Clinic-pathological features of metabolic associated fatty liver disease with hepatitis B virus infection.

BACKGROUND: Metabolic associated fatty liver disease (MAFLD) is a novel concept proposed in 2020. AIM: To compare the characteristics of MAFLD and MAFLD with hepatitis B virus (HBV) infection. METHODS: Patients with histopathologically proven MAFLD from a single medical center were included. Patients were divided into MAFLD group (without HBV infection) and HBV-MAFLD group (with HBV infection). Propensity score matching was utilized to balance the baseline characteristics between two groups. RESULTS: A total of 417 cases with MAFLD were included, 359 (86.1%) of whom were infected with HBV. There were significantly more males in the HBV-MAFLD group than in the MAFLD group (P < 0.05). After propensity score matching, 58 pairs were successfully matched with no significant differences found in gender, age, body mass index, lipid levels, liver enzymes, and the other metabolic associated comorbidities between the two groups (P > 0.05). The rank sum test results showed that the degree of liver steatosis in the MAFLD group was more severe than that in the HBV-MAFLD group, while the degree of inflammation and fibrosis in the liver was less severe (P < 0.05). In multivariate analysis, HBV infection was associated with significantly lower grade of hepatic steatosis [odds ratio (OR) = 0.088, 95% confidence interval (CI): 0.027-0.291] but higher inflammation level (OR = 4.059, 95%CI: 1.403-11.742) and fibrosis level (OR = 3.016, 95%CI: 1.087-8.370) after adjusting for age, gender, and other metabolic parameters. CONCLUSION: HBV infection is associated with similar metabolic risks, lower steatosis grade, higher inflammation, and fibrosis grade in MAFLD patients.

Efficacy and safety of autologous stem cell transplantation for decompensated liver cirrhosis: A retrospective cohort study.

AIM: To evaluate the long-term efficacy and safety of autologous stem cell transplantation (SCT) for decompensated liver cirrhosis. METHODS: Consecutive patients with decompensated liver cirrhosis were included and assigned into the SCT group and non-transplantation (non-SCT) group according to whether they received SCT treatment. Patients were followed up for ten years. The long-term survival rate and incidence of hepatocellular carcinoma (HCC) were compared between groups. RESULTS: A total of 159 patients were enrolled, including 27 cases in the SCT group and 132 cases in the non-SCT group. The baseline characteristics were significantly different between the two groups. Propensity score matching (PSM) was used to match SCT and non-SCT patients. After PSM, 92 subjects were enrolled in the final analysis, including 23 cases in the SCT group and 69 cases in the non-SCT group. The overall mortality was 73.9% and 55.1%, and the median survival period was 48 and 64 mo, respectively. However, no significant difference was found in the long-term survival rate between the two groups (P > 0.05). In addition, the incidence of HCC was higher in the SCT group than in the non-SCT group (47.8% vs 21.7%, P < 0.05). After adjusting for other covariates, SCT (OR = 3.065, 95%CI: 1.378-6.814) and age (OR = 1.061, 95%CI: 1.021-1.102) were independently correlated with the development of HCC in this decompensated liver cirrhosis cohort. CONCLUSION: Autologous SCT may fail to improve the long-term efficacy and increase the incidence of HCC for decompensated liver cirrhosis. Close monitoring of HCC is strongly recommended in patients undergoing autologous SCT.

[Effects of different straw-returning regimes on soil organic carbon and carbon pool management index in Guanzhong Plain, Northwest China].

A four-year (2008-2012) field experiment was conducted to investigate the effects of different straw-returning regimes on soil total organic carbon (TOC), labile organic carbon (LOC) and the ratio of LOC to TOC (LOC/TOC) as well as TOC stock (SCS) and soil carbon pool management index (CPMI) in a farmland with maize-wheat double cropping system in Guanzhong Plain area, Shaanxi Province, China. The results indicated that soil TOC and LOC contents and SCS were significantly increased when wheat or maize straw was returned to field, and the increasing extent showed the rising order as follows: double straw-returning > single straw-returning > no straw-returning. Compared to no straw returning, a significant increase of TOC and LOC contents and SCS was found in the treatment of wheat straw chopping retention combined with maize straw chopping subsoiling retention (WC-MM), and CPMI of WC-MM was significantly higher than in the other treatments in 0-20 cm soil layer. Compared to no wheat straw returning, soil CPMIs in 0-10 cm and 10-20 cm soil layer increased by 19.1% and 67.9% for the wheat straw chopping returning treatment, and by 22.6% and 32.4% for the maize straw chopping subsoiling treatment, respectively. Correlation analysis showed that soil CPMI was a more effective index reflecting the sequestration of soil organic carbon in 0-30 cm soil layer than the ratio of LOC to TOC. This study thus suggested that WC-MM regime is the best straw-returning regime for soil organic carbon sequestration.

Serum HBsAg and HBeAg levels are associated with liver pathological stages in the immune clearance phase of hepatitis B virus chronic infection.

The association between hepatitis B surface antigen (HBsAg) and hepatitis B 'e' antigen (HBeAg) levels and liver inflammation and fibrosis in patients with chronic hepatitis B (CHB) in the immune clearance (IC) remains elusive. The aim of the present study was to investigate whether HBsAg and HBeAg levels were associated with liver inflammation and fibrosis in CHB patients during the IC phase. Kendall's rank correlation analysis and receiver operating characteristic curves were used to determine the correlation between HBsAg, HBeAg and liver pathological stages. Multivariate analysis by forward logistic regression was used to analyze significant predictors of cirrhosis. A liver pathology­predicting model (IC model), which used routinely assessed markers in combination with HBsAg and HBeAg levels, was constructed. There were significantly positive correlations between the HBsAg and HBeAg levels (γ=0.317, P<0.001), and between the HBsAg and HBV­DNA levels (γ=0.489, P<0.001). However, there was no correlation between the HBsAg and alanine aminotransferase levels. HBsAg and HBeAg levels differed significantly at various liver pathological stages and declined progressively in advanced liver pathological stages. Multivariate logistic regression analysis showed that age, HBsAg and HBeAg levels as well as the international normalized ratio (INR) were independent predictors of liver fibrosis during the IC phase. The IC model had a specificity and sensitivity of 88.64 and 78.24%, respectively, a positive predictive value of 48.15% and negative predictive value of 96.79%. In conclusion, HBsAg and HBeAg levels were negatively and indirectly correlated with liver inflammation and fibrosis in CHB patients in the IC phase. The IC model reliably predicted the probability of liver cirrhosis.

[Effect of long-term shallow tillage and straw returning on soil potassium content and stratification ratio in winter wheat/summer maize rotation system in Guanzhong Plain, Northwest China].

Soil stratified sampling method and potassium chemical fractionation analysis were used to investigate effects of long-term shallow tillage and straw returning on soil K contents and stratification ratios in winter wheat/summer maize rotation system in Guanzhong Plain of Northwest China. The results showed that after 13-year continuous shallow tillage and straw returning, surface accumulation and stratification effect obviously occurred for soil available K (SAK) and non-exchangeable K (NEK), which was particularly remarkable for SAK and its fractions. Serious depletion of SAK occurred in 15-30 cm soil layer, and the SAK value was lower than the critical value of soil potassium deficiency. Meanwhile, significant differences were found between SR1 and SR2 values of SAK and its fractions, SR was obtained by values of topsoil layer (0-5 cm) divided by corresponding values of lower soil layers (5-15 cm layer, SR1, or 15-30 cm layer, SR2). However, no significant difference was observed between SR values of NEK and mineral K. In conclusion, returning of all straw over 10 years in the winter wheat/summer maize rotation system contributed greatly to maintaining soil K pool balance, while special attention should be paid to the negative effects of surface accumulation and stratification of SAK on soil K fertility.

Serum ceruloplasmin levels correlate negatively with liver fibrosis in males with chronic hepatitis B: a new noninvasive model for predicting liver fibrosis in HBV-related liver disease.

AIMS: This study aimed to investigate associations between ceruloplasmin (CP) levels, inflammation grade and fibrosis stages in patients with chronic hepatitis B (CHB) and to establish a noninvasive model to predict cirrhosis. METHODS: Liver biopsy samples and sera were collected from 198 CHB patients randomized into a training group (n=109) and a validation group (n=89). CP levels were determined using nephelometric immunoassays. Relationships between CP and liver inflammation and fibrosis were analyzed by Spearman rank correlation. Receiver operator characteristic (ROC) curves were used to evaluate the diagnostic value of CP for determining liver fibrosis in CHB. The liver pathology-predictive model was built using multivariate logistic regression analysis to identify relevant indicators. RESULTS: CP levels were lower in males than in females, lower in patients with inflammation stage G4 compared to other stages and lower in cirrhotic compared to non-cirrhotic patients. Using area under the curve (AUC) values, CP levels distinguished different stages of inflammation and fibrosis. Multivariate analysis showed that CP levels were all significantly associated with cirrhosis in males. A model was developed combining routine laboratory markers APPCI (alpha-fetoprotein [AFP], prothrombin time, and platelets [PLT] with CP) to predict fibrosis in CHB patients. The APPCI had a significantly greater AUC than FIB-4 (aspartate aminotransferase [AST]/ alanine aminotransferase [ALT]/PLT/age), APRI (AST/PLT ratio index), GPI (globin/PLT), and APGA (AST/PLT/gammaglutamyl transpeptidase [GGT]) models (all P-values<0.001). CONCLUSIONS: CP levels correlate negatively and indirectly with inflammation and fibrosis stages in male CHB patients. The APPCI model uses routine laboratory variables with CP to accurately predict liver fibrosis in CHB.