Effects of autologous peripheral stem cell transplantation on acoustic radiation force impulse in patients with HBV-related decompensated cirrhosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To perform a prospective study the effects of autologous peripheral blood stem cell (APBSC) transplantation on acoustic radiation force impulse (ARFI) in patients with hepatitis B virus (HBV)-related decompensated cirrhosis.</p><p><b>METHODS</b>A total of 68 hospitalized patients with HBV-related decompensated cirrhosis undergoing conventional treatment were included in the study. Thirty-three of these patients also received APBSC transplantation therapy (treatment group) and 35 did not (control group). The treatment group was observed for postoperative adverse reaction, and changes (pre-vs.post-treatment) in total bilirubin, prothrombin time (PT), albumin (Alb), spleen size and ARFI imaging findings. Statistical analyses were carried out using the t-test, non-parametric test, and chi-square test.</p><p><b>RESULTS</b>The patients who received APBSC transplantation showed improving levels of Alb and PT, but not of total bilirubin, at postoperative weeks 24, 36 and 48, and reduced spleen length and ARFI findings at postoperative weeks 36 and 48.Compared to the baseline data (week 0) for the treatment group and to the data for the control groups, these differences were statistically significant (P less than 0.05).</p><p><b>CONCLUSIONS</b>APBSC transplantation can reduce ARFI imaging findings and improve the pathology of liver fibrosis in patients with HBV-related decompensated cirrhosis.</p>

Liver histopathological features influencing HBeAg seroconversion in patients with HBeAg-positive chronic hepatitis B responding to Peg-IFN treatment / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic efficiency of antiviral treatment with pegylated-interferon (Peg-IFN) for hepatitis B e antigen (HBeAg)-positive chronic hepatitis B (CHB) and to explore whether liver histopathological features or other factors influence the HBeAg seroconversion treatment response.</p><p><b>METHODS</b>Eighty HBeAg-positive CHB patients with diagnosis confirmed by liver puncture were treated with Peg-IFN(2a or 2b)body weight dose, once weekly). At treatment week 48, the rate of HBeAg seroconversion was determined and used to analyze the influence of liver histopathological features (liver biopsy assessment of: inflammation, graded G0 to G4; fibrosis stage, graded S0 to S4), sex, age, differential levels (pre-treatment baseline vs. week 48 post-treatment) of serum alanine transferase (ALT), and HBV DNA, by binary logistic analysis.</p><p><b>RESULTS</b>At week 48, the overall rate of HBeAg seroconversion was 30.0%. The rate of HBeAg seroconversion gradually advanced with increased liver inflammation (X2 = 8.435, P = 0.015): 9.09% of the 22 patients with G1; 31.58% of the 38 patients with G2; 47.30% of the 19 patients with G3; the one patient with G4. In contrast, the rate of HBeAg seroconversion showed a much weaker association with liver fibrosis (X2 = 5.917, P = 0.116). Only baseline HBeAg level, and no other baseline index, was significantly different between the patients who achieved HBeAg seroconversion and those who did not. Liver inflammation and baseline HBeAg level were identified as influencing factors of HbeAg seroconversion in response to Peg-IFN treatment.</p><p><b>CONCLUSION</b>Peg-IFN therapy induces a higher rate of HBeAg seroconversion in HBeAg-positive CHB patients with severe liver inflammation; histological analysis of pre-treatment liver biopsies may help to identify patients most likely to benefit from the antiviral regimen.</p>

Study on the relationship between HBV viral loads and the changes of liver pathological features in patients with HBeAg-negative chronic hepatitis B / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between serum HBV DNA loads and liver histology damage in the patients with HBeAg-negative chronic hepatitis B.</p><p><b>METHODS</b>The retrospective study was performed. The 514 patients were divided into two groups according to the HBeAg status and the HBeAg positive group was as control. The relationship among HBV DNA loads, live histological inflammation grades and fibrosis stages was analyzed.</p><p><b>RESULTS</b>The HBV DNA loads in HBeAg-negative group and HBeAg-positive group were (5.38 +/- 1.27) log10 copies/ml and (6.80 +/- 1.18) log10 copies/ml respectively (P < 0.001). The inflammation grades and fibrosis stages of liver tissues in HBeAg-negative group were all significantly higher than those in HBeAg-positive group (P < 0.001). In HBeAg-negative group, HBV DNA loads displayed a positive correlation with the inflammation grades and fibrosis stages of liver tissues (P < 0.001).</p><p><b>CONCLUSION</b>In the patients with HBeAg-negative chronic hepatitis B, HBV viral loads are lower than those with HBeAg-positive chronic hepatitis B, and HBV viral loads display a positive correlation with liver the inflammation grades and fibrosis stages of liver tissues.</p>

Analysis of risk factors of patients with chronic liver failure complicated invasive fungal infections / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To evaluate the risk factors of chronic liver failure (CLF) complicated invasive fungal infections (IFI) and prevention and treatment.</p><p><b>METHODS</b>The clinical data and risk factors of 52 patients with CLF complicated IFI were analyzed retrospectively and were compared with those not complicated IFI. Risk factors were analyzed by chi-square test and Logistic regression test and Ridit test.</p><p><b>RESULTS</b>In 52 patients with CLF complicated IFI, there were 69 fungal infections in different tissue and organs, the most were in oral cavity, but other tissue and organs especially bellows infections were rising. Candida albicans infections were the most, but cryptococcus neoformans infections and aspergillus infections were rising. The risk factors included species of bacteria infections, serum total bilirubin, hospital days, times of antibiotics using, number of invasive operation, species of antibiotics and degrees of ascites. The mortality of patients with CLF complicated IFI were much higher than those not complicated IFI.</p><p><b>CONCLUSION</b>Patients with CLF complicated IFI have poor progress and prognosis. The effective prevent methods are treating primary disease actively, reducing hospital days, detecting patients' body fluids closely, identifying source of infection as early as possible, using antibiotics correctly, reducing or avoiding invasive operation, using immunoactivators and disinfecting air regularly.</p>