A Prospective Multicenter Study of the Chinese Scoring System for Hepatitis B Liver Failure.

Objective: To evaluate the clinical utility of a Chinese scoring system for hepatitis B liver failure in a prospective and multicenter study. Methods: Clinical data for 1,143 patients with hepatitis B liver failure who had been followed up for a minimum of 6 months were collected from seven liver disease centers across China. The disease severity and prognosis for the patients were predicted using the Chinese scoring system and compared to those predicted with the model for end-stage liver disease (MELD) score, MELD-Na score, and Child-Turcotte-Pugh (CTP) score. Results: The Chinese scoring system was more effective at predicting the outcomes of survival and mortality than the MELD score. In the peak disease stage, the area under the receiver operating characteristic curve for the Chinese scoring system was 0.954, significantly higher than that (0.896) for the MELD scoring system (P < 0.001). The positive prediction at 30, 90, and 180 days with the Chinese scoring system was 0.764 (95% CI: 0.714-0.808), 0.731 (95% CI: 0.694-0.769), and 0.724 (95% CI: 0.679-0.765), also significantly higher than that with the MELD, MELD-Na, and CTP scores (P < 0.001). In addition, the Chinese scoring system was superior to the MELD, MELD-Na, and CTP scores (P < 0.001) at predicting the prognosis of patients with hepatitis B liver failure at both 30 and 180 days. Conclusion: The Chinese scoring system demonstrated superior performance to the three established scoring systems in assessing the severity and outcomes of hepatitis B liver failure in this cohort.

Early, short-term, low-dose glucocorticoid therapy effectively blocks progression of severe acute exacerbation of chronic hepatitis B to liver failure.

OBJECTIVE: To determine whether early, short-term, low-dose glucocorticoid treatment prevents the progression of severe acute exacerbation of chronic hepatitis B to liver failure. METHODS: We prospectively enrolled 125 patients with severe acute exacerbation of chronic hepatitis B from the Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University between September 2013 and March 2016. The patients were randomized to a hormone group (3-day, low-dose glucocorticoid treatment plus conventional treatment; 63 patients) and a control group (conventional treatment only; 62 patients). We analyzed markers of liver function, complications, mortality rates, and duration and cost of hospitalization. RESULTS: Serum alanine transaminase levels were significantly lower in the hormone group than in the control group at 3 days (P = 0.009) and 1 week (P = 0.018) after treatment. The decrease in this level from the baseline value on day 3 was greater in the hormone group than in the control group (P = 0.023). The trend of the changes in this level significantly differed between the two groups (P = 0.008). The incidence of liver failure (8.06% vs. 30.16%; P = 0.002) and the duration of hospitalization (23.79 vs. 31.79 days; P = 0.031) were significantly lower in the hormone group than in the control group. CONCLUSION: Low-dose, short-term glucocorticoid treatment early in the course of severe acute exacerbation of chronic hepatitis B along with conventional treatment significantly reduced the risk of progression to liver failure and shortened the duration of hospitalization, without increasing the complication rate.

Liver Tissue-specific Genes IGFALS,CYP3A4,SLC22A1 and CYP2E1 May be Associated with Poor Prognosis of Liver Cancer / 中国医学科学院学报

Objective To explore the function and mechanism of related genes in the occurrence and development of liver cancer, and the possibility of key genes as potential biomarkers and prognostic indicators for the treatment of liver cancer.Methods We selected 4 datasets(GSE57957, GSE121248, GSE36376 and GSE14520)from the GEO database.With

[Community characteristics of soil nematode in Abies georgei var. smithii forest in Sejila Mountain of Tibet, Southwest China].

In order to understand the present status of nematode diversity in soil ecosystem of Abies georgei var. smithii forest, the typical forest type in subalpine zone of southeastern Tibet, an investigation was made on the nematode community in different soil layers of 0-30 cm depth from the summer, 2010 to the spring, 2011. The nematode individual density, diversity index, and trophic group index were taken to analyze the composition and structural characteristics of the soil nematode community. A total of 7915 soil nematodes belonging to 2 classes, 6 orders, 38 families, and 67 genera were collected by shallow dish method. The nematode individual density was averagely 620 nematodes x 100 g(-1) dry soil, and the nematode individuals in surface soil layer (0-5 cm) accounted for 56.9% of the total, indicating the obvious surface gathering characteristics of the nematode community. Tylencholaimus, Helicotylenchus, and Plectus were the dominant genus. Plant-parasite nematode was the dominant trophic group, while fungi-feeding nematode had the largest proportion among the non plant-parasite nematodes. Soil organic matter was mainly decomposed by fungi. The ANOVA analysis indicated that there were no significant differences in the Shannon, Pielou, Margalef, and Simpson indices of soil nematode community among different seasons. The Pielou index had no significant difference among different soil layers, while the differences of Shannon, Margalef, and Simpson indices tended to be increased with increasing soil depth. It was concluded that the A. georgei var. smithii forest ecosystem in Sejila Mountain had a high maturity, with strong resistance to environment disturbances.