Predictors of liver failure in primary biliary cirrhosis.

BACKGROUND: The disease progression of patients with primary biliary cirrhosis (PBC) varies significantly, and the prognostic markers that identify those patients who will develop liver failure have been scarcely studied from a Chinese cohort. Aims. We aimed to determine the predictive factors of liver failure in patients with PBC. METHODS: Patients who were first diagnosed as PBC with hepatic compensation between January 2007 and December 2009 were enrolled in this cohort study. RESULTS: Altogether 398 patients were finally included. Of these patients, 80% were women, 98% had positive antimitochondrial antibodies, and 45% had positive antinuclear antibodies (ANA). To December 2012, a total of 38 patients developed liver failure. According to the outcome, patients who developed liver failure had had higher serum concentration of baseline total bilirubin (TBil) (p = 0.013) and total bile acid (TBA) (p < 0.001), and lower concentrations of baseline total cholesterol (Tch) (p = 0.008), than patients who did not develop liver failure. Additionally, the proportion of ANA positivity was statistically different between the two groups (p = 0.009). In the established model for predicting liver failure in PBC, three variables were finally selected out, including Tch (odds ratio (OR) 0.552, 95% confidence interval (CI) 0.394-0.774, p < 0.001), TBA (OR 1.006, 95% CI 1.002-1.010, p = 0.002), and ANA (+ versus -, OR 5.518, 95% CI 1.155-26.376, p = 0.032). CONCLUSIONS: ANA, Tch, and TBA are predictors of liver failure in PBC.

Efficacy of Lianhuaqingwen capsule compared with oseltamivir for influenza A virus infection: a meta-analysis of randomized, controlled trials.

In this meta-analysis, the authors review the results of studies on the efficacy of lianhuaqingwen capsule (LHQW-C) compared with oseltamivir in treating influenza A virus infection. The authors searched PubMed, Embase, Wanfang Data, and the China National Knowledge Infrastructure (CNKI) from the date of inception until December 31, 2012. The Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Database of Systematic Reviews (CDSR) were also searched. Five randomized, controlled trials were finally included and analyzed in this review. Compared with individuals treated with oseltamivir, this metaanalysis showed that participants treated with LHQW-C had a shorter duration of (1) fever, weighted mean difference (WMD) = -4.65 (95% CI, -8.91 to -0.38; P = .030); (2) cough, WMD = -9.79 (95% CI, -14.61 to -4.97; P < .0001); (3) sore throat, WMD = -13.01 (95% CI, -21.76 to -4.27; P = .004); and (4) body ache, WMD = -16.68 (95% CI, -32.33 to -1.03; P = .040). The review also found that the efficacy of the 2 treatments on viral shedding was similar with WMD = -0.24 (95% CI, -4.79 to 4.31; P = .920). The authors conclude that LHQW-C was superior to oseltamivir in improving the symptoms of influenza A virus infection.

In vitro inhibition of HBV replication by a novel compound, GLS4, and its efficacy against adefovir-dipivoxil-resistant HBV mutations.

BACKGROUND: HBV infection continues to be an important worldwide cause of morbidity and mortality. Patients with chronic hepatitis B can be successfully treated using nucleoside/nucleotide analogues. However, drug-resistant HBV mutants frequently arise, leading to treatment failure and progression to liver disease. Here, we report the effects of GLS4, a non-nucleosidic inhibitor that exhibits a novel and highly specific anti-HBV activity. METHODS: The median inhibitory concentrations (IC(50)s) of GLS4 on HBV were measured by Southern blotting. HBV capsid and core protein levels were detected by immunoblotting. To determine the antiviral activity of GLS4 against adefovir dipivoxil (ADV)-resistant HBV mutants, HepG2 cells transiently transfected with PUC-HBV1.2 plasmids that contained one of three major ADV-resistant mutations (rtA181T, rtA181V and rtN236T) were treated with GLS4. Intracellular HBV replicative intermediates were detected by Southern blotting. The effect on the in vitro assembly of HBV capsid protein was examined using dynamic light scattering and electron microscopy. RESULTS: The IC(50) of GLS4 was 0.012 µM, which is significantly lower than that of lamivudine (0.325 µM). Immunoblot analysis of HepG2.2.15 cells and transiently transfected HepG2 cells indicated that GLS4 treatment interfered with the formation of core particles (assembly). The ADV-resistant HBV mutant strains were also sensitive to GLS4. Upon examining the in vitro assembly of HBV core protein 149 by electron microscopy, increased aberrant particles were observed after GLS4 treatment. CONCLUSIONS: GLS4 is a new and unique potential anti-HBV agent that possesses a different mechanism of action than existing therapeutic drugs.