cirrhosis. Additionally, SMAD2, EGFR, AKT1, RHOA and GAS5 might be associated with the curative effect of HQDG on hepatitis B cirrhosis patients.
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Objective To study and analyze of entecavir dispersible tablets on the treatment of patients with decompensated hepatitis B cirrhosis. Methods From February 2014 to September 2016, 100 patients with decompensated hepatitis B cirrhosis were randomly divided into the control group and the experimental group, 50 patients in each group. The control group were received routine treatment, while the experimental group were received entecavir dispersible tablets treatment on the basis of conventional treatment. The therapeutic effects in the two groups were compared and analyzed. Results The effective rate in the experimental group was 92.0%, and 70.0% in the control group. The effective rate in the experimental group was significantly higher than that in the control group, the difference has statistically significant (P<0.05). The Child-pugh score in the experimental group was (6.12±1.43) points, and the score in the control group was (7.23±1.95) points. The score in the control group was significantly higher than that in the experimental group, with statistical difference (P<0.05). The negative rate of HBeAg in the experimental group was 22.0%, while 86% in the control group the difference has statistically significant (P<0.05). Conclusion The clinical effect is better which entecavir dispersible tablets is used in the treatment of the patients with decompensated hepatitis B cirrhosis, which can improve the treatment efficiency to a great extent, recover the liver function, has the further promotion and application significance.
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Objective To study the effect and safety of compound Biejiaruangan tablets combined with entecavir on the treatment of viral hepatitis B cirrhosis.Methods100 cases with hepatitis B cirrhosis in Zhejiang Taizhou hospital from June 2014 to December 2016 were selected as the research object in this study which were randomly divided into the control group and the experimental group 50 cases in each group.The control group were given entecavir, the experimental group were given compound Biejiaruangan tablets combined with entecavir.The clinical effect and the adverse reaction in the two groups were compared.ResultsThe effective rate was 90.0% in the experimental group, which was significantly higher than 72.0% in the control group(P<0.05).There were 2 patients vomiting in the experimental group, the adverse reaction rate was 4.0%.There were 9 cases of vomiting and headache in the control group, the adverse reaction rate was 18.0%.T,he adverse reaction rate(in the experimental group was significantly lower than that in the control group(P<0.05).ConclusionThe clinical effect of compound Biejiaruangan tablets combined with entecavir on the treatment of viral hepatitis B cirrhosis is better, which can reduce the rate of adverse reactions in a certain extent, is high safety, and worth popularizing.
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Objective Alprostadil can improve the clinical efficacy of the treatment of hepatitis B cirrhosis, but little literature is available about its effect on serum inflammatory factors in patients with hepatitis B cirrhosis.This study aimed to investigate the effect of alprostadil on serum inflammatory factors and liver function of the patients with hepatitis B cirrhosis and its possible action mechanisms.Methods We equally randomized 162 cases of hepatitis B cirrhosis admitted to our hospital from August 2014 to July 2015 into a control and an observation group, the former treated by conventional antiviral, liver-protecting and supportive therapies, and the latter with alprostadil in addition, both for 4 weeks.Then, we obtained the serum inflammatory factors, the contents of serum interleukin-6 (IL-6), high sensitive C reactive protein (hs-CRP) and tumor necrosis factor alpha (TNF-α) as well as such liver function indexes as glutamic-pyruvic transaminase (ALT), total bilirubin (TBil) and prothrombin activity (PTA), and compared them between the two groups before and after treatment.Results After 4 weeks of treatment, the effectiveness rate was significantly higher in the observation than in the control group (82.72% vs 62.96%, P<0.05).Compared with the baseline, the patients in the observation group showed significant improvement after treatment in serum IL-6 ([275.62±43.39] vs [97.15±19.73] pg/mL, P<0.05), hs-CRP ([425.54±55.58] vs [50.23±6.69] ng/L, P<0.05), TNF-α ([321.74±80.73] vs [85.45±13.61] pg/mL, P<0.05), ALT ([139.54±37.36] vs [96.13±23.62] μmol/L, P<0.05), TBil ([395.39±41.13] vs [271.55±25.12] μmol/L, P<0.05), and PTA ([38.50±4.19] vs [68.36±8.11]%), and the improvement was significantly better than in the control group (P<0.05).Conclusion Alprostadil helps alleviate the inflammatory condition, improve the liver function, and promote clinical efficacy in patients with hepatitis B cirrhosis.
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Objective: To discuss the predictive value of liver and spleen stiffness detected by transientelasticity imaging technology on esophageal varices bleeding (EVB) of patients with hepatitis B cirrhosis. Methods: 100 patients with hepatitis B cirrhosis (18 cases were no EV, 30 cases were mild EV, 28 cases were moderate EV and 24 cases were severe EV) were selected. In these patients, 52 cases were no bleeding, 28 cases were single hemorrhage and 20 cases were multiple hemorrhage. As the Child-Pugh grading, there were 34 cases were A grade, 30 cases were B grade and 36 cases were C grade. All of the liver and spleen stiffness of these patients were detected by instantaneous elasticity imaging technology, and to compare different Child-Pugh grading of patients, different EV degree, and liver and spleen stiffness on different EVB situation. Results: The liver and spleen stiffness of patients in Child-Pugh C stage were significantly higher than that in Child-Pugh A stage and B stage, respectively (t=21.13, t=12.04, t=11.24, t=9.741; P<0.05). With the aggravating of the severe degree of EV, the liver and spleen stiffness were significant increasing, and there were significant differences between different EV degree patients for liver stiffness and spleen stiffness, respectively (F=7.494, F=8.129, P<0.05). The liver and spleen stiffness of multiple hemorrhage group were significant higher than that of no-hemorrhage group and single hemorrhage group, respectively (t=13.13, t=18.14, t=12.15, t=17.46; P<0.05). Conclusion: By using instantaneous elasticity imaging technology to detect liver and spleen stiffness can predict EVB of patient with hepatitis B cirrhosis and it has higher clinical value, therefore, it is a sophisticated noninvasive examination with simple operation and better repeatability.
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This study was aimed to observe the clinical curative effect of Wen-Yang Jian-Pi (WYJP) decoction for treating hepatitis B cirrhosis patients with refractory ascites.A total of 81 hepatitis B cirrhosis patients with refractory ascites after admission to our hospital were randomly divided into two groups,41 patients were in the treatment group and 40 were in the control group.Patients in both groups received basic treatment,including antivirus,liver-protective,antiinfective and diuretic therapy,as well as albumin supplementation;while the treatment group were additionally given oral traditional Chinese medicine (TCM) of WYJP decoction at the same time.Changes of subjective symptoms,abdominal circumference,urine volume,main hepatic function indexes,and main indexes of B-ultrasound before and after treatment were measured and compared between two groups.Patients in both groups were treated for 3 one-month therapeutic courses,with 3 to 5 day-intervals,after which the curative effect was evaluated.The results showed that the total effective rate in the treatment group was 87.8％,which was significant higher than that of 70.0％ in the control group (P ＜ 0.05).And the treatment group in ascites,urine volume,symptoms,body signs and B ultrasonic improvement were better than those of the control group,with statistical significance (P ＜ 0.05).It was concluded that WYJP decoction has definite therapeutic effect on hepatitis B cirrhosis patients with refractory ascites.
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Objective To investigate the clinical efficacy of entecavir in the treatment of hepatitis B cirrhosis associated with hepatic diabetes. Methods 78 cases of hepatitis B Hepatic Cirrhosis with diabetes were selectedfrom June 2015 to December 2016, and randomly divided into study group (n=39) and control group (n=39). The study group were treated with entecavir, the control group were treated with adefovir dipivoxil. Two groups of patients with hepatitis B cirrhosis combined with hepatic diabetes were treated continuously for 48 weeks, the changes of FPG, HOMA-β, beta and HOMA-IR were recorded. Results There was no significant difference between the two groups in the treatment of FPG, HOMA-β, and HOMA-IR. After treatment, the two groups of FPG and HOMA-IR decreased significantly compared with before treatment, while HOMA-β was significantly higher than before treatment, but the changes of the above indexes in the study group were better than those in the control group (P<0.05). Conclusion Entecavir combined with hypoglycemic agents can achieve more ideal blood glucose control effect in patients with hepatitis B cirrhosis combined with hepatic diabetes..
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Objective To investigate the clinical value of re-using ultrafiltrated and concentrated ascites fluid for refractory ascites in patients with hepatitis B cirrhosis. Methods A retrospective study was conducted, one hundred and thirteen patients with intractable ascites (all patients received intraperitoneal reinfusion of ultrafiltrated and concentrated ascites fluid therapy) admitted to the Department of Gastroenterology of No.254 Hospital of the Chinese People's Liberation Army from December 2013 to November 2016 were enrolled and assigned as the study group, fifty-two patients with intractable ascites admitted in the same period as above group in this hospital without undergoing above ascites fluid reinsfusion were served as the control group. Both groups were given conventional therapies, including measures for hepatoprotection, increase of plasma osmotic pressure, correction of hypoproteinemia (intravenous injection albumin 10 g, 3 times a week), reduction of portal venous pressure (octreotide 0.2 mg, q8 h), improvement of microcirculation, correction of water and electrolyte balance disorders, diuresis (furosemide 100 mg/d), etc. On the basis of the above conventional treatment, the system with ascites ultrafiltration, concentration and reinfusion into abdominal cavity was applied to carry out the concentrated ascites fluid reinfusion therapy in the study group. The relieve of abdominal bloating, conscious, blood pressure, 24-hour urine output, endogenous creatinine clearance rate (CCr), serum potassium ion (K+), serum sodium ion (Na+), ascites albumin quantity, serum albumin levels before treatment and after treatment for 1 week, abdominal infection situation after treatment for 1 week were observed in the study group. The difference in incidence of abdominal infection between the study group and control group (at the end of 12 weeks after treatment) was compared. Results In the study group, after treatment, the patients with abdominal bloating had different degrees of relief, 24-hour urine output was increased compared with that before treatment (mL: 1291.3±123.4 vs. 1265.0±61.5, P = 0.051), no cases with conscious changes, blood pressure instable. There were no statistical significant difference in blood K+ and Na+ (P > 0.05). And ascites albumin concentration was increased compared with before treatment (g/L: 19.1±2.9 vs. 17.2±4.1, P = 0.000); 1 week after treatment, CCr was significantly higher than that before treatment (μmol/L: 71.2±8.7 vs. 56.1±5.4, P = 0.000); serum albumin was increased after 3 times of treatment in 1 week (g/L: 25.7±4.4 vs. 24.6±3.0), but the difference was not statistically significant (P = 0.054). No abdominal infection occurred within 1 week after treatment were observed in patients of study group. There was no statistical significant difference in the incidence of abdominal infection between the study group and control group in 12 weeks after treatment [9.7% (11/113) vs. 13.6% (7/52), P = 0.476]. Conclusions The re-using of ultrafiltrated and concentrated ascites fluid can effectively relieve the abdominal bloating symptom, improve CCr, be beneficial to the re-use of ascites albumin, and does not increase the incidence of abdominal infection within 12 weeks after the therapy, therefore the treatment has relatively high therapeutic value for intractable ascites in patients with hepatitis B cirrhosis.
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Objective To investigate the clinical efficacy of entecavir in the treatment of hepatitis B cirrhosis associated with hepatic diabetes. Methods 78 cases of hepatitis B Hepatic Cirrhosis with diabetes were selectedfrom June 2015 to December 2016, and randomly divided into study group (n=39) and control group (n=39). The study group were treated with entecavir, the control group were treated with adefovir dipivoxil. Two groups of patients with hepatitis B cirrhosis combined with hepatic diabetes were treated continuously for 48 weeks, the changes of FPG, HOMA-β, beta and HOMA-IR were recorded. Results There was no significant difference between the two groups in the treatment of FPG, HOMA-β, and HOMA-IR. After treatment, the two groups of FPG and HOMA-IR decreased significantly compared with before treatment, while HOMA-β was significantly higher than before treatment, but the changes of the above indexes in the study group were better than those in the control group (P<0.05). Conclusion Entecavir combined with hypoglycemic agents can achieve more ideal blood glucose control effect in patients with hepatitis B cirrhosis combined with hepatic diabetes..
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Objective To investigate the clinical value of re-using ultrafiltrated and concentrated ascites fluid for refractory ascites in patients with hepatitis B cirrhosis. Methods A retrospective study was conducted, one hundred and thirteen patients with intractable ascites (all patients received intraperitoneal reinfusion of ultrafiltrated and concentrated ascites fluid therapy) admitted to the Department of Gastroenterology of No.254 Hospital of the Chinese People's Liberation Army from December 2013 to November 2016 were enrolled and assigned as the study group, fifty-two patients with intractable ascites admitted in the same period as above group in this hospital without undergoing above ascites fluid reinsfusion were served as the control group. Both groups were given conventional therapies, including measures for hepatoprotection, increase of plasma osmotic pressure, correction of hypoproteinemia (intravenous injection albumin 10 g, 3 times a week), reduction of portal venous pressure (octreotide 0.2 mg, q8 h), improvement of microcirculation, correction of water and electrolyte balance disorders, diuresis (furosemide 100 mg/d), etc. On the basis of the above conventional treatment, the system with ascites ultrafiltration, concentration and reinfusion into abdominal cavity was applied to carry out the concentrated ascites fluid reinfusion therapy in the study group. The relieve of abdominal bloating, conscious, blood pressure, 24-hour urine output, endogenous creatinine clearance rate (CCr), serum potassium ion (K+), serum sodium ion (Na+), ascites albumin quantity, serum albumin levels before treatment and after treatment for 1 week, abdominal infection situation after treatment for 1 week were observed in the study group. The difference in incidence of abdominal infection between the study group and control group (at the end of 12 weeks after treatment) was compared. Results In the study group, after treatment, the patients with abdominal bloating had different degrees of relief, 24-hour urine output was increased compared with that before treatment (mL: 1291.3±123.4 vs. 1265.0±61.5, P = 0.051), no cases with conscious changes, blood pressure instable. There were no statistical significant difference in blood K+ and Na+ (P > 0.05). And ascites albumin concentration was increased compared with before treatment (g/L: 19.1±2.9 vs. 17.2±4.1, P = 0.000); 1 week after treatment, CCr was significantly higher than that before treatment (μmol/L: 71.2±8.7 vs. 56.1±5.4, P = 0.000); serum albumin was increased after 3 times of treatment in 1 week (g/L: 25.7±4.4 vs. 24.6±3.0), but the difference was not statistically significant (P = 0.054). No abdominal infection occurred within 1 week after treatment were observed in patients of study group. There was no statistical significant difference in the incidence of abdominal infection between the study group and control group in 12 weeks after treatment [9.7% (11/113) vs. 13.6% (7/52), P = 0.476]. Conclusions The re-using of ultrafiltrated and concentrated ascites fluid can effectively relieve the abdominal bloating symptom, improve CCr, be beneficial to the re-use of ascites albumin, and does not increase the incidence of abdominal infection within 12 weeks after the therapy, therefore the treatment has relatively high therapeutic value for intractable ascites in patients with hepatitis B cirrhosis.
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Objective To investigate the tryptophan (Trp) metabolism change in the patients with chronic hepatitis B (CHB) and hepatitis B cirrhosis (HBC) and to analyze the related risk .Methods Eighty-one cases of CHB and 40 cases of HBC hospitalized in the First Affiliated Hospital of Chongqing Medical University from October 2015 to January 2016 served as the stud-y subjects ,and 40 healthy persons as the controls .High performance liquid chromatography -fluorescence detection (HPLC-FD) were adopted to detect the levels of plasma Trp ,kynurenine (Kyp) and its metabolite 5-hydroxy tryptamine (5-HT) .HBV-DNA vi-ral replication number was detected by real-time quantitative PCR .The serological indicators differences among 3 groups were ana-lyzed .The risk factors were analyzed and screened by the Logistic regression analysis and Pearson correlation analysis .Results Compared with the control group ,plasma 5-HT and Trp levels in the CHB group and HBC group were significantly decreased (P<0 .01);plasma Kyn/Trp in the HBC group was significantly higher than that in the other two groups (P<0 .01) .Kyn/Trp in the HBC group was negatively correlated with A/G (r= -0 .686 ,P<0 .01) ,and Kyn/Trp in the CHB group was positively correlated with Log DNA (r= 0 .784 ,P<0 .01) .The Logistic regression analysis indicated that Kyn/Trp was the risk factor of CHB and HBC .Conclusion Detecting plasma Trp and its metabolite can serve as the adjuvant indicators for assessing the progression of hep-atitis B .
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Objective:To investigate the significance of serum sP-selectin,sICAM-1 and immunoglobulin in the prognosis of hepatitis B cirrhosis.Methods:162 cases of hepatitis B patients with cirrhosis were treated as the research object in clinical laboratory of Chizhou People′s Hospital from January 2014 to December 2016,and detected in the serum of soluble P-selectin(sP-selectin), soluble intercellular adhesion molecule-1(sICAM-1),immunoglobulin and serum related index.Comparison of liver cirrhosis and liver cancer patients mean difference,Pearson analysis of serum soluble P-selectin(sP-selectin),soluble intercellular adhesion molecule-1 (sICAM-1),the correlation of immunoglobulin and serum indexes,logistic regression analysis of risk factors of liver cirrhosis to hepatocellular carcinoma,the receiver operating characteristic(ROC)OR>1 parametric curve evaluation of predictive value of hepatocellular carcinoma to liver cirrhosis.Results:The levels of sP-selectin,sICAM-1,IgM,IgG and IgA in patients with primary liver cancer were significantly higher than those in compensated cirrhosis and decompensated liver cirrhosis(P<0.05).The levels of sP-selectin,sICAM-1,IgM,IgG and IgA in patients with decompensated cirrhosis were significantly higher than those in decompensated liver cirrhosis(P<0.05).sP-selectin,sICAM-1,IgM,IgG,IgA were significantly higher in patients with grade C and grade B(P<0.05)in patients with different grades of cirrhosis.SP-selectin,sICAM-1,IgM,IgG,IgA were significantly higher in patients with grade B(P<0.05).There was no significant difference in the expressions of sP-selectin,sICAM-1 and immunoglobulin in patients with multiple foci of carcinoma and primary hepatocellular carcinoma(P>0.05).SP-selectin,sICAM-1 and immunoglobulin in patients with stage Ⅱprimary liver cancer were significantly higher than those in stage Ⅰ(P<0.05).There was a positive correlation between sP-selectin, sICAM-1 and immunoglobulin in patients with liver cirrhosis(P<0.05).In liver cirrhosis was the transfer of primary liver cancer as the dependent variable for Logistic regression analysis,the results showed that ALT,AST,sP-selectin,sICAM-1,IgM,IgG,IgA were risk factors of liver cirrhosis to hepatocellular carcinoma.ROC curve analysis showed that the sensitivity and specificity of sICAM-1 and sP-selectin in diagnosis of liver cirrhosis were higher than other factors.Conclusion:Serum sP-selectin,sICAM-1 has a higher accuracy of clinical diagnosis of hepatitis B cirrhosis prognosis evaluation,diagnostic specificity and sensitivity of liver cirrhosis to hepatocellular carcinoma was higher than that of simple detection of immunoglobulin,the combined detection in the diagnosis of liver cirrhosis is worthy of clinical prognosis.
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Objective:To investigate the significance of 25 ( OH )-vitamin D in its diagnostic value of primary biliary cirrhosis. Methods:44 cases with PBC,41 cases with Hepatitis B cirrhosis and 110 normal people as control group were all analyzed bi-ochemical results and significance of serum 25 ( OH )-vitamin D. We Used receiver operator characteristic curve ( ROC ) to analyze serum 25(OH)-vitamin D in its diagnostic value of primary biliary cirrhosis. Results:Biochemical results of TBIL,DBIL,IBIL,GLB, AST,ALT,ALP,γ-GT were higher in PBC than that in normal people and Hepatitis B cirrhosis. While the serum 25(OH)-vitamin D of PBC was much more lower than that in normal and people and Hepatitis B cirrhosis. The difference between them were statistical difference(P<0. 05). The area under the ROC curve of PBC was 0. 926,it showed serum 25(OH)-vitamin D diagnosis for PBC had quite value. When the cut-off level of serum 25(OH)-vitamin D was 17. 275 ng/ml,the sensitivity for the diagnosis was 92. 8%,the re-spectively was 84. 1%. Conclusion:Serum 25(OH)-vitamin D diagnosis for PBC has quite value,the cut-off level of serum 25(OH)-vitamin D is 17. 275 ng/ml.
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Objective To investigate the relationship of antithrombin‐Ⅲ activity and thrombosis risk in liver cirrhosis with Child‐Pugh classification .Methods In our hospital from June to December 2014 ,60 liver cirrhosis patients were selected randomly included into this experiment group ,The 60 cases of control group were from medical examination of health in our hospital .The plasma AT‐Ⅲ activity and D‐D concentration in all these cases were detected and analyzed .Results The AT‐Ⅲ in cirrhosis patients were significantly lower than which in healthy persons(P<0 .05) .The lower level of AT‐Ⅲ is in these patients which were in seri‐ous condition(P<0 .05) ,the abnormal rate of D‐D concentration is also higher at the same time(P<0 .05) .Conclusion The detec‐tion of AT‐Ⅲ level in patients with liver cirrhosis is directly related to the severity of clinical and thrombosis risk .The AT‐Ⅲ de‐tection level can be used to judge the patient′s condition and develop appropriate treatment strategies .
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Objective To study effect of positive liver soup on serum leptin (LEP), adiponectin (ADP) and insulin resistance (IR) in patients with hepatitis B cirrhosis.Methods 68 cases of hepatitis B patients with cirrhosis according to randomized divided into the control group (34 cases) and treatment group (34 cases).Oral treatment administered to the control group (Inosine Tablets and vitamin C),treatment group in the control group based on liver soup treatment, treatment for 3 months, serum leptin (LEP),adiponectin (ADP) and insulin resistance (IR) index before and after treatment were detected.Results Before treatment, there was no significant difference between ADP and LEP in the control group and the treatment group.After 3 months of treatment, there was no significant difference between ADP and LEP level in control group, while the level of ADP and LEP in treatment group were significantly decreased (P<0.05), and were significantly lower than that in control group (P<0.05).There was no significant difference in FPG, fasting insulin level and IRS index between the control group and the treatment group before treatment.After 3 months of treatment, the control group FPG, fasting insulin level and IRS index were not significantly different.FPG, fasting insulin and IRS index in the treatment group were significantly decreased (P<0.05), and were significantly lower than those in the control group (P<0.05).Conclusion Positive liver soup can reduce serum LEP, ADP level, and improve IR in treatment of hepatitis B liver cirrhosis.
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OBJECTIVE:To observe therapeutic efficacy and safety of telbivudine combined with adefovir dipivoxil in long-term treatment of active hepatitis B cirrhosis. METHODS:76 patients with active hepatitis B cirrhosis in our hospital were ran-domly divided into observation group and control group,with 38 cases in each group. Control group was treated with adefovir dip-ivoxil 10 mg,qd;observation group was additionally treated with telbivudine 600 mg,qd,on the basis of control group. Both groups received 2-year consecutive treatment. TBIL,ALB,ALT,AST,rate of HBV-DNA negative conversion and serum virologi-cal index were compared between 2 groups after treatment,and clinical efficacy and ADR were also compared between 2 groups. RESULTS:After treatment,the levels of AST,ALB,ALT and TBIL in observation group were significantly better than the control group,with statistical significance(P<0.05);the rate of HBV-DNA negative conversion,the decreased of serum virus in observa-tion group were significantly higher than control group after 1 and 2 years treatment,with statistical significance(P<0.05). The to-tal effective rate of observation group was significantly higher than that of control group,with statistically significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Telbivudine combined with adefovir dipivoxil can significantly improve the liver function of patients with hepatitis B cirrhosis and have good long-term therapeutic efficacy with high safety.
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Objective To explore the relationship between serum HBV DNA level , expression of PD-1 on CTL and liver functions in patients with hepatitis B virus cirrhosis. Methods 109 HBV hepatic cirrhosis patients with , HBV DNA positive , HBeAg positive and HLA-A2 positive were divided into two groups according to their HBV DNA levels,52 cases in group A, HBV DNA 2-4 log10 copies/mL, 57cases in group B, HBV DNA 5-7 log10 copies/mL , differences of HBV specific CTL surface PD-1 expressions , HBV specific CTL levels and liver functions were compared between two groups. Results HBV specific CTL surface PD-1 expressions of group A were lower than that of group B (t = 11.101, P < 0.01), HBV specific CTL levels of group A were higher than that of group B (t = 24.424, P < 0.01), ALT of group A were lower than that of group B (t = 2.652, P < 0.01), ALB of group A were higher than that of group B (t = 2.347, P < 0.05). Child-pugh rating, grade C of group A was lower than that of group B (χ2= 4.262,P < 0.05). Conclusions HBV specific CTL surface PD-1 expression levels were higher in those hepatic cirrhosis patients with , high level of serum HBV DNA, and HBV specific CTL levels were lower, liver functions damage were much serious. So, lower HBV DNA levels , lower HBV specific CTL surface PD-1 expression levels and higher HBV specific CTL levels can product relatively good effect of anti-viral treatment.