Cognition-tracking-based strategies for diagnosis and treatment of minimal hepatic encephalopathy

Metabolic Brain Disease - Minimal hepatic encephalopathy (MHE), which shows mild cognitive impairment, is a subtle complication of cirrhosis that has been shown to affect daily functioning and...     

髓系来源的抑制细胞在肝病发病中的作用研究进展*

髓系来源的抑制细胞来源于骨髓祖细胞和未成熟的髓系细胞。近年来的研究表明,该细胞参与调节多种肝脏疾病的病理变化。本文系统地归纳了髓系来源的抑制细胞的历史、分群、作用机制和当前该细胞在各种肝病发病中的免疫调控作用及其与疾病进展的关系。     

Phylogenetic analysis of hepatitis delta virus isolated from HBsAg positive patients in Shahrekord,Iran

ObjectiveTo find out the phylogenetic background of hepatitis delta virus (HDV) samples isolated in Shahrekord, Iran.MethodsA total of 350 hepatitis B surface antigen (HBsAg) positive sera samples were found from blood donors and HBsAg positive patients in blood transfusion center and clinical laboratory in Shahrekord, Iran. HDV RNA was extracted using RNXPlus (CinnaGen, Iran). A total of 421 bp corresponding to hepatitis delta antigen have been isolated from HDV in Shahrekord, then were amplified in polymerase chain reaction system, sequenced for determining nucleotide sequence and compared with identified nucleotide sequences of these genes in other countries.ResutlsAmong 350 HBsAg positive samples, we could detect HCV RNA in only two samples. After sequencing, the nucleotide sequences had a variability of 1/7-3/0 for HD Ag gene. The greatest sequence similarity existed between Iranian HD Ag sequence and JF694493-Iran, U25667-China with a sequence similarity of 99.7% and the least relationship between Iranian HD Ag sequence and AF008420-USA with a similarity of 92.9%.ConclusionsIt is suggested that precise genotype of HDV circulating in the region can be determined by more expansive sampling from different parts of Chahar mahal and Bakhtiari province and neigh bouring provinces (Esfehan and Khoozestan).     

谷胱甘肽S转移酶的研究进展及其与肿瘤的相关性

药物代谢是细胞解毒机制的重要组成部分之一,其中主要涉及两种酶:Ⅰ和Ⅱ相药物代谢酶。谷胱甘肽S转移酶(GST)是一种重要的Ⅱ相药物代谢酶,可与Ⅰ相药物代谢酶一起催化药物形成高水溶性终产物。所以,GST能够抵御内源性和外源性亲电子物质的损害,并在抗肿瘤过程中发挥重要作用。编码GST的基因至少分布在7条染色体上,构成了一个超基因家族,编码具有GST活性的蛋白。GST有许多功能,传统观点认为,细胞中的GST可发挥防御内、外源性毒性化合物损害的作用。另外,GST在肿瘤细胞中高表达,可介导谷胱甘肽结合至大量抗癌药物底物上,导致肿瘤耐药的发生。     

乙型肝炎慢加急性肝衰竭前期的临床特征及预后评分模型的建立

目的探讨乙型肝炎相关慢加急性肝衰竭(HBV-ACLF)前期患者的临床特征,并建立相应的预后评分模型。方法利用HBV-ACLF中国诊断标准研究(COSSH-ACLF)队列,回顾性分析725例乙型肝炎相关慢加急性肝功能障碍(HBV-ACHD)患者的临床特征,采用多因素COX回归分析90 d预后的相关独立危险因素并建立预后评分模型,并利用内部500例和外部390例HBV-ACHD患者进行验证。结果在725例HBV-ACHD患者中,男性为主(76.8%),96.8%患者有肝硬化基础,并发症以腹水(66.5%)多见,器官衰竭以凝血功能衰竭(4.1%)为主,90 d病死率为9.2%。多因素COX回归分析得出,总胆红素(TBil)、白细胞计数(WBC)、碱性磷酸酶(ALP)是HBV-ACHD患者90 d病死率的最佳预测指标,并建立评分模型COSSH-ACHDs=0.75×ln(WBC)+0.57×ln(TBil)-0.94×ln(ALP)+10,其受试者工作特征曲线下面积(auROC)显著高于终末期肝病模型(MELD)、MELD-Na、CTP及CLIF-C ADs(P<0.05),500例内部随机选择组和390例外部验证组均验证了类似结果。结论HBV-ACHD患者是一组以肝硬化失代偿为主、合并少量器官衰竭的人群,其90 d病死率为9.2%,COSSH-ACHDs具有更高的预测HBV-ACHD患者90 d预后的效能,为临床早期诊治提供循证医学依据。     

Historical Comparison of Overall Survival after Hepatic Resection for Patients With Large and/or Multinodular Hepatocellular Carcinoma

The present study compared the efficacy of hepatic resection (HR) in patients with large hepatocellular carcinoma (HCC) and those with multinodular tumor and examined how that efficacy has changed over time in a large medical center.The intermediate stage of HCC comprises a highly heterogeneous patient population. Moreover, official guidelines have different views on the suitability of HR to treat such patients.A consecutive sample of 927 patients with preserved liver function and large and/or multinodular HCC who were treated by initial HR were divided into 3 groups: those with a single tumor ≥5 cm in diameter (n = 588), 2 to 3 tumors with a maximum diameter >3 cm (n = 225), or >3 tumors of any diameter (n = 114). Hospital mortality and overall survival (OS) in each group were compared for the years 2000 to 2007 and 2008 to 2013.Patients with >3 tumors showed the highest incidence of hospital mortality of all groups (P < 0.05). Kaplan–Meier survival analysis showed that OS varied across the 3 groups as follows: single tumor > 2 to 3 tumors > 3+ tumors (all P < 0.05). OS at 5 years ranged from 24% to 41% in all 3 groups for the period 2000 to 2007, and from 35% to 46% for the period 2008 to 2013. OS was significantly higher during the more recent 6-year period in the entire patient population, those with single tumor, and those with 3+ tumors (all P < 0.05). However, in patients with 2 to 3 tumors, OS was only slightly higher during the more recent 6-year period (P = 0.084).Prognosis can vary substantially for these 3 types of HCC. Patients with >3 tumors show the highest hospital mortality and lowest OS after HR. OS has been improving for all 3 types of HCC at our medical center as a consequence of improvements in surgical technique and perioperative management.