Association between immunoglobulin G4-related diseases and autoimmune hepatitis / 临床肝胆病杂志

With the improvement in people's awareness of diseases and the level of diagnosis and treatment, the incidence rates of immunoglobulin G4-related disease (IgG4-RD) and autoimmune liver disease (AILD) are constantly increasing, and IgG4-related sclerosing cholangitis is the overlapping part of the disease spectrum of IgG4-RD and AILD, while the association between IgG4-related autoimmune hepatitis (IgG4-AIH) and these two diseases remains unclear. This article reviews the hepatic manifestation of IgG4-RD, summarizes the clinical features of IgG4-AIH, and analyzes whether IgG4-AIH is a subtype of AIH or a hepatic involvement of IgG4-RD. It is believed that IgG4-AIH has similar but different clinical manifestations and histopathological features from classical AIH, and IgG4-AIH may be classified as two types, i.e., a subtype of AIH and the liver manifestation of IgG4-RD. The research on the pathogenesis, clinical features, and clinical diagnosis and treatment of IgG4-AIH should be taken seriously in future.

Liver histological changes in patients with hepatitis B e antigen-negative chronic hepatitis B virus infection with low hepatitis B virus load / 中华传染病杂志

Objective To determine the predictive factors for antiviral therapy in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV) infection [HBeAg(-) CHBI] patients with HBV DNA＜4.3 lg IU/mL.Methods A total of 179 HBeAg (-) CHBI patients were retrospective analyzed.Histology activity index (HAI) and fibrosis (S) were scored according to the Knodell HAI scoring system,and HAI＞3 and/or S≥3 was adopted as indications for treatment.Univariate and multiple regression analysis were used to assess factors associated with treatment indications.Receiver operating curves (ROC) and area under curve (AUC) were used to determine the predictive value of relevant factors.Results There were 81 cases with HAI＞3 (45.3％) and 72 with S≥3 (40.22％),and the proportion of patients with indications for treatment was 54.7 ％.Multiple regression analysis showed that age,γ-glutamyl transpeptadase (γ-GT),platelet (PLT) and albumin (Alb) were the predictive factors for the severity of liver damage and indication for treatment (all P＜0.05).The AUC for age,PLT,γ-GT and Alb were 0.655,0.657,0.726 and 0.65,respectively,and the corresponding Yoden index for age,PLT,γ-GT,and Alb were 0.297,0.426,0.03 and 0.012,respectively,the sensitivities of predicting HBeAg (-CHBI for treatment indications were 0.643,0.842,0.705 and 0.653,respectively.Conclusions This study shows that 54.7％ of HBeAg(-)CHBI patients with HBV DNA＜4.3 lg IU/ml have significant liver histological changes and require antiviral treatment.Older age,higher γ-GT,lower PLT and lower Alb levels are the predictive factors for treatment.

Transient elastography in diagnosis of non-alcoholic fatty liver disease / 中华全科医师杂志

Clinical data of 113 patients with non-alcoholic fat liver disease (NAFLD) diagnosed by liver biopsy from January 2015 to January 2017 in Taizhou People's Hospital were retrospectively reviewed . Patients all underwent transient elastographic ( TE) examination and the values of fat attenuation index (FAI) were obtained.The hepatocyt fatty changes in pathological examination were scored as 0 (＜5%, n＝40), 1 (5%-33%,n ＝27), 2 (34% -66%,n ＝28) and 3 (＞66%, n ＝18).There were significant differences in AST , Glu, TC and FAI among patients with hepatocyte fatty change scores 0, 1, 2 and 3, and the FAI was significantly correlated with the degree of fatty liver disease .The areas under the ROC curve (AUCs) of FAI in patients with hepatocyte fatty change scores 1, 2 and 3 were 0.78, 0.90 and 0.96, respectively.Logistic regression analysis showed that FAI was correlated with TG , TC and BMI.The results suggest that FAI in TE can be a non-invasive, rapid and objective evaluation method for patients with NAFLD.

Relationship between vitamin D and inflammatory diseases / 中华全科医师杂志

Traditionally regarded as a vitamin regulating calcium and phosphorus homeostasis, vitamin D is now discovered as a highly versatile molecule involved in immunity, cancer, infectious diseases, fibrosis, fatty liver diseases, and alcoholic liver diseases.In several studies, lower vitamin D status has been found to be associated with increased risk and unfavorable outcome of acute infections.This paper reviews the research progress of the roles played by vitamin D in various inflammatory diseases and its mechanisms.

Research progress on microRNAs involvement in liver diseases / 中华临床感染病杂志

MicroRNAs (miRNAs) are small non-coding RNAs that regulate both mRNA and protein expression of target genes and play important roles in proliferation,differentiation,development and metabolism of cells.This paper reviews the research progress on miRNAs involvement in liver diseases,including viral hepatitis,fatty liver,drug induced liver disease,primary biliary cirrhosis and primary hepatocellular carcinoma.

Efficacy and safety of entecavir and tenofovir in patients with chronic hepatitis B virus infection:a meta-analysis / 中华传染病杂志

Objective To compare the efficacy and safety of tenofovir (TDF) and entecavir (ETV) in patients with chronic hepatitis B (CHB) .Methods Studies that compared the treatment efficacy and safety between TDF and ETV in CHB patients were searched through electronic databases before Mar 2015 .Alanine aminotransferase (ALT) normalization rate ,hepatitis B virus (HBV) DNA suppression rate ,hepatitis B e antigen (HBeAg ) seroconversion rate ,drug resistance rate and safety profile were reviewed .RevMan 5 .2 was used for analysis .Results A total of 13 studies met inclusion criteria and 1 934 patients were analyzed ,including 884 patients treated with TDF and 1 050 with ETV .The HBV DNA suppression rate of TDF was superior to ETV at week 48 (OR=1 .36 ,95% CI:1 .05 -1 .76 ,P=0 .02) .The ALT normalization rate of ETV was superior to TDF at week 24 (OR= 0 .68 ,95% CI:0 .48-0 .96 ,P= 0 .03) .The virological response at week 24 ,ALT normalization rate at week 48 and serological response at week 24 and 48 were not significantly different between patients treated with TDF and ETV (all P>0 .05) .The resistance rate was not significantly different between patients treated with TDF and ETV 24 months after treatment (P=0 .51) .And the safety profiles of these two drugs were similar (P>0 .05) .Conclusions TDF has better virological response compared with ETV .The drug resistance rate and safety profile are similar between TDF and ETV .