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Liver fibrosis is the healing reaction of chronic liver injury caused by various factors such as viral infection， alcohol， and chemical substances and is a key link in the progression of chronic liver diseases to liver cirrhosis and liver cancer. Liver macrophages are considered important mediators of liver injury and repair， and the polarization trend of macrophages has a bidirectional regulatory effect on liver fibrosis. This article reviews the role of different phenotypes of liver macrophages in the development and progression of liver fibrosis， in order to provide new ideas for the prevention and treatment of fibrosis.
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ObjectiveTo investigate the regulatory effect of miRNA-933 on the apoptosis and proliferation of human hepatic stellate cell line LX-2 and its mechanism. MethodsFirstly， with human liver tissue for research， gene microarray technology was used to detect the differentially expressed genes in liver tissue between liver cirrhosis/chronic hepatitis B tissue and normal liver tissue， among which the significantly differentially expressed miRNAs were identified， and thus miRNA-933 was determined as the research object. Then， with the human hepatic stellate cell line LX-2 for research， miRNA-933 mimic and inhibitor （miRNA-933 siRNA） were used to construct the LX-2 models of overexpression and knockdown， and the cells transfected with mimic-NC （overexpression） or siRNA-NC （knockdown） were established as the negative control group. Quantitative real-time PCR and Western blot were used to measure the expression levels of miRNA-933 and activation biomarkers； techniques such as cell proliferation assay and flow cytometry were used to investigate the effect and mechanism of miRNA-933 on cell apoptosis， proliferation， and activation. The independent-samples t test was used for comparison of continuous data between two groups； a one-way analysis of variance was used for comparison between multiple groups， and Bonferroni correction was also performed. ResultsA total of 18 significantly differentially expressed miRNAs were obtained based on the results of gene microarray， among which miRNA-933 was significantly downregulated （P<0.05）. After LX-2 cells were transfected with miRNA-933 mimic or siRNA， compared with the negative control group， miRNA-933 siRNA significantly downregulated the expression of miRNA-933 （P=0.000 7）， while miRNA-933 mimic significantly upregulated the expression of miRNA-933 （P=0.000 3）. Western blot and quantitative real-time PCR showed that miRNA-933 siRNA significantly upregulated the expression of collagen I and α-SMA （P<0.001）， while miRNA-933 mimic significantly inhibited the expression of collagen I and α-SMA （P<0.05）. Flow cytometry showed that compared with the negative control group， miRNA-933 siRNA significantly downregulated the apoptosis rate of LX-2 cells （P=0.031 9）， and miRNA-933 mimic significantly upregulated the apoptosis rate of LX-2 cells （P=0.005 5）. Western blot showed that compared with the negative control group， miRNA-933 siRNA could inhibit the expression of Caspase-3 （P=0.006 7） and poly（ADP-ribose） polymerase-1 （PARP-1） （P=0.003 0） and upregulate the expression of B-cell lymphoma-2 （Bcl-2） in LX-2 cells （P=0.002 0）， while miRNA-933 mimic could significantly upregulate the expression of Caspase-3 （P=0.011 8） and PARP-1 （P=0.049 5） and downregulated the expression of Bcl-2 （P=0.002 1）. Cell proliferation assay showed that compared with the negative control group， miRNA-933 siRNA could promote the proliferation of LX-2 cells （P=0.011 5）， while on the contrary， miRNA-933 mimic could inhibit the proliferation of LX-2 cells （P=0.001 2）. Western blot and quantitative real-time PCR showed that miRNA-933 siRNA significantly inhibited the expression of Kruppel-like factor 6 （KLF6） and downregulated the expression of activating transcription factor 4 （ATF4）， activating transcription factor 3 （ATF3）， and C/EBP homologous protein （CHOP）， while miRNA-933 mimic promoted the expression of the above proteins （all P<0.05）. ConclusionThis study shows that miRNA-933 may promote cell apoptosis and inhibit cell activation and proliferation by promoting the activation of the KLF6/ATF4/ATF3/CHOP/Bcl-2 signal axis in LX-2 cells.
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Objective:Clinical characteristics and diagnosis and treatment process was reported and analyzed of a patient with brucellosis complicated with thyroid abscess, providing reference for the clinical diagnosis of brucellosis complicated with thyroid abscess.Methods:Clinical medical records of a patient with brucellosis complicated with thyroid abscess who was treated at the General Surgery Department of Yanchi County People's Hospital in Wuzhong City, Ningxia Hui Autonomous Region in November 2021 were collected. The clinical manifestations, blood routine, brucella antibodies, thyroid function, bacterial culture, thyroid ultrasound and other examination results, as well as the diagnosis and treatment process, were comprehensively analyzed. Results:The patient was a male, 61 years old, who presented with a neck mass without typical clinical manifestations of brucellosis. Thyroid ultrasound revealed a space occupying lesion, and the preliminary diagnosis was thyroid cystadenoma. Thyroid right lobe and isthmus resection surgery was performed. During the operation, it was found that some of the thyroid glands were tightly adhered to the cervical blood vessels, so the resection surgery was changed to abscess drainage, and the drainage fluid was purulent and bloody. The bacterial culture result of thyroid purulent fluid (intraoperative puncture fluid and postoperative drainage fluid) was brucella lamblia, and the serum brucella test tube agglutination test titer was 1 ∶ 400 (+++). The patient improved and was discharged after local drainage and anti brucella treatment. Follow up for 4 months showed no abnormalities. Conclusions:Brucellosis which begins with a local infection of the thyroid gland is extremely rare, with no characteristic clinical manifestations, and is prone to misdiagnosis. Timely correction of the surgical plan during the treatment process avoids the removal of the patient's thyroid, which has a certain clinical reference value.
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Objective:To analyze the clinical phenotypic characteristics and therapeutic effect of cutaneous anthrax patients in Ningxia Hui Autonomous Region (referred to as Ningxia).Methods:A retrospective analysis was conducted on the medical records of 76 confirmed patients with cutaneous anthrax in three prefecture level hospitals in Ningxia from 2017 to 2022. According to the length of hospital treatment, the patients were divided into a disease course ≥7 d group ( n = 54) and a disease course < 7 d group ( n = 22), and the clinical phenotypic characteristics (including patients' general condition, clinical symptoms, and laboratory tests) and therapeutic effects (the effect of hormone use and the choice of antibiotics) of the two groups were analyzed by methods such as χ 2 test. Results:Among 76 patients with cutaneous anthrax, males accounted for 81.6% (62/76) and females accounted for 18.4% (14/76), with a statistically significant difference in gender composition ratio (χ 2 = 5.71, P = 0.017). Among the 76 patients, 73 caces (96.1%) achieved clinical cure. There was no statistically significant differences between the groups in clinical characteristics such as temperature, pain, pruritus, edema, and site of onset ( P > 0.05). There were no statistically significant differences between groups in laboratory tests such as blood routine, liver function, hypersensitive C-reactive protein, secretion culture, PCR, etc. ( P > 0.05). There was a statistically significant difference in the distribution of edema resolution time between patients using hormone or not (χ 2 = 17.01, P = 0.002). There was no statistically significant difference in the distribution of disease course between different antibiotic treatment regimens when using hormone (χ 2 = 5.43, P = 0.143). There was a statistically significant difference in the distribution of disease course between different antibiotic treatment regimens when no using hormone (χ 2 = 108.46, P < 0.001). Conclusions:The majority of cutaneous anthrax patients in Ningxia from 2017 to 2022 are males. Early use of hormones can affect the duration of edema in patients. For patients who have not received hormone therapy, different treatment plans can affect the patient's course of disease.
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Objective To investigate the value of serum markers in the early diagnosis of liver cirrhosis with minimal hepatic encephalopathy (MHE). Methods A prospective analysis was performed for 81 patients who were hospitalized and treated in General Hospital of Ningxia Medical University from April 2020 to February 2022, and all these patients were diagnosed with hepatitis B cirrhosis based on clinical manifestation, laboratory examination, and radiological examination or liver biopsy. According to digital connection test A (NCT-A) and digital symbol test (DST), these patients were divided into simple cirrhosis group with 45 patients and MHE group with 36 patients. Related indices were measured, including liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and total bilirubin (TBil)], albumin, blood ammonia, cholinesterase, and prothrombin time. The independent samples t -test was used for comparison of normally distributed continuous data between two groups; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups; the chi-square test was used for comparison of categorical data between groups. The logistic regression analysis and the area under the ROC curve (AUC) were used to investigate the predictive factors for MHE. Results Compared with the simple cirrhosis group, the MHE group had a significant increase in NCT-A score ( Z =-7.110, P < 0.001) and a significant reduction in DST score ( t =12.223, P < 0.001). The univariate analysis showed that there were significant changes in AST, albumin, prothrombin time, cholinesterase, and blood ammonia in the patients with MHE ( Z =-2.319, -2.643, -1.982, -6.594, and -5.331, all P < 0.05), while the multivariate analysis showed that only cholinesterase and blood ammonia were significant predictive factors (all P < 0.05) and were correlated with Child-Pugh score (all P < 0.05). Cholinesterase, blood ammonia, and their combination had an AUC of 0.925, 0.845, and 0.941, respectively, in the diagnosis of MHE, with an optimal cut-off value of 2966, 60, and 0.513, respectively. Conclusion Blood ammonia, cholinesterase, and their combined measurement have a potential clinical value in the early diagnosis of liver cirrhosis with MHE.
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Objective:To study the remote multi-disciplinary team (MDT) model in diagnosis and treatment of plague, in order to provide scientific basis for clinical treatment of plague.Methods:A retrospective analysis was made on the diagnosis and treatment process of a case of bubonic plague, a sudden imported Class A infectious disease, which was secondary to septicemic plague, involving a remote MDT team consisting of the Infectious Diseases Department, Intensive Care Unit, Respiratory and Critical Care Department, Cardiology Department, Pharmacy Department, and Nosocomial Infection Department of the General Hospital of Ningxia Medical University.Results:The patient was a middle-aged female who was engaged in herding work on the grassland. The first symptom was a sudden pain in the left lower abdomen for three days, accompanied by chest tightness and shortness of breath. After hospitalization, blood culture indicated Yersinia, abdominal CT indicated left lower abdominal lymph node enlargement, and lymph node puncture fluid was positive for Yersinia pestis nucleic acid. Combined with clinical symptoms and signs, the patient was diagnosed as bubonic plague secondary to septicemic plague, and was isolated for treatment. After remote MDT consultation, comprehensive treatment was given, including anti-infection treatment of streptomycin and ciprofloxacin, short-term application of hormones, nutritional support, and local application of chloramphenicol ointment, etc. Secondary acute pancreatitis occurred during the course of the disease, which improved after symptomatic treatment. Finally, after 20 days of treatment, MDT expert group assessed that it met the discharge criteria. No abnormalities were found in follow-up visits outside the hospital. Conclusion:The remote MDT is effective in the treatment of bubonic plague secondary to septicemic plague, which is worth popularizing.
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Objective:To compare the clinical efficacy and safety of conventional transcatheter arterial chemoembolization (TACE) with drug-eluting bead transcatheter arterial chemoembolization (DEB-TACE) in treatment of patients with unresectable hepatocellular carcinoma.Methods:The data of patients with unresectable hepatocellular carcinoma who underwent hepatic artery chemoembolization at General Hospital of Ningxia Medical University from July 2019 to April 2020 were retrospectively analyzed. Of 282 patients who were enrolled, there were 233 males and 49 females, aged (55.9±10.0) years. The groups were divided into the conventional TACE group ( n=179) and the DEB-TACE group ( n=103) based on the treatments. The efficacy of the two groups was compared according to the modified response evaluation criteria in solid tumors. Postoperative adverse effects and liver function between the two groups were compared. Results:The differences in comparing the preoperative and postoperative liver function indexes between the two groups were not statistically significant. Patients who died and were lost to follow-up at 6 months after surgery were excluded and 240 patients were excluded in the efficacy analysis, with 148 patients in the conventional TACE group and 92 patients in the DEB-TACE group. At 6 months after treatment in the conventional TACE group, there were 64 patients (43.2%) with complete remission, 18 patients (12.2%) with partial remission, 27 patients (18.2%) with stable disease, and 39 patients (26.4%) with disease progression. In the DEB-TACE group, the corresponding figures were 38 patients (41.3%), 17 patients (18.5%), 26 patients (28.3%), and 11 patients (12.0%), respectively. The efficacy of DEB-TACE was better than conventional TACE with statistically significant differences between the 2 groups (χ 2=8.96, P=0.030). The incidence of postoperative embolic syndrome was 53.1% (95/179) in the conventional TACE group, which was significantly higher than the 34.0% (35/103) in the DEB-TACE group (χ 2=7.34, P=0.007). Conclusion:The efficacy and safety of DEB-TACE for unresectable hepatocellular carcinoma were superior to those of the conventional TACE group.
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Objective:To analyze the clinical phenotype of adult patients with epidemic encephalitis B (encephalitis B) in Ningxia Hui Autonomous Region, and to explore the influence of related factors of the development of encephalitis B.Methods:The medical records of confirmed patients with encephalitis B admitted to the General Hospital of Ningxia Medical University from August to November 2018 were collected, and the general data of patients and the results of laboratory indexes such as blood routine examination and cerebrospinal fluid routine examination were analyzed. Logistic regression analysis and survival curve were used to evaluate the risk factors of the development of encephalitis B.Results:Totally 97 patients with encephalitis B were included, 32 of them died, with a case fatality rate of 32.99%. There were 63 males and 34 females, and the age of onset was (59.13 ± 14.70) years old. There were statistically significant differences in case distribution rate between different sexes and ages (χ 2 = 97.00, 291.00, P < 0.001). The most common clinical type was extremely severe (43 cases), followed by mild (27 cases), severe (15 cases) and ordinary (12 cases). The results of laboratory tests showed that the number of neutrophils, lymphocytes and monocytes in the blood of patients increased; and the white blood cells number in cerebrospinal fluid increased significantly, while neutrophils ratio increased slightly. There were significant differences in cerebrospinal fluid glucose level and neutrophil ratio among patients with different clinical types of encephalitis B ( H = 4.21, 2.74, P < 0.05). There were statistically significant differences in death, hypertension, cerebrovascular diseases, and pulmonary infection among patients with different clinical types of encephalitis B (χ 2 = 34.22, 16.97, 9.91, 15.59, P < 0.05). Logistic regression analysis showed that hypertension [ OR (95% CI) = 5.544 (1.450-21.191)] and pulmonary infection [ OR (95% CI) = 6.490 (1.887-22.325)] were risk factors for the development of encephalitis B patients ( P = 0.012, 0.003). Pulmonary infection was the influencing factor for the death of encephalitis B patients (χ 2 = 18.88, P < 0.001). The survival curve showed that the survival status of encephalitis B patients with cerebrovascular disease and pulmonary infection was significantly worse than that of patients without comorbidity or complications (χ 2 = 6.45, 20.33 , P < 0.05). Conclusions:The majority of encephalitis B patients in this outbreak are the elderly people, and the patient's nervous system has inflammatory reaction. Complicated pulmonary infection is an important factor for the aggravation and death of encephalitis B patients.
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Objective:To explore the correlation of cognitive impairment with abnormal brain regions having low-frequency fluctuation (ALFF) by resting-state blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI) in patients with mild hepatic encephalopathy (MHE).Methods:Fifty-nine patients (28 patients with chronic cirrhosis and 31 patients with MHE, according to results of digital symbol test [DST] scores/digital connection test A [NCT-A] scores) admitted to our hospital from March 2018 to January 2020 were enrolled; 33 healthy control subjects matched in gender, age and years of education were chosen as controls. Resting-state BOLD-fMRI was performed in all subjects, and the original images were processed to obtain ALFF brain map. Statistical methods were used to obtain the brain regions with different ALFF values in the three groups, and the brain regions enjoying correlations between ALFF values and venous blood ammonia content/DST scores/NCFA scores in patients from the MHE group.Results:As compared with the control group, patients in the MHE group exhibited significantly lower ALFF values in the right central posterior gyrus, bilateral cuneiform lobe, left lateral occipital gyrus, left occipital gyrus, and left pars opercularis, and significantly increased ALFF values in the right thalamus, left parahippocampal gyrus and surrounding ventricle (bilateral caudate nucleus head)( P<0.05). Bivariate correlation analysis suggested that ALFF values were negatively correlated with blood ammonia in the left pars opercularis, left margin superior gyrus, bilateral precuneus, left superior temporal gyrus, right middle frontal gyrus and surrounding area, and right insula ( P<0.05); ALFF values were positively correlated with DST scores in left medial cingulate gyrus and right cerebellar hemisphere; ALFF values in the left frontal lobe and left posterior cerebellar lobe were positively correlated with NCT-A scores, and ALFF values in the left parahippocampal gyrus were negatively correlated with NCT-A scores ( P<0.05). Conclusion:The ALFF differences in multiple brain regions of patients with MHE may be related to cognitive impairment.
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Objective:To investigate the application of magnetic resonance imaging (MRI) in clinical staging and classification of adult Japanese encephalitis.Methods:The clinical data and craniocerebral MRI findings of 35 adult patients with Japanese encephalitis admitted in General Hospital of Ningxia Medical University from August to September 2018 were analyzed retrospectively. The MRI imaging characteristics were compared among patients with different stages and types, the apparent diffusion coefficient (ADC value) of thalamic lesions in patients of different stages was analyzed. SPSS 23.0 software was used to analyze the data.Results:Six moderate cases all had lesions involving the thalamus, and the number of intracranial lesions was <2. In 11 severe cases, 8 had lesions involving thalamus and 5 had lesions involving hippocampus; the number of intracranial lesions was <2 in 3 cases, the number of intracranial lesions was 2-4 in 3 cases, and the number of intracranial lesions was >4 in 5 cases. In 18 cases critical cases, the lesions involved thalamic in 14 cases, hippocampus in 14 cases, cerebral cortex in 14 cases, cerebral feet in 9 cases, basal ganglia area in 6 cases, and brain stem in 2 cases, respectively; 2 cases had the intracranial lesions <2, 6 cases had intracranial lesions 2-4, 10 cases had intracranial lesions >4. In 11 preliminary stage patients, 9 cases had DWI high signal and 2 had FLAIR slightly high signal; in 19 extreme stage patients, 16 cases had DWI high signal, 11 cases had FLAIR slightly high signal, 3 cases had T1WI high signal and 6 cases had T2WI high signal. In 5 recovery stage patients, 1 case had DWI slightly high signal, 5 cases had FLAIR high signal, and 1 case had T2WI high signal. The ADC values of thalamic lesions in recovery and extreme patients were higher than those in the preliminary stage ( q=3.931 and 4.012, P<0.05). The ADC value of thalamic lesions in the recovery period was higher than that in the extreme period ( q=3.372, P<0.05). Conclusions:The number of lesions and the range of involvement are associated with disease severity in adult Japanese encephalitis. The DWI sequence is easy to detect at early stage, and the FLAIR sequence shows a long time span of lesions; and the DWI and FLAIR sequences are of great significance for the early clinical staging and classification of adult encephalitis patients. At the same time, the ADC value shows a trend of disease progresses, which can be used as a supplement for the clinical staging in adult encephalitis patients.
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Objective To analyze the magnetic resonance imaging (MRI) images of patients with adult Japanese encephalitis (JE),and to investigate the diagnostic value of MRI for the disease.Methods Thirty-two adult JE patients who underwent cranial MRI at General Hospital of Ningxia Medical University between August 2016 and September 2018 were enrolled.All patients had disease onset between August and September and they aged 17 to 83 years old.The clinical data,laboratory results,MRI signal characteristics of each scanning sequence and the distribution of the brain lesions were retrospectively analyzed.Results Of the 32 adult JE patients,29 (90.6％)cases had acute onset,28 (87.5％) cases had unconsciousness and cognitive impairment,26 (81.2％) cases had intracranial hypertension,3 (9.4％) cases had meningeal irritation,3 (9.4％) cases had Parkinson-like symptoms,10 (31.2％) cases had epilepsy,and 15 (46.9％) cases had decreased muscle strength.Twenty patients were positive for JE virus-specific IgM antibodies.Twenty-eight patients underwent cerebrospinal fluid examination,15 (53.6％) cases showed intracranial pressure ≥180 mmH2O (1 mmH2O =0.009 8 kPa),7 (25％) cases developed lymphocyte reaction,and 16 (57.1％) cases showed mixed cell reaction.Twenty-three cases (71.9％) showed lesions of brain on MRI,including thalamus (17 cases,73.9％),hippocampus (13 cases,56.5％),cerebral peduncle (6 cases,26.1％),cortical and subcortical (4 cases,17.4％),basal ganglia (2 cases,8.7％),brainstem (1 case,4.3％) and splenium of corpus callosum (1 case,4.3％).Positive T1 weight image (T1WI) and T2 weight image (T2WI) results were found in 21 patients,respectively,23 patients had positive T2-fluid attenuated inversion recovery (FLAIR) images,and 20 patients had positive diffusion weighted imaging (DWI) images.Among them,T2-FLAIR and DWI images showed more lesions,wider range of lesions and clearer boundary of cortical involvement range than T1WI and T2WI images.Conclusions Bilateral thalamus and hippocampus are often involved in adult JE.T2-FLAIR and DWI sequences are more sensitive to detect lesions.Combining MRI images with epidemiological characteristics,clinical manifestations,and laboratory tests is of great assistance for early diagnosis of JE.
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Objective@#To investigate the diagnostic value of serum α-enolase (ENO1) in the primary hepatocellular carcinoma.@*Methods@#From May 2012 to March 2017, 163 cases with liver diseases who met the inclusion and exclusion criteria were admitted to the Infectious Diseases Department of the General Hospital of Ningxia Medical University. Among them, 28 cases were of chronic hepatitis B (CHB), 31 cases with liver cirrhosis (LC), 104 cases with hepatocellular carcinoma (HCC), and 18 healthy volunteers (NC). Patient data and serum samples were collected and liver disease related indicators were measured to detect ENO1 levels with enzyme-linked immunosorbent assay (ELISA). The measured indicators were expressed in median. Mann-Whitney U nonparametric test was used to analyze the differences between the data. A Spearman’s correlation analysis was used for bivariate correlation analysis. The sensitivity and specificity of ENO1 and alpha-fetoprotein in the diagnosis of liver cancer were analyzed by ROC curve.@*Results@#Serum level of ENO1 in CHB group, LC group and HCC group was significantly higher than normal group. Serum level of ENO1 in HCC group was higher than CHB group (P = 0.001) and LC group (P < 0.01). Area under the curve (AUC) for serum ENO1 and alpha-fetoprotein were 0.782 (cut-off value 75.96, P = 0.000 1) and 0.800 (cut-off value 27.02, P = 0.000 1), respectively. There was a positive correlation between ENO1 and AFP (P = 0.001). The combined detection had significantly improved the detection efficiency (AUC = 0.835). Serum ENO1 was statistically significant (P < 0.05) in HCC tumor size (AUC = 0.663), tumor metastasis (AUC = 0.681), TNM stage (AUC = 0.710, stage I vs. II), and Edmondson grade (AUC = 0.685) (P < 0.05) and the elevated levels of ENO1 had significantly reduced (P < 0.05) the survival time.@*Conclusion@#ENO1 can be a new candidate marker for the diagnosis of early stage HCC and its progression.
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Objective@#To investigate the role of enolase 1 (ENO1) in hepatocellular carcinoma (HCC) and possible mechanism.@*Methods@#Real-time PCR and Western blot were used to measure the expression of ENO1 in HCC tissue, adjacent tissue, hepatoma cells, and normal hepatocytes. The siRNA interference technique was used for ENO1 knockout in HepG2 cells, and then CCK-8, colony formation assay, and transwell assay were used to measure the proliferation, migration, and invasion abilities of HepG2 cells. Real-time PCR and Western blot were used to measure the expression of proteins and genes involved in the activation of the Notch signaling pathway. The two-independent-samples t test and a one-way analysis of variance were used for comparison.@*Results@#HCC tissue and HepG2 cells had significantly higher expression of ENO1 than adjacent tissue and normal hepatocytes (P < 0.05). There were significant reductions in the proliferation, migration, and invasion abilities of HepG2 cells after siRNA interference (P < 0.05). There were also significant reductions in the expression of N1ICD, snail, slug, HEY1, HES1, and HES5 (P < 0.05).@*Conclusion@#ENO1 may promote the development of HCC, possibly by participating in the regulation of the Notch signaling pathway.
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<p><b>OBJECTIVE</b>The aim of this study was to explore the diagnostic value of liver stiffness measurement combined with serum high-sensitivity C-reactive protein detection in HBV-related cirrhosis patients complicated with primary liver cancer.</p><p><b>METHODS</b>A total of 156 previously untreated chronic hepatitis B-related cirrhosis patients and 50 healthy subjects were included in this study. The 156 patients were divided into two groups: those with primary liver cancer (67 cases) and without liver cancer (89 cases). The 50 healthy subjects were considered as normal control group. Liver stiffness measurement (LSM) was conducted and serum high-sensitivity C-reactive protein (CRP) level was assayed in all the 156 patients and 50 normal individuals, and their measurement values were statistically compared and analyzed.</p><p><b>RESULTS</b>The LSM value was (39.72±29.05) kPa in the liver cancer patients, significantly higher than the (27.81±18.46) kPa in the cirrhosis alone patients and (4.25±0.74) kPa in the healthy controls (P<0.01 for both). Serum hs-CRP levels in the liver cancer patients was 5.81mg/L, significantly higher than 1.78 mg/L in the cirrhosis alone patients and 0.38mg/L in healthy controls, (P<0.01 for both). The higher the grade of LSM values was, the positive rate of CRP was higher in the cirrhosis patients complicated with primary liver cancer. In patients with LSM values ≥27.6 kPa, the serum CRP positive rate was 64.2% in patients with primary liver cancer, significantly higher than the 38.0% in patients with cirrhosis alone (P<0.01). In the 67 HBV-related cirrhosis patients complicated primary liver cancer, the LSM value and serum hs-CRP level in AFP-positive patients were (48.95±28.59) kPa and 4.91 mg/L, respectively, higher than those in the AFP-negative patients (28.64±26.83) kPa and 4.16 mg/L, but with a non-significant difference (P>0.05).</p><p><b>CONCLUSION</b>Liver stiffness measurement combined with serum high-sensitivity C-reactive protein detection may have potential diagnostic implications as a marker of primary liver cancer occurrence in patients with HBV-related cirrhosis.</p>
Asunto(s)
Humanos , Biomarcadores , Proteína C-Reactiva , Metabolismo , Diagnóstico por Imagen de Elasticidad , Fibrosis , Hepatitis B Crónica , Metabolismo , Cirrosis Hepática , Metabolismo , Virología , Neoplasias HepáticasRESUMEN
<p><b>OBJECTIVE</b>To explore the clinical significance of high-sensitivity C-reactive protein (hsCRP) in the development of chronic hepatitis B (CHB).</p><p><b>METHODS</b>A total of 182 patients with untreated CHB and 50 healthy individuals (controls) participated in the study. Correlation analysis was performed to determine the association of serum hs-CRP with the age,sex,medical history,serum hepatitis B virus (HBV) DNA, liver function parameters,liver stiffness measure (LSM) and hepatic fibrosis; in addition, correlation analysis was carried out for the associations of degree of liver damage with grade of hepatic fibrosis, LSM and the serum levels of hs-CRP.</p><p><b>RESULTS</b>CHB patients showed significantly higher serum hs-CRP levels than healthy controls (2.38 ± 2.79 vs.0.78 ± 1.07; t =2.495, P < 0.05). Serum hs-CRP levels were significantly correlated with HBV DNA (r = 0.159), liver function parameters (total bilirubin, r = 0.271; alanine aminotransferase, r = 0.298; aspartate aminotransferase, r = 0.389), and LSM, r = 0.562) (all P < 0.05). The correlations with liver function (r = 0.340), LSM (r = 0.292) and hepatic fibrosis grade were positive (r = 0.434) (all P < 0.01).</p><p><b>CONCLUSION</b>Serum hs-CRP levels in CHB patients can reflect degree of liver damage and of liver fibrosis.</p>
