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sTREM-1 as promising prognostic biomarker for acute-on-chronic liver failure and mortality in patients with acute decompensation of cirrhosis
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作者 Song-Man Yu Hai Li +13 位作者 Guo-Hong Deng xian-bo wang Xin Zheng Jin-Jun Chen Zhong-Ji Meng Yu-Bao Zheng Yan-Hang Gao Zhi-Ping Qian Feng Liu Xiao-Bo Lu Yu Shi Jia Shang Ruo-Chan Chen Yan Huang 《World Journal of Gastroenterology》 SCIE CAS 2024年第9期1177-1188,共12页
BACKGROUND Acute decompensation(AD)of cirrhosis is associated with high short-term mortality,mainly due to the development of acute-on-chronic liver failure(ACLF).Thus,there is a need for biomarkers for early and accu... BACKGROUND Acute decompensation(AD)of cirrhosis is associated with high short-term mortality,mainly due to the development of acute-on-chronic liver failure(ACLF).Thus,there is a need for biomarkers for early and accurate identification of AD patients with high risk of development of ACLF and mortality.Soluble triggering receptor expressed on myeloid cells-1(sTREM-1)is released from activated innate immune cells and correlated with various inflammatory processes.AIM To explore the prognostic value of sTREM-1 in patients with AD of cirrhosis.METHODS A multicenter prospective cohort of 442 patients with cirrhosis hospitalized for AD was divided into a study cohort(n=309)and validation cohort(n=133).Demographic and clinical data were collected,and serum sTREM-1 was measured at admission.All enrolled patients were followed-up for at least 1 year.RESULTS In patients with AD and cirrhosis,serum sTREM-1 was an independent prognosis predictor for 1-year survival and correlated with liver,coagulation,cerebral and kidney failure.A new prognostic model of AD(P-AD)incorporating sTREM-1,blood urea nitrogen(BUN),total bilirubin(TBil),international normalized ratio(INR)and hepatic encephalopathy grades was established and performed better than the model for end-stage liver disease(MELD),MELD-sodium(MELD-Na),chronic liver failure-consortium(CLIF-C)ACLF and CLIF-C AD scores.Additionally,sTREM-1 was increased in ACLF and predicted the development of ACLF during first 28-d follow-up.The ACLF risk score incorporating serum sTREM-1,BUN,INR,TBil and aspartate aminotransferase levels was established and significantly superior to MELD,MELD-Na,CLIF-C ACLF,CLIF-C AD and P-AD in predicting risk of ACLF development.CONCLUSION Serum sTREM-1 is a promising prognostic biomarker for ACLF development and mortality in patients with AD of cirrhosis. 展开更多
关键词 Soluble triggering receptor expressed on myeloid cell-1 Acute decompensation CIRRHOSIS Acute-on-chronic liver failure Prognostic biomarker
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Prevalence and risk factors of osteoporosis detected by dual-energy X-ray absorptiometry among Chinese patients with primary biliary cholangitis
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作者 Jia-Liang Chen Yao Liu +1 位作者 Yu-Fei Bi xian-bo wang 《World Journal of Gastroenterology》 SCIE CAS 2023年第29期4580-4592,共13页
BACKGROUND Osteoporosis is an extrahepatic complication of primary biliary cholangitis(PBC)that increases the risk of fractures and mortality.However,Epidemiological studies of osteoporosis in patients with PBC in Chi... BACKGROUND Osteoporosis is an extrahepatic complication of primary biliary cholangitis(PBC)that increases the risk of fractures and mortality.However,Epidemiological studies of osteoporosis in patients with PBC in China and the Asia-Pacific region is lack.AIM To assess the prevalence and clinical characteristics of osteoporosis in Chinese patients with PBC.METHODS This retrospective analysis included consecutive patients with PBC from a tertiary care center in China who underwent bone mineral density(BMD)assessment using dual-energy X-ray absorptiometry between January 2013 and December 2021.We defined subjects with T-scores≤-2.5 in any sites(L1 to L4,femoral neck,or total hip)as having osteoporosis.Demographic,serological,clinical,and histological data were collected.Independent risk factors for osteoporosis were identified by multivariate logistic regression analysis.RESULTS A total of 268 patients with PBC[236 women(88.1%);mean age,56.7±10.6 years;163 liver biopsies(60.8%)]were included.The overall prevalence of osteoporosis in patients with PBC was 45.5%(122/268),with the prevalence of osteoporosis in women and men being 47.0%and 34.4%,respectively.The prevalence of osteoporosis in postmenopausal women was significantly higher than that in premenopausal women(56.3%vs 21.0%,P<0.001).Osteoporosis in patients with PBC is associated with age,fatigue,menopausal status,previous steroid therapy,body mass index(BMI),splenomegaly,gastroesophageal varices,ascites,Mayo risk score,histological stage,alanine aminotransferase,albumin,bilirubin,platelet and prothrombin activity.Multivariate regression analysis identified that older age,lower BMI,previous steroid therapy,higher Mayo risk score,and advanced histological stage as the main independent risk factors for osteoporosis in PBC.CONCLUSION Osteoporosis is very common in Chinese patients with PBC,allowing for prior screening of BMD in those PBC patients with older age,lower BMI,previous steroid therapy and advanced liver disease. 展开更多
关键词 Primary biliary cholangitis OSTEOPOROSIS Bone mineral density Dual-energy X-ray absorptiometry PREVALENCE Chinese
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Score model for predicting acute-on-chronic liver failure risk in chronic hepatitis B 被引量:5
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作者 Fang-Yuan Gao Yao Liu +10 位作者 Xiao-Shu Li Xie-Qiong Ye Le Sun Ming-Fan Geng Rui wang Hui-Min Liu Xiao-Bing Zhou Li-Li Gu Yan-Min Liu Gang Wan xian-bo wang 《World Journal of Gastroenterology》 SCIE CAS 2015年第27期8373-8381,共9页
AIM: To establish a clinical scoring model to predict risk of acute-on-chronic liver failure(ACLF) in chronic hepatitis B(CHB) patients.METHODS: This was a retrospective study of 1457 patients hospitalized for CHB bet... AIM: To establish a clinical scoring model to predict risk of acute-on-chronic liver failure(ACLF) in chronic hepatitis B(CHB) patients.METHODS: This was a retrospective study of 1457 patients hospitalized for CHB between October 2008 and October 2013 at the Beijing Ditan Hospital, Capital Medical University, China. The patients were divided into two groups: severe acute exacerbation(SAE) group(n = 382) and non-SAE group(n = 1075). The SAE group was classified as the high-risk group based on the higher incidence of ACLF in this group than in the non-SAE group(13.6% vs 0.4%). Two-thirds of SAE patients were randomly assigned to risk-model derivation and the other one-third to model validation. Univariate risk factors associated with the outcome were entered into a multivariate logistic regression model for screening independent risk factors. Each variable was assigned an integer value based on the regression coefficients, and the final score was the sum of these values in the derivation set. Model discrimination and calibration were assessed using area under the receiver operating characteristic curve and the Hosmer-Lemeshow test. RESULTS: The risk prediction scoring model includedthe following four factors: age ≥ 40 years, total bilirubin ≥ 171 μmol/L, prothrombin activity 40%-60%, and hepatitis B virus DNA > 107 copies/m L. The sum risk score ranged from 0 to 7; 0-3 identified patients with lower risk of ACLF, whereas 4-7 identified patients with higher risk. The Kaplan-Meier analysis showed the cumulative risk for ACLF and ACLF-related death in the two risk groups(0-3 and 4-7 scores) of the primary cohort over 56 d, and log-rank test revealed a significant difference(2.0% vs 33.8% and 0.8% vs 9.4%, respectively; both P < 0.0001). In the derivation and validation data sets, the model had good discrimination(C index = 0.857, 95% confidence interval: 0.800-0.913 and C index = 0.889, 95% confidence interval: 0.820-0.957, respectively) and calibration demonstrated by the Hosmer-Lemeshow test(χ2 = 4.516, P = 0.808 and χ2 = 1.959, P = 0.923, respectively).CONCLUSION: Using the scoring model, clinicians can easily identify patients(total score ≥ 4) at high risk of ACLF and ACLF-related death early during SAE. 展开更多
关键词 Acute-on-chronic liver FAILURE Chronichepatitis B Prediction model RISK SCORE SEVERE acuteexacerbation
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A Study on Physiological Character of Fresh Tea Leaves in Different Cold-Resistant Varieties 被引量:1
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作者 Hai-Tao Huang Ji-Zhong Yu +3 位作者 xian-bo wang Tie-Feng Zhou Cun Ao Wei Zhang 《茶叶》 2013年第4期259-263,共5页
In order to reveal the cold resistant mechanism of tea plant,two varieties with different cold resistances were studied.The activities of catalase(CAT),peroxidase(POD),superoxide dismutase(SOD) and polyphenol oxidase(... In order to reveal the cold resistant mechanism of tea plant,two varieties with different cold resistances were studied.The activities of catalase(CAT),peroxidase(POD),superoxide dismutase(SOD) and polyphenol oxidase(PPO) were investigated,and the contents of soluble protein,sugar and malondialdehyde(MDA) were determined in fresh tea leaves in the autumn.The results showed that the activities of POD and the content of soluble sugar were both much higher in the variety with strong cold resistance,and the content of soluble protein was associated with the cold resistance,while the cold resistance of the plant was not related with the activities of the CAT,SOD and PPO,and the content of MDA.It is considered that the activity of POD and contents of soluble sugar could be used as indicators to identify the cold resistance of tea varieties. 展开更多
关键词 抗寒品种 鲜茶叶 生理特性 可溶性糖含量 POD活性 可溶性蛋白质 超氧化物歧化酶 MDA含量
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Prevalence and clinical characteristics of autoimmune liver disease in hospitalized patients with cirrhosis and acute decompensation in China
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作者 Zi-Xuan Shen Dan-Dan Wu +36 位作者 Jie Xia xian-bo wang Xin Zheng Yan Huang Bei-Ling Li Zhong-Ji Meng Yan-Hang Gao Zhi-Ping Qian Feng Liu Xiao-Bo Lu Jia Shang Hua-Dong Yan Yu-Bao Zheng Wen-Yi Gu Yan Zhang Jian-Yi Wei Wen-Ting Tan Yi-Xin Hou Qun Zhang Yan Xiong Cong-Cong Zou Jun Chen Ze-Bing Huang Xiu-Hua Jiang Sen Luo Yuan-Yuan Chen Na Gao Chun-Yan Liu Wei Yuan Xue Mei Jing Li Tao Li Xin-Yi Zhou Guo-Hong Deng Jin-Jun Chen Xiong Ma Hai Li 《World Journal of Gastroenterology》 SCIE CAS 2022年第31期4417-4430,共14页
BACKGROUND Autoimmune liver disease(AILD)has been considered a relatively uncommon disease in China,epidemiological data for AILD in patients with cirrhosis and acute decompensation(AD)is sparse.AIM To investigate the... BACKGROUND Autoimmune liver disease(AILD)has been considered a relatively uncommon disease in China,epidemiological data for AILD in patients with cirrhosis and acute decompensation(AD)is sparse.AIM To investigate the prevalence,outcome and risk factors for AILD in cirrhotic patients complicated with AD in China.METHODS We collected data from patients with cirrhosis and AD from two prospective,multicenter cohorts in hepatitis B virus endemic areas.Patients were regularly followed up at the end of 28-d,90-d and 365-d,or until death or liver transplantation(LT).The primary outcome in this study was 90-d LTfree mortality.Acute-on-chronic liver failure(ACLF)was assessed on admission and during 28-d hospitalization,according to the diagnostic criteria of the European Association for the Study of the Liver(EASL).Risk factors for death were analyzed with logistic regression model.RESULTS In patients with cirrhosis and AD,the overall prevalence of AILD was 9.3%(242/2597).Prevalence of ACLF was significantly lower in AILD cases(14%)than those with all etiology groups with cirrhosis and AD(22.8%)(P<0.001).Among 242 enrolled AILD patients,the prevalence rates of primary biliary cirrhosis(PBC),autoimmune hepatitis(AIH)and PBC-AIH overlap syndrome(PBC/AIH)were 50.8%,28.5%and 12.0%,respectively.In ACLF patients,the proportions of PBC,AIH and PBC/AIH were 41.2%,29.4% and 20.6%.28-d and 90-d mortality were 43.8% and 80.0% in AILD-related ACLF.The etiology of AILD had no significant impact on 28-d,90-d or 365-d LTfree mortality in patients with cirrhosis and AD in both univariate and multivariate analysis.Total bilirubin(TB),hepatic encephalopathy(HE)and blood urea nitrogen(BUN)were independent risk factors for 90-d LT-free mortality in multivariate analysis.The development of ACLF during hospitalization only independently correlated to TB and international normalized ratio.CONCLUSION AILD was not rare in hospitalized patients with cirrhosis and AD in China,among which PBC was the most common etiology.90-d LT-free mortality were independently associated with TB,HE and BUN. 展开更多
关键词 PREVALENCE Autoimmune liver disease Cirrhosis and acute decompensation MORTALITY Acuteon-chronic liver failure
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Chinese Consensus on Diagnosis and Treatment of Hepatic Encephalopathy
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作者 Xin-yue Chen Jun Cheng +17 位作者 Fang-ling Duan Jian-gao Fan Xiao-ling Fan Li-min Guo Ming-zhou Guo Tao Han Jing-yuan Liu Xiong Ma Wei Shen Shi-guang Feng xian-bo wang Yun Wu Wen Xie Yao Xie Hui-chun Xing Ping-geYuan Yong-ping Yang Fu-kui Zhang 《国际感染病学(电子版)》 CAS 2012年第3期151-176,共26页
Hepatic encephalopathy(HE)is a complex,neuropsychiatric abnormality that occurs as a consequence of metabolic disorders in patients with hepatic insufficiency.The pathogenesis is complex with a strong prognosticator o... Hepatic encephalopathy(HE)is a complex,neuropsychiatric abnormality that occurs as a consequence of metabolic disorders in patients with hepatic insufficiency.The pathogenesis is complex with a strong prognosticator of death.To standardize the clinical management of HE,relevant new data were reviewed and assessed by Chinese Committee of Experts on Hepatic Encephalopathy in China and was discussed and debated extensively.Then the consensus on the management of HE was developed.The final recommendations are based on the data available at the time of production of the document and may be updated with pertinent scientific developments at a later time.All the discussion was organized by the editorial board of Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition),Chinese Journal of Liver Diseases(Electronic Edition)and Infection International(Electronic Edition).The evidence gradings in the consensus are listed in Table1. 展开更多
关键词 ENCEPHALOPATHY CONSENSUS AMMONIA Infection EDITORIAL discussion assessed LISTED CIRRHOSIS document
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Development and Validation of a Prognostic Model for One-year Survival of Cirrhosis Patients with First-ever Spontaneous Bacterial Peritonitis 被引量:5
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作者 Rui-Rui wang Hong-Qiu Gu +6 位作者 Ying-Ying Wei Jin-Xiang Yang Yi-Xin Hou Hui-Min Liu Zhi-Yun Yang xian-bo wang Yu-Yong Jiang 《Journal of Clinical and Translational Hepatology》 SCIE 2021年第5期647-654,共8页
Background and Aims: Spontaneous bacterial peritonitis(SBP) is one of the leading causes of death in patients withliver cirrhosis. We aimed to establish a prognostic model toevaluate the 1-year survival of cirrhosis p... Background and Aims: Spontaneous bacterial peritonitis(SBP) is one of the leading causes of death in patients withliver cirrhosis. We aimed to establish a prognostic model toevaluate the 1-year survival of cirrhosis patients after thefirst episode of SBP. Methods: A prognostic model was developedbased on a retrospective derivation cohort of 309cirrhosis patients with first-ever SBP and was validated in aseparate validation cohort of 141 patients. We used Uno’sconcordance, calibration curve, and decision curve (DCA)analysis to evaluate the discrimination, calibration, and clinicalnet benefit of the model. Results: A total of 59 (19.1%)patients in the derivation cohort and 42 (29.8%) patientsin the validation cohort died over the course of 1 year. Aprognostic model in nomogram form was developed withpredictors including age [hazard ratio (HR): 1.25;95% confidenceinterval (CI): 0.92–1.71], total serum bilirubin (HR:1.66;95% CI: 1.28–2.14), serum sodium (HR: 0.94;95%CI: 0.90–0.98), history of hypertension (HR: 2.52;95% CI:1.44–4.41) and hepatic encephalopathy (HR: 2.06;95%CI: 1.13–3.73). The nomogram had a higher concordance(0.79) compared with the model end-stage liver disease(0.67) or Child-Turcotte-Pugh (0.71) score. The nomogramalso showed acceptable calibration (calibration slope, 1.12;Bier score, 0.15±0.21) and optimal clinical net benefit in thevalidation cohort. Conclusions: This prediction model developedbased on characteristics of first-ever SBP patientsmay benefit the prediction of patients’ 1-year survival. 展开更多
关键词 Spontaneous bacterial peritonitis Liver cirrhosis Bacterial infection NOMOGRAM Prognostic model PREDICTORS Long-term outcome
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直径≤3 cm的乙肝病毒相关性肝细胞癌患者术后复发的独立危险因素 被引量:1
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作者 Ling-Ling He Xiao-Li Liu +4 位作者 Shuan Zhang Meng-Ge Li xian-bo wang Yu-Yong Jiang Zhi-Yun Yang 《Gastroenterology Report》 SCIE EI 2019年第4期250-257,I0001,共9页
背景:乙型肝炎病毒(HBV)相关性肝细胞癌(HCC)术后复发率较高。本研究旨在探讨HBV相关性单发小HCC(肿瘤直径≤3 cm)术后1年内复发的影响因素。方法:本回顾性研究的对象是只有单个小原发肿瘤的HBV相关性HCC患者,包括203例训练队列和64例... 背景:乙型肝炎病毒(HBV)相关性肝细胞癌(HCC)术后复发率较高。本研究旨在探讨HBV相关性单发小HCC(肿瘤直径≤3 cm)术后1年内复发的影响因素。方法:本回顾性研究的对象是只有单个小原发肿瘤的HBV相关性HCC患者,包括203例训练队列和64例验证队列。所有入组病例均完成了术后1年随访。通过Cox回归分析筛选出与肿瘤复发相关的潜在因素,基于这些因素构建预测模型,然后通过受试者工作特征(ROC)曲线分析该预测模型的预后价值,并计算其ROC曲线下面积(AUC)。结果:酗酒史、血清甲胎蛋白、总蛋白和谷氨酰转肽酶水平可独立预测术后1年复发率。基于上述4个因素的预测模型的AUC值,在训练队列中为0.711(95%CI:0.634-0.772),在验证队列中为0.727(95%CI:0.601-0.831)。基于该预测模型的复发评分可将患者分为低危复发组和高危复发组,其在训练队列中的1年复发率分别为17.0%和49.5%(P<0.001),在验证队列中的1年复发率分别为43.2%和74.1%(P=0.031),差异均有统计学意义。结论:酗酒史、血清甲胎蛋白、总蛋白和谷氨酰转肽酶水平是HBV相关性单发小HCC(肿瘤直径≤3 cm)患者术后1年内复发的独立预测因素。 展开更多
关键词 血清甲胎蛋白 COX回归分析 酗酒史 肝细胞癌患者 原发肿瘤 肿瘤复发 预后价值 肿瘤直径
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