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1.
Article in Chinese | WPRIM | ID: wpr-884198

ABSTRACT

Objective:To evaluate the short-term prognostic value of model for end-stage liver disease (MELD) combined with high density lipoprotein-cholesterol (HDL-C) in patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).Methods:From December 2015 to December 2018, 182 patients with HBV-ACLF who were treated in Henan Provincial People′s Hospital were included. Prognosis and clinical data including HDL-C, total bilirubin, international standardized ratio (INR), creatinine of patients within 24 hours after admission were collected and analyzed retrospectively.The values of MELD were calculated. The binary logistic regression analysis was used to analyze the independent risk factors affecting 90-day mortality in HBV-ACLF patients.The receiver operator characteristic curve (ROC) and MedCalc 15.2 software were used to assess the predictive value of MELD, HDL-C and MELD-HDL-C model for prognosis. Kaplan-Meier survival curve was performed to analyze the prognosis of patients in different groups.Results:Sixty patients were divided into the death group and 122 patients were divided into the survival group according to the prognosis during hospitalization and 90 days after discharge. The MELD score of patients in the survival group was 21(19, 24), which was significantly lower than that in the death group (29(25, 34)), and the HDL-C value of patients in the survival group was significantly higher than that in the death group (0.3 (0.1, 0.6) mmol/L vs 0.2(0.1, 0.5) mmol/L). The differences were both statistically significant ( Z=-6.290 and -4.087, respectively, both P<0.01). Multivariate logistic regression analysis showed that MELD score and HDL-C value were the independent risk factors for 90-day mortality in patients with HBV-ACLF(odds ratio ( OR)=1.432, 95% confidence interval ( CI)1.271-1.613; OR=0.584, 95% CI 0.487-0.700, respectively; both P<0.01). Areas under the ROC of MELD, HDL-C and MELD-HDL-C scoring models were 0.775, 0.782 and 0.878, respectively. MELD-HDL-C scoring model was superior to both MELD and HDL-C , and the differences were both statistically significant ( Z=3.944 and 3.104, respectively, both P<0.01). When the MELD-HDL-C Youden′s index was set at 0.72, the optimal threshold was 24.69. Patients with MELD-HDL-C score≥24.69 had lower survival rate than patients with MELD-HDL-C score<24.69, and the difference was statistically significant ( χ2=142.900, P<0.01). Conclusion:MELD, HDL-C and MELD-HDL-C scoring systems could predict the short-term prognosis in patients with HBV-ACLF, and the predictive value of MELD-HDL-C has the superiority.

2.
Article in Chinese | WPRIM | ID: wpr-884174

ABSTRACT

Objective:To evaluate the efficacy and safety of elbasvir/grazoprevir (EBR/GZR) in patients with genotype 1 chronic hepatitis C in the real-world.Methods:This was an open-label, single-center, retrospective real-world study. A total of 103 genotype 1 chronic hepatitis C patients who were treated with EBR/GZR in Henan Provincial People′s Hospital from May 2018 to October 2019 were enrolled.And the clinical baseline characteristics of patients and the effectiveness and safety of antiviral therapy were respectively evaluated.Results:A total of 103 patients were enrolled in the study with an age of (47.6±13.9) years. Fifty-five (53.4%) patients were male and 48(46.6%) were female. One point nine percent (2/103) patients were genotype 1a hepatitis C and 98.1%(101/103) were genotype 1b hepatitis C. Seventeen genotype 1b hepatitis C patients were previously treated with interferon, and three patients co-infected with hepatitis B virus (HBV). Among the 103 cases, 35 had underlying diseases and 26 had combined medication. Ninty-eight cases completed 12-week treatment and 89 cases completed 12-week follow-up after treatment.Overall, 89 cases achieved sustained virological response. The overall incidence of adverse reactions was 20.4%(21/103), and the main adverse reactions were fatigue, insomnia and anxiety. No serious adverse event occurred. The three patients with HBV co-infection had no hepatitis B activation after treatment.Conclusion:EBR/GZR is effective and safe in the patients with genotype 1 chronic hepatitis C in China.

3.
Article in Chinese | WPRIM | ID: wpr-879138

ABSTRACT

In this paper, network pharmacology method and molecular docking technique were used to investigate the target genes of Olibanum and Myrrha compatibility and the possible mechanism of action in the treatment of rheumatoid arthritis(RA). Our team obtained the main active components of Olibanum-Myrrha based on literatures study, relevant traditional Chinese medicine systematic pharmacological databases and literature retrieval, and made target prediction of the active components through SwissTargetPrediction database. At the same time, RA-related targets were collected through DrugBank, GeneCards and Therapeutic Target Database(TDD) databases; and VENNY 2.1 was use to collect intersection targets to map common targets of drug and disease of Venn diagram online. The team used STRING database to construct PPI protein interaction network diagram, and screen out core targets according to the size of the interaction, and Cytoscape 3.6.0 software was used to construct network models of "traditional Chinese medicine-component-target" "traditional Chinese medicine-component-target-disease" and core target interaction network model. The intersection target was analyzed by using DAVID 6.8 online database for GO function analysis and KEGG pathway enrichment analysis, and Pathon was used to visualization. AutoDock Vina and Pymol were used to connect the core active components with the core targets. Sixteen active components of Olibanum-Myrrha pairs were found and collected in the laboratory, and 320 relevant potential targets, 468 RA-related targets and 62 intersection targets were obtained through the Venn diagram. It mainly acted on multiple targets, such as IL6, TNF, IL1 B and MAPK1, involving TNF signaling pathway and Toll-like receptor signaling pathway in RA treatment. Finally, in this study, possible targets and signaling pathways of Olibanum-Myrrha compatibility therapy for RA were discussed, and molecular docking between core targets and core active components was conducted, which could provide scientific basis for the study on the mechanism of Olibanum-Myrrha compatibility.


Subject(s)
Arthritis, Rheumatoid/genetics , Drugs, Chinese Herbal , Frankincense , Humans , Medicine, Chinese Traditional , Molecular Docking Simulation
4.
Article in Chinese | WPRIM | ID: wpr-867616

ABSTRACT

Objective:To evaluate the efficacy of artificial liver blood purification system in the treatment of severe and critical patients with corona virus disease 2019(COVID-19), and to observe the dynamic changes of lymphocyte subsets and cytokines after treatment.Methods:A total of six patients with COVID-19 admitted to the ward of public health center of Henan Provincial People′s Hospital from January 31 to February 18, 2020 were enrolled, including three severe cases and three critical cases. The protocals of artificial liver treatment were developed according to the patients′ conditions, and the patients′ epidemiological history, clinical characteristics, and laboratory examination data were retrospectively analyzed. At the same time, dynamic changes of lymphocyte subsets and cytokines were detected before and after artificial liver treatment.Results:By February 24, 2020, two severe patients were discharged after cured, and one case was discharged after improved, with an average stay of 19 days. Two critical patients were still hospitalized and one died. Three severe patients were all treated with hemofiltration, while two critical patients were treated with hemofiltration plus plasma exchange, and one was treated with continuous bedside hemofiltration.Among six patients, the ratio of neutrophils to lymphocytes before treatment were 6.42, 2.63, 15.00, 15.09, 12.04 and 30.41, respectively. After treatment, the ratio of neutrophils to lymphocytes became 4.77, 6.05, 4.86, 5.43, 32.77 and 23.46, respectively.The absolute numbers of lymphocytes in six patients before treatment were low, with a median of 382/μL. After treatment of artificial liver, the absolute numbers of lymphocytes increased, with a median of 476/μL. Cytokines were detected in three critical patients, and the interleukin 6 (IL-6) levels in two cases were 26 042.00 ng/L and 282.03 ng/L, respectively before treatment. After treatment, the levels decreased to 226.85 ng/L and 26.15 ng/L, respectively. IL-6 continued increasing from 30.14 ng/L to 709.25 ng/L in one another critical patient, who eventually died.Conclusions:In severe and critical patients with COVID-19, artificial liver treatment can reduce inflammation and increase the absolute numbers of lymphocytes and the subsets. The IL-6 level may be correlated with disease progression and may be a useful prognostic factor for early identification of severe and critical COVID-19.

5.
Journal of Clinical Hepatology ; (12): 2230-2235, 2020.
Article in Chinese | WPRIM | ID: wpr-829399

ABSTRACT

ObjectiveTo investigate the mechanism of action of miR-196b in regulating the growth and apoptosis of hepatoma cells by targeting nuclear apoptosis-inducing factor 1 (NAIF1). MethodsReal-time PCR was used to measure the expression of miR-196b in hepatoma HuH-7, SNU-449, HepG2, and SMCC7721 cells versus normal human HL7702 hepatocytes. The hepatoma HepG2 cells were collected and divided into Control group (blank control), Anti-NC group (transfected with inhibitor control), Anti-miR-196b group (transfected with miR-196b inhibitor), si-NC group (transfected with siRNA control), si-NAIF1 group (transfected with NAIF1 siRNA), Anti-miR-196b+si-NAIF1 group (co-transfected with miR-196b inhibitor and NAIF1 siRNA), and Anti-miR-196b+si-NC group (co-transfected with miR-196b inhibitor and siRNA control). MTT assay was used to measure the change in proliferation, plate colony formation assay was used to measure colony formation ability, flow cytometry was used to measure cell apoptosis, and Western blot was used to measure the protein expression of Bax and C-caspase-3. Target gene prediction software predicted that NAIF1 might be a target gene of miR-196b, and the luciferase reporting system was used to identify the targeting relationship. The 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 the SNK-q test was used for further comparison between two groups. ResultsThere was a significant difference in the expression level of miR-196b between hepatoma HuH-7, SNU-449, HepG2, and SMCC7721 cells and normal human HL7702 hepatocytes (1.85±0.16/1.63±012/2.36±0.25/1.92±0.13 vs 1.00±0.09, F=29.05, P<0.001). Compared with the Anti-NC group, the Anti-miR-196b group had significant reductions in the expression level of miR-196b (0.42±0.03 vs 1.02±0.10, P<0.05), cell proliferation (0.20±0.02 vs 0.30±0.05, P<0.05), and colony formation ability (64.35±6.97 vs 119.54±11.82, P<0.05) and significant increases in apoptosis rate (22.30%±2.09% vs 4.26%±0.35%, P<0.05) and relative protein expression of Bax (0.69±0.08 vs 0.30±0.05, P<0.05) and C-caspase-3 (0.63±0.05 vs 0.21±0.04, P<0.05). Compared with the si-NC group, the si-NAIF1 group had significant increases in proliferation ability (0.46±0.05 vs 0.31±0.04, P<0.05) and colony formation ability (138.92±9.66 vs 118.47±838, P<0.05) and significant reductions in apoptosis rate (4.12%±0.40% vs 1.23%±0.12%, P<0.05), NAIF1 (0.10±0.01 vs 0.17±0.02, P<0.05), and protein expression of Bax (0.18±0.02 vs 0.29±0.03, P<0.05) and C-caspase-3 (0.12±0.01 vs 020±0.03, P<0.05). Compared with the Anti-miR-196b+si-NC group, the Anti-miR-196b+si-NAIF1 group had significant increases in proliferation ability (0.28±0.02 vs 0.21±0.03, P<0.05) and colony formation ability (97.12±8.23 vs 66.35±5.20, P<0.05) and significant reductions in apoptosis rate (9.60%±1.11% vs 21.14%±1.32%, P<0.05), NAIF1 (0.30±0.04 vs 0.52±0.06, P<0.05), and protein expression of Bax (0.28±0.03 vs 0.67±0.06, P<0.05) and C-caspase-3 (0.22±0.05 vs 0.60±004, P<0.05). ConclusionDownregulation of miR-196b can inhibit the growth and induce the apoptosis of hepatoma cells via negative regulation of NAIF1.

6.
Article in Chinese | WPRIM | ID: wpr-873838

ABSTRACT

Objective To investigate the characteristics of blood routine in 129 patients with COVID-19, and analyze the correlation between blood routine parameter changes and clinical classification. Methods A total of 129 COVID-19 patients were recruited and their blood samples were collected at the beginning and the end of treatment.The neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), lymphocyte-to-monocyte ratio(LMR) and C-reactive protein(CRP) were determined and used to calculate Δ NLR, Δ PLR, Δ LMR.The differences in these parameters were compared between the non-severe group (93 cases) and the severe group (36 cases).In addition, the relationship between the changes in blood routine test result and the prognosis of patients was determined. Results The average age of 129 patients was 46.9±17.4 years old, and the ratio of male to female was 1.2 ∶ 1.Thirty-five (35) cases (27.1%) had leucopenia (< 4×109/L) and 59 cases (45.7%) had lymphopenia (< 1.1×109/L).There were statistically significant differences in age, treatment days, blood routine indexes between these two groups.In all the patients, the differences between before and after treatment were statistically significant in the following: leukocyte number, neutrophil cell percentage, lymphocyte number, lymphocyte percentage, monocyte number, monocyte percentage.The differences in RBC, HGB, CRP, and NLR between the two groups before and after treatment were also statistically significant (P < 0.05). Conclusion The older COVID-19 patients have lower number of lymphocytes, higher NLR and PLR, lower LMR and higher CRP.They have a higher risk of progressing to severe disease.After treatment, there is an increase in the number of granulocytes, especially the number of lymphocytes, while a decrease in CRP and NLR.The change of lymphocyte count, NLR and CRP levels can predict the risk of severe COVID-19 and evaluate the therapeutic effect.

7.
Chinese Journal of Hepatology ; (12): 521-526, 2019.
Article in Chinese | WPRIM | ID: wpr-810759

ABSTRACT

Objective@#To explore the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection who received entecavir alone or in combination with anluohuaxianwan for 78 weeks.@*Methods@#Patients with chronic HBV infection were randomly treated with entecavir alone or in combination with anluohuaxian for 78 weeks. Ishak fibrosis score was used for blind interpretation of liver biopsy specimens. The improvement in liver fibrosis condition before and after the treatment was compared. Student's t test and non-parametric test (Mann-Whitney U-Test and Kruskal-Wallis test) were used to analyze the measurement data. The categorical variables were analyzed by Chi-square test method and Spearman’s rank correlation coefficient was used to test bivariate associations.@*Results@#Liver fibrosis improvement rate after 78 weeks of treatment was 36.53% (80/219) and the progression rate was 23.29% (51/219). The improvement of liver fibrosis was associated to the degree of baseline fibrosis and treatment methods (P < 0.05). The improvement rate of hepatic fibrosis in patients treated with anluohuaxianwan combined with entecavir at baseline F < 3 (54.74%, 52/95) was significantly higher than that in patients treated only with entecavir (33.33%, 16/48), P = 0.016 and the progression rate of hepatic fibrosis (13.68%, 13/95) was lower than that in patients treated alone (18.75%, 9/48), P = 0.466. In patients with baseline F < 3, the proportion of patients with improved and stable liver fibrosis in the combined treatment group (68.1%, 32/47) was higher than that in the treatment group alone (51.7%, 15/29).@*Conclusion@#Combined anluohuaxianwan and entecavir treatment can significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection. Furthermore, it has the tendency to improve the stability rate and reduce the rate of progression of liver fibrosis.

8.
Chinese Journal of Hepatology ; (12): 352-357, 2019.
Article in Chinese | WPRIM | ID: wpr-810626

ABSTRACT

Objective@#To evaluate the efficacy and safety of sofosbuvir (Nanjing Zhengda Tianqing Pharmaceutical Co., Ltd.) combined with ribavirin in patients with genotype 2 chronic hepatitis C virus infection.@*Methods@#Treatment-naïve or treatment experienced genotype 2 chronic hepatitis C patients from sixteen research centers of China were screened. All subjects received once-daily dose of sofosbuvir (400 mg) combined with ribavirin (body weight < 75 kg, 1 000 mg/day, 400 mg in the morning and 600 mg in the evening; body weight > 75 kg, 1 200 mg/d, 600 mg in the morning and 600 mg in the evening) for 12 weeks. Patients were followed-up for a period of 12 weeks after discontinuation of treatment. Continuous variables were expressed as mean ± standard deviation. The proportion of subjects with virologic response at different follow-up time points and 95% confidence intervals were estimated by maximum likelihood ratio and Clopper-Pearson interval.@*Results@#132 cases with genotype 2 chronic hepatitis C virus infection from sixteen research centers of China were included, 12 cases of whom were associated with cirrhosis, and the remaining 120 cases were not associated with cirrhosis. One hundred and thirty-one cases completed the study, and one patient lost to follow-up at week 4 after the end of treatment. The sustained virological response rate was 96.2% (95% confidence interval: 92.37% - 99.16%) after 12 weeks of drug withdrawal. Virological relapse occurred in four cases. Of the 132 subjects enrolled in the study, 119 (90.2%) reported 617 adverse events during treatment, of which 359 (76.5%) were TEAE related to sofosbuvir and/or ribavirin. There were nine TEAEs of grade 3 and above, and six cases (4.5%) of them had six severe adverse events. Only one serious adverse event was associated with sofosbuvir and ribavirin (unstable angina pectoris). There were no adverse events leading to drug discontinuation or death.@*Conclusion@#Sofosbuvir combined with ribavirin has a high SVR rate in the treatment of genotype 2 chronic hepatitis C virus infection, and most of the adverse events occurred were mild with acceptable safety profile.

9.
Chinese Journal of Hepatology ; (12): 274-280, 2019.
Article in Chinese | WPRIM | ID: wpr-805050

ABSTRACT

Objective@#To observe ascitic interleukin-7 expression level in cirrhotic patients complicated with spontaneous bacterial peritonitis, and to detect the effect of recombinant human IL-7 on CD4+ and CD8+T lymphocyte function.@*Methods@#A total of 84 patients with liver cirrhosis who were hospitalized from August 2017 to April 2018 were selected. Among them, 51 cases were complicated with cirrhosis and untainted ascites, and 33 cases were cirrhosis complicated with spontaneous bacterial peritonitis. Peripheral blood and ascites were collected routinely. The levels of IL-7 in peripheral blood and ascites were measured by enzyme-linked immunosorbent assay. CD4+T cells and CD8+T cells were purified from ascites, and were stimulated with recombinant IL-7. Cellular proliferation, key transcription factors for mRNA, and cytokines production by CD4+T cells in response to IL-7 stimulation was measured. mRNA expression corresponding to perforin, granzyme B, and granulysin as well as cytokines production by CD8+T cells was also measured in response to IL-7 stimulation. Cytolytic and non-cytolytic activity of CD8+T cells in response to IL-7 stimulation was also investigated in both direct and indirect contact co-culture system. Measurement data of the normal distribution were compared between the two groups by Student’s t-test and the data before and after stimulation were compared by paired t-test. Measurements that did not conform to normal distribution were compared between the two groups using Mann-Whitney U test, and data before and after stimulation were compared using Wilcoxon paired test.@*Results@#There was no significant statistical difference in serum IL-7 levels between the two groups [(5 001 ± 1 458) pg/ml vs. (4 768 ± 1 128) pg/ml, P = 0.41]. The level of ascitic IL-7 in cirrhotic patients complicated with SBP was significantly lower than cirrhosis patients with untainted ascites [(966.4 + 155.8) pg/ml vs. (792.1 + 126.4) pg/ml, P < 0.01]. Recombinant IL-7 stimulation promoted the proliferation of CD4+ and CD8+T cells from ascites in patients with liver cirrhosis complicated by SBP. T-bet mRNA relative expression and IFN-γ secretion in CD4+T cells was also elevated in response to IL-7 stimulation in vitro. Moreover, IL-7 stimulation also increased the mRNA expressions of perforin, granzyme B, and granulysin as well as productions of IFN-γ and TNF-α by CD8+T cells. Recombinant IL-7 stimulation elevated cytolytic and non-cytolytic activity of CD8+T cells from ascites in patients with liver cirrohosis complicated by SBP, which manifested as increased target cell death and IFN-γ production in both direct and indirect contact co-culture system.@*Conclusion@#Ascitic IL-7 promotes T lymphocyte function in patients with liver cirrhosis complicated with SBP.

10.
Article in Chinese | WPRIM | ID: wpr-745015

ABSTRACT

Objective To investigate the clinical value of a new-generation cartridge Xpert MTB/RIF Ultra assay on detection of Mycobacterium tuberculosis(MTB)and rifampin(RIF)resistance.Methods A total of 111 patients from He'nan Provincial Chest Hospital with suspected tuberculosis(TB)and retreated TB were enrolled into this study from March to December 2016,including 33 cases of tuberculosis detection group(CDG)and 78 cases of drug resistant high-risk group(DRG).The sputum samples of patients were collected.The sensitivity and specificity of Xpert MTB/RIF Ultra,sputum smear,solid Lowenstein-Jensen(L-J)culture and mycobacterial growth indicator tube(MGIT)culture for MTB were evaluated.RIF resistance was performed by Xpert MTB/RIF Ultra,traditional phenotypic drug sensitivity test and Xpert MTB/RIF assay.Measurement data were compared using t-test,and categorical data were compared using chi-squared test.Results Using clinical diagnosis result as the standard,in the CDG,the sensitivity of Xpert MTB/RIF Ultra for MTB detection(75.8%)was not significantly different from those of sputum smear(66.7%),L-J culture(63.6%),MGIT culture(75.6%)and Xpert MTB/RIF(66.7%)(x2=0.67,1.15,0.00 and 0.67,respectively,all P>0.05).In the DRG,the sensitivity of Xpert MTB/RIF Ultra(94.9%)was better than those of L-J culture(55.1%)and MGIT culture(80.8%)with statistical significance(x2=32.8 and7.25,respectively,both P <0.05).The sensitivity of Xpert MTB/RIF Ultra was not significantly different from sputum smear(84.6%)and Xpert MTB/RIF(91.0%)(x2=3.41 and 0.39,respectively,both P>0.05).Xpert MTB/RIF Ultra took the shortest time to obtain the final results,which was(1.76±0.18)h and significantly shorter than smear test([5.04±0.49]h),L-J culture([31.67±0.56]h),MGIT culture([22.36±9.68]h),Xpert MTB/RIF([2.00±0.30]h)(t=16.90,31.98,24.38 and 7.05,respectively,all P <0.01).Using culture result as the standard,the sensitivity for MTB detection of Xpert MTB/RIF and Xpert MTB/RIF Ultra were 93.2% and 98.9%,and the specificity of Xpert MTB/RIF and Xpert MTB/RIF Ultra were both 100%.The sensitivity for MTB detection of Xpert MTB/RIF Ultra(52.2%)was significantly better than that of Xpert MTB/RIF(21.7%)in 23 smear-negative pulmonary TB patients with statistical significance(x2=4.98,P=0.025).Using traditional drug susceptibility test as the standard,the sensitivities for RIF resistance detection of Xpert MTB/RIF and Xpert MTB/RIF Ultra in culture-positive TB patients were 90.9% and 93.2%,respectively,and the specificities were 89.5% and 92.9%,respectively.Conclusions Xpert MTB/RIF Ultra has a higher MTB detection rate than Xpert MTB/RIF in smear-negative pulmonary TB patients.In drug-resistant pulmonary TB patient,MTB/RIF Ultra has high sensitivity,and it takes shorter time to detect MTB and RIF resistance.Thus,Xpert MTB/RIF Ultra has a good application prospect in clinical work.

11.
Article in Chinese | WPRIM | ID: wpr-707225

ABSTRACT

Objective To explore the regulatory effects of cucumin onoxidation and antioxidation in non-alcoholic steatohepatitis (NASH ) .Methods Fifty-six clean male rats were randomly divided into 7 groups by random numbers table .Eight rats in normal control group were fed by normal diet for 12 weeks .Twenty-four rats in model group were fed by choline dificinet (CD) diet and randomly sacrificedat week 4 ,8 and 12 with 8 rats each time point .Twenty-four rats incucumin treatment group were given cucumin at high (500 mg/[kg · d]) ,medium (100 mg/[kg · d]) and low (50 mg/[kg · d]) dosages with 8 rats each dosage from week 5 of CD diet for 8 weeks ,and the rats were sacrificed at week 12 .The liver tissues were reserved for pathology test and detections of thiobarbituric acid reactive substances (TBARS) ,glutathione (GSH) ,the activities of superoxide dismutase (SOD) ,manganese superoxide dismutase (MnSOD) ,glutathione peroxidase (GPx) ,and levels of triglyceride (TG) and total cholesterol (TC) .The measurement data with normal distribution were analyzed using t test ,and the data with non-normal distribution were analyzed using rank sum Z test .Results The liver of rats presented with the performance of NASH when fed with CD diet for 4 weeks ,and presented with early fibrosis after 8 weeks of CD diet ,even progressed to cirrhosis after 12 weeks of CD diet .The NAS scores of medium and high dose curcumin treatment groups were 6 .50 (5 .25 ,7 .00) and 6 .00 (5 .00 ,6 .75) ,respectively ,which were both lower than that model group at week 12 (8 .00 [7 .00 ,8 .00])(Z=2 .441 and 2 .728 ,respectively , both P< 0 .01) ,while fibrosis stages at week 12 were not significantly different compared with model group (Z=0 .795 and 1 .807 ,respectively ,both P> 0 .05) .TG and TC levels in liver tissues of rats in low ,medium and high doses treatment group were not significantly different compared with model group at week 12(TG :t=0 .54 ,1 .18 and 1 .66 ,respectively ;TC :t=0 .11 ,0 .59 and 0 .62 ,respectively ;all P>0 .05) .The GSH contentin liver of rats in high dose group was (1185 .82+204 .01) mg/g ,which was significantly different from that in model group at week 12 (735 .29 + 35 .08) (t=4 .97 ,P<0 .01) .The TBARS contents in the liver of the middle and high doses curcumin treatment group were significantly different from that of model group at week 12 (t=7 .58 and 11 .62 ,respectively ,both P< 0 .01) .The SOD activities in liver of rats in low ,medium and high doses curcumin treatment group were statistically different from that in model group (t=4 .17 ,4 .32 and 6 .10 ,respectively ,all P<0 .01) .MnSOD activity in liver of rats in high dose group was significantly different from model group at week 12 (t=8 .42 ,P<0 .01) .The live GPx contents in low ,medium and high doses curcumin treatment group were all not significantly different from that in model group at week 12 (t=0 .27 ,0 .21 and 0 .60 ,respectively ,all P>0 .05) .Conclusions CD diet in SD rats could induce hepatic lipid deposition in liver ,and cause liver antioxidative system disorders ,GSH exhaustion ,and decreases of SOD and GPx activities .Curcumin treatment could improve liver NAS score of NASH rats ,and might play a protective role by upregulating the SOD activity and increasing liver GSH content .But curcumin has no effects on liver GPx activity and fat deposition in liver of NASH rats .

12.
Article in Chinese | WPRIM | ID: wpr-702215

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Objective To explore the efficacy and complications of small insicion surgical treatment and the routine microscopic surgical treatment for children with tight filum terminale type of tethered cord syndrome.Methods According to the clinical manifestations and imaging findings,a total of 43 children with tethered cord syndrome were classified into two groups.Namely the control group (30 cases) who underwent the routine microscopic surgery and the observation group (13 cases) who underwent the small insicion surgical treatment.The difference including prognosis,complications,hospital stays,size of the wound between the two groups were analyzed.Results The 43 children were followed up for 3 to 24 months with an average of 9 months.The results indicated that the postoperative effective rate of the control group was 93.3%,while it was 100% in the observation group.The difference between the two groups was not statistically significant(P > 0.05).The rate of complications of the control group was 6.67% whlie it was 0.00% in the observation group,and the difference of the two groups was statistically significant(P < 0.05).The difference of hospital stays and the size of the wound between the two groups were statistically significant (P < 0.05).Conclusion The small insicion surgical treatment could guarantee the surgical effect for children with tight filum terminale type of tethered cord syndrome,and it can reduce the surgical trauma,post operation hospitalization duration,incidence of complications and intraoperative scar tissues.

13.
Chinese Journal of Hepatology ; (12): 927-932, 2018.
Article in Chinese | WPRIM | ID: wpr-810344

ABSTRACT

Objective@#To recognize the efficacy and safety of paritaprevir/ritonavir-ombitasvir combined with dasabuvir (OBV/PTV/RTV+DSV) in the treatment of genotype 1b chronic hepatitis C.@*Methods@#Patients with genotype 1b chronic hepatitis C who were admitted to the People's Hospital of Henan Province, Huashan Hospital of Shanghai and the Fifth Medical Center of the General Hospital of the People's Liberation Army of China between November 2017 to August 2018 were enlisted. All patients received OBV/PTV/RTV+DSV antiviral therapy. HCV RNA levels were measured at baseline, weeks 1, 2, 3, 4, 8, 12, and 24, then 12 weeks, and 24 weeks after completion of treatment; patients’ comorbidity, concomitant medications, and clinical adverse events were recorded.@*Results@#108 patients were enrolled in the study, with an average age of 49.1 years, 44 patients were male (40.8%), 96.3% (104/108) were newly diagnosed, and four patients had previous treatment history, of whom three were treated with IFN and one with IFN + DAA. Ninety-eight cases completed 12 weeks treatment and 89 cases were in follow up for 12 weeks, after discontinuation of the drug. Overall, 89 cases (100%) achieved SVR12.One patient treated with PR and DAA had HCV RNA level of 869175 IU/mL at 4 weeks of treatment, which was significantly higher than the baseline HCV RNA level (301776IU/ML), and was judged as failure of treatment; and follow-up was discontinued. Of all enrolled patients, 19 (17.6%) had underlying diseases and 15 (13.9%) had combined medications. During treatment, adverse events (AE) occurred in 11 patients (10.1%). The main adverse events were pruritus and elevated bilirubin.@*Conclusion@#Combined antiviral therapy (OBV/PTV/RTV+DSV) of 12 weeks are highly effective with good safety profile in the treatment of Chinese patients with genotype 1b chronic hepatitis C.

14.
Chinese Journal of Hepatology ; (12): 756-764, 2018.
Article in Chinese | WPRIM | ID: wpr-810222

ABSTRACT

Objective@#Hepatitis B surface antigen (HBsAg) loss is seldom achieved with nucleos(t)ide analog (NA) therapy in chronic hepatitis B patients but may be enhanced by switching to finite pegylated-interferon (Peg-IFN) alfa-2a. We assessed HBsAg loss with 48- and 96-week Peg-IFN alfa-2a in chronic hepatitis B patients with partial response to a previous NA.@*Methods@#Hepatitis B e antigen (HBeAg)-positive patients who achieved HBeAg loss and hepatitis B virus DNA < 200 IU/mL with previous adefovir, lamivudine or entecavir treatment were randomized 1:1 to receive Peg-IFN alfa-2a for 48 (n = 153) or 96 weeks (n = 150). The primary endpoint of this study was HBsAg loss at end of treatment. The ClinicalTrials.gov identifier is NCT01464281.@*Results@#At the end of 48 and 96 weeks' treatment, 14.4% (22/153) and 20.7% (31/150) of patients, respectively, who switched from NA to Peg-IFN alfa-2a cleared HBsAg. Rates were similar irrespective of prior NA or baseline HBeAg seroconversion. Among those who cleared HBsAg by the end of 48 and 96 weeks' treatment, 77.8% (14/18) and 71.4% (20/28), respectively, sustained HBsAg loss for a further 48 weeks. Baseline HBsAg < 1 500 IU/mL and week 24 HBsAg < 200 IU/mL were associated with the highest rates of HBsAg loss at the end of both 48- and 96-week treatment (51.4% and 58.7%, respectively). Importantly, extending treatment from 48 to 96 weeks enabled 48.3% (14/29) more patients to achieve HBsAg loss.@*Conclusion@#Patients on long-term NA who are unlikely to meet therapeutic goals can achieve high rates of HBsAg loss by switching to Peg-IFN alfa-2a. HBsAg loss rates may be improved for some patients by extending treatment from 48 to 96 weeks, although the differences in our study cohort were not statistically significant. Baseline and on-treatment HBsAg may predict HBsAg loss with Peg-IFN alfa-2a.

15.
Chinese Journal of Hepatology ; (12): 710-713, 2018.
Article in Chinese | WPRIM | ID: wpr-807390

ABSTRACT

Since 2014, the United States and Europe has approved all oral, interferon free- regimens that combine with direct-acting antiviral agents. Hence, the sustained virological response rate of patients with chronic HCV genotype 1 infection has improved over 90%, and the treatment modalities has introduced a new era. These drugs, ombitasvir and dasabuvir, received customary authorization of Food and Drug Administration in 2015 and are the first combined direct-acting antiviral agents for treating HCV genotype 1 infection. It has superior application prospects in China because of its high-sustained virological response rate and safety profile. This article reviews the pharmacokinetics, drug interactions, efficacy and safety of this therapeutic regimen.

16.
Chinese Journal of Hepatology ; (12): 426-428, 2018.
Article in Chinese | WPRIM | ID: wpr-806713

ABSTRACT

Objective@#To evaluate the feasibility of hepatitis C virus (HCV) infection by survey methods based on big data of hospital.@*Methods@#Inpatients data of anti-HCV was collected in 2016 and 2011. Patient’s data related to Department of Liver Diseases were excluded. The research population was divided into Surgical and Non-surgical Department. The characteristics of the two groups were analyzed and the changing trends of anti -HCV positive rate in different years was compared and analyzed.@*Results@#Patients in the surgical and non-surgical department of hospital were equally distributed across gender, urban and rural areas, and region, but the distribution of patients in surgical departments were relatively equal in all age groups. The positive rate of anti -HCV in hospitalized patients in 2016 was 0.82%, and anti -HCV positive rate was 0.58% in surgical department of 1~55 years old. Among them, anti-HCV was positive in 0.06% who underwent surgical procedure at the age of ≤25 (born after 1993 and screened for hepatitis C antibody), which was significantly lower than those in other age groups were. The anti -HCV positive rate of patients (all age groups) was lower in 2016 than that in 2011(0.75% vs. 0.97%). The anti-HCV positive rates of surgical department in both years had a decreasing trend with age.@*Conclusion@#The prevalence rate of anti-HCV, among patients population of operation departments, might reflect the prevalence rate of HCV infection among general population. Using the convenience of hospital data acquisition, we might dynamically understand the change of HCV infection.

17.
Article in Chinese | WPRIM | ID: wpr-751953

ABSTRACT

Many factors can cause liver fibrosis and cirrhosis in clinical practice, and liver cirrhosis caused by liver vascular lesions often has insidious progression. Due to a lack of knowledge in clinicians and limited diagnostic and treatment techniques, patients often have poor prognosis. The liver vascular system has a unique structure, and patients with different locations and extents of lesion have different clinical manifestations and outcomes. Correct diagnosis and differentiation of liver cirrhosis caused by different types of liver vascular lesions is an important and difficult issue and needs careful attention in clinical practice. This article summarizes the association of portal vein lesion, hepatic vein lesion, hepatic sinusoid lesion, and hepatic artery lesion with liver cirrhosis. A deep understanding of the clinical manifestations, pathological features, and key points in differential diagnosis of these lesions helps with correct diagnosis and treatment of such disease.

18.
Article in Chinese | WPRIM | ID: wpr-734143

ABSTRACT

Objective To explore the efficacy and safety of daclatasvir (DCV ) combined with asunprevir (ASV) for chronic genotype 1b (GT1b) hepatitis C .Methods Twenty-nine GT1b hepatitis C patients who were treated with DCV combined ASV in Henan Provincial People′s Hospital from September 2017 to November 2017 were included .Hepatitis C virus (HCV ) RNA levels were tested before treatment ,1 week ,2 weeks ,3 weeks ,4 weeks ,8 weeks ,12 weeks and 24 weeks after treatment , and 12 weeks after the end of the treatment .The comorbidities ,combined use of drugs and adverse clinical events were registered .T test was used to compare the measurement data with normal distribution and M (P25,P75) was used for measurement data with non-normal distribution .Results A total of 29 patients with GT1b were included ,with 4 cirrhosis cases and 25 non cirrhotic cases .Seven patients had history of previous interferon and ribavirin combination treatment .There were 9 patients with comorbidity and 7 patients with combined medication . Finally , 25 patients completed a 24-week course of antiviral treatment ;3 patients were lost to follow-up ,and 1 patient withdrew after 16weeks of antiviral treatment because of a virus rebound .Of the 26 followed up patients ,25 achieved sustained virological response at 12-week (SVR12 ) , and one patient failed .And the HCV RNA NS5A resistance-associated variants (RAV) were detected in the patients with treatment failure .No severe adverse clinical events occurred in 26 patients .Conclusions DCV combined with ASV is effective and safe in the treatment of GT 1b chronic hepatitis C .However , the effect of RAV on therapeutic efficacy should be concerned during the treatment .

19.
Article in Chinese | WPRIM | ID: wpr-734141

ABSTRACT

Objective To evaluate the prevalence and risk factors of metabolic syndrome among hepatitis C patients in Chinese Han population .Methods This was a multicenter ,cross-sectional study . A total of 997 Chinese Han patients with hepatitis C virus (HCV) infection were enrolled .Demographic data ,anthropometric data and clinical parameters related to metabolic syndrome were collected .Statistical analysis was performed by t-test (normal distribution) or Mann-Whitney U two-sample test (non-normal distribution) and χ test .Binary logistic regression analyses were used to determine the parameters significantly related to metabolic syndrome .Results Among the 997 patients ,170 (17 .1%) patients were diagnosed with metabolic syndrome .Binary logistic regression showed that genotype 2 (OR=1 .594 ;95% CI :1 .045-2 .431 , P= 0 .030) ,older age (OR= 1 .040 ;95% CI :1 .022 -1 .058 , P< 0 .01) , overweight (OR=3 .876 ;95% CI :2 .593-5 .792 ,P<0 .01) ,fatty liver history (OR=2 .106 ;95% CI : 1 .384-3 .204 ,P=0 .001) ,homeostasis model assessment insulin (HOMA-IR) (OR=1 .263 ;95% CI :1 .118-1 .427 , P<0 .01) ,fasting insulin (OR=0 .949 ;95% CI :0 .915 -0 .985 , P=0 .006) ,lower serum albumin level (OR=0 .957 ;95% CI :0 .915 -1 .000 , P=0 .049) and higher γ-GT level (OR=1 .004 ;95% CI :1 .000 -1 .008 , P= 0 .0041 ) were all significantly associated with the presence of metabolic syndrome .Conclusions Hepatitis C patients with genotype 2 ,older age ,overweight ,fatty liver history ,higher HOMA-IR ,lower fasting insulin level ,lower serum albumin level or higher γ-GT level should be screened for metabolic syndrome .

20.
Journal of Clinical Hepatology ; (12): 242-245, 2018.
Article in Chinese | WPRIM | ID: wpr-694713

ABSTRACT

Chronic Hepatitis C is a global epidemic,and people with different sexes,ages,races,and nationalities are susceptible to hepatitis C virus (HCV) infection.This article elaborates on the management method and individualized treatment regimens for special populations,including children with hepatitis C,patients with renal injury,patients undergoing liver transplantation,patients with liver cirrhosis,patients with HIV infection,and patients with acute hepatitis C.

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