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Objective To investigate the role of P-I-R classification and Laennec grading in evaluating histological changes in patients with hepatitis B cirrhosis after receiving antiviral therapy, as well as the association of these two evaluation systems with clinical prognosis. Methods A total of 218 patients from 14 centers were consecutively screened from October 2013 to October 2014, and these patients were diagnosed with liver cirrhosis based on pathology (Ishak score ≥5), received antiviral therapy for 72 weeks, completed two liver biopsies, and met the P-I-R classification criteria. The 218 patients were divided into non-hepatocellular carcinoma (HCC) group with 186 patients and HCC group with 32 patients. The chi-square test and the Fisher's exact test were used for comparison of categorical data between groups. For the comparison of HCC after antiviral therapy, the non-parametric Mann-Whitney U test was used for continuous variables, and for the comparison of P-I-R classification and Laennec grading, the non-parametric Kruskal-Wallis H test was used for continuous variables. Univariate and multivariate Cox regression analyses were used to calculate hazard ratio ( HR ) and 95% confidence interval ( CI ), and the Kaplan-Meier method was used to calculate the cumulative incidence rate of HCC. Results After 72 weeks of antiviral therapy, there was a significant difference in P-I-R classification between the non-HCC group and the HCC group ( P < 0.001). There were significant differences in the distribution of Laennec grading and P-I-R classification before and after antiviral therapy ( P < 0.001). After antiviral therapy, the 218 patients were divided into 4A group with 33 patients, 4B group with 71 patients, and 4C group with 114 patients according to Laennec grading, and there were significant differences between these three groups in platelet count (PLT) ( H =36.429, P < 0.001), liver stiffness measurement (LSM) ( H =13.983, P =0.004), Ishak score ( χ 2 =23.060, P < 0.001), and HAI score ( P < 0.001). After antiviral therapy, the 218 patients were divided into R group with 70 patients, I group with 52 patients, and P group with 96 patients according to P-I-R classification, and there were significant differences between these three groups in PLT ( H =7.193, P =0.028), LSM ( H =6.238, P =0.045), Ishak score ( χ 2 =7.986, P < 0.001), HAI score ( P =0.002), and HCC ( P < 0.001). There was a significant difference in the incidence rate of HCC between the P and R groups based on P-I-R classification ( HR =24.21, 95% CI : 0.46-177.99, P =0.002). After adjustment for other confounding factors, P-I-R classification was an independent predictive factor for HCC ( HR =12.69, 95% CI : 4.63-34.80, P =0.002). Conclusion Both P-I-R classification and Laennec grading can reflect the features and changes of fibrosis before and after antiviral therapy, and P-I-R classification is more sensitive to fibrosis changes after antiviral therapy. P-I-R classification (after treatment) can be used to assess the risk of HCC in patients after antiviral therapy.
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ObjectiveTo investigate the association of high-density lipoprotein cholesterol (HDL-C) with the prognosis of patients with alcohol-related hepatocellular carcinoma (HCC) after radical treatment. MethodsA retrospective analysis was performed for the clinical data of 43 patients with alcohol-related HCC who were admitted to The Fifth Medical Center of Chinese PLA General Hospital and underwent radical treatment from January 2008 to July 2015, and according to HDL-C level, the patients were divided into normal group with 26 patients and abnormal group with 17 patients. The two groups were compared in terms of basic information, laboratory markers, imaging indices, Barcelona Clinic Liver Cancer tumor stage, and Child-Pugh class of liver function. The t-test test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to plot survival curves and the log-rank test was used for comparison between groups. Univariate and multivariate Cox proportional hazards models were used to analyze independent risk factors for prognosis. ResultsThere was a significant difference in prealbumin between the two groups (162.38±60.86 mg/L vs 120.06±64.08 mg/L, t=2.184, P=0.035). Number of tumors (hazard ratio ［HR］=2.839, 95%confidence interval ［CI］: 1.120~7.200,P=0.028), tumor size (HR=2.634, 95%CI: 1.062~6.529,P=0037), and HDL-C level (HR=2.400, 95%CI: 1.040~5.537,P=0.040) were independent risk factors for the overall survival of patients with alcohol-related HCC. There were significant differences in 1-, 3-, and 5-year cumulative survival rates between the normal group and the abnormal group (88.5%/72.4%/55.7% vs 70.6%/43.7%/17.5%, χ2=5.881, P=0.015). ConclusionThe reduction in HDL-C level might indicate poor prognosis of patients with alcohol-related HCC.
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Hepatitis B virus (HBV) causes liver injury by stimulating host immune response and may lead to liver fibrosis, liver cirrhosis, and liver cancer. Progression of liver fibrosis is a key factor in liver disease-related death. This article summarizes the association of HBV genotype, HBV gene mutation in basic core promoter region/pre-C region, pre-S region, and X region, HBV gene splicing, HBV RNA, HBcAg, and HBsAg with the progression of liver fibrosis. It is pointed out that the above biological characteristics of HBV are closely associated with the progression of liver fibrosis.
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This study was aimed to discuss the antibacterial and immunomodulation effect ofRe-Du-Ning (RDN) injection. Mice were randomly divided into the normal group, model group,Shuang-Huang-Lian (SHL) group (7.8 mL·kg-1), RDN high dose group (20.30 g·kg-1), middle dose group (10.15 g·kg-1), and low dose group (5.08 g·kg-1), in order to observe the death protective effect of mice with bacterial infection on antibacterial experimentin vivo. Mice were randomly divided into the normal group, model group,Xiang-Gu Duo-Tang (XGDT) group (0.19 mg·kg-1), RDN high dose group (20.30 g·kg-1), middle dose group (10.15 g·kg-1), and low dose group (5.08 g·kg-1). The 2, 4-dinitrochlorobenzene was used to induce delayed hypersensitivity. Immunomodulation was observed by the content of serum hemolysin and the carbon particle clearance index. The results showed that the RDN high dose group and middle dose group had antibacterial effect, which reduced the mortality of mice. The RDN high dose, middle dose and low dose group can enhance the phagocytosis of macrophage in immunosuppressive mice, increase the formation of hemolysin, and strengthen delayed hypersensitivity reaction among immunocompromised mice. It was concluded that RDN injection had antibacterial effect. Its immunomodulation effect was through the enhancing of non-specific immunity, humoral immunity and cellular immunity of mice.
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This article was aimed to study the analgesic and antipyretic effect of Re-Du-Ning (RDN) Injection. Heating model was building on SD rats after subcutaneous injection of yeast. And then, RDN Injection was intravenous injected at the dose of 10.16 g·kg-1, 5.08 g·kg-1, and 2.54 g·kg-1, respectively. Observation was made on changes of rats' temperature. RDN Injection was intravenous injected into ICR mice at the dose of 20.30 g·kg-1, 10.15 g·kg-1, 5.08 g·kg-1 for 7 consecutive days. The methods of mice twist, hot plate and jaw pain were used in the testing of analgesic action of RDN Injection. The results showed that RDN Injection at high and middle dose can significantly reduce the temperature of heating rats models (P < 0.05 or P < 0.01). It can also significantly reduce the twisting times of mice by acetic acid (P< 0.05 or P< 0.01). It can also significantly increase the pain threshold of mice by hot plate and jaw pain (P< 0.05 or P< 0.01). It was concluded that RDN Injection had a good analgesic and antipyretic effect in mice.
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<p><b>OBJECTIVE</b>To investigate pharmacokinetic parameters of peoniflorin, albiflorin and amygdaloside after administration of Guizhi Fuling capsule in beagle dogs.</p><p><b>METHOD</b>Plasma was collected from forelimb vein of Beagle dogs after oral administration of Guizhi Fuling capsule. HPLC-MS/MS method was used to determine the concentrations of constituents in plasma. The pharmacokinetic parameters were analyzed by program DAS 2.0.</p><p><b>RESULT</b>The limit of quantitation of peoniflorin, albiflorin and amygdaloside were 0.25, 2.64, 0.04 microg x L(-1), respectively. After administrated with different doses, half-life of peoniflorin in dogs were 4.33, 3.62 h, albiflorin were 6.16, 5.91 h, amygdaloside were 2.43, 1.32 h. The AUC(0-t) of all components were related to dose.</p><p><b>CONCLUSION</b>The pharmacokinetic course of peoniflorin, albiflorin and amygdaloside can be described by two-compartment model, and these components have high expose.</p>