AIM To understand the prevalence of hepatitis C virus(HCV) infection in blood donors over a nearly 27-year interval and to explore the factors that affect the outcome of HCV infection.METHODS A retrospective and cross...AIM To understand the prevalence of hepatitis C virus(HCV) infection in blood donors over a nearly 27-year interval and to explore the factors that affect the outcome of HCV infection.METHODS A retrospective and cross-sectional study was conducted.The participants,mostly plasma donors,were selected from three administrative villages in the Jiangsu province in Eastern China.A questionnaire was administered among the villagers who had a history of blood donation from the late 1980 s to the early 1990 s.All participants underwent physical examination,liver B-ultrasonography,and liver stiffness measurement.In addition,10 m L of blood was collected from each participant to measure simple liver function parameters(albumin,alanine aminotransferase,aspirate aminotransferase),blood factors(platelet),and for hepatitis B surface antigen,anti HCV,and antihuman immunodeficiency virus detection.HCV RNA detection,HCV genotyping,and other tests were carried out in anti HCV-positive patients.RESULTS After a median of 27 years(25-31 years) from the last blood donation to the time of survey,a total of 1694 participants were investigated,and the anti HCVpositive individuals were categorized into three groups:blood donors(n = 12,3.3%),plasma donors(n = 534,68.5%),and mixed donors(n = 324,58.8%).A total of 592(68.05%) patients had detectable HCV RNA,and 91.9% had genotype 1 b.A total of 161(27.2%,161/592) patients with chronic HCV were considered to have cirrhosis with a liver stiffness measurement level higher than 12 k Pa.Multiple logistic(binary) regression analysis results showed that platelet and Ig G levels were associated with cirrhosis.CONCLUSION The nearly 27-year interval investigation revealed that chronic hepatitis C infection is a very serious public health problem in Eastern China.Plasma donation and subsequent return of blood cells to the donor are the main causes of hepatitis C infection.The main HCV genotype is 1 b.Nearly 28% of cases progressed to cirrhosis.Age,especially over 60 years,and regular drinking habits were risk factors associated with cirrhosis.展开更多
BACKGROUND Only a few cases of chronic hepatitis B(CHB)with primary biliary cholangitis(PBC)have been reported based on histological evidence from liver biopsies.AIM To observe the clinicopathological features and out...BACKGROUND Only a few cases of chronic hepatitis B(CHB)with primary biliary cholangitis(PBC)have been reported based on histological evidence from liver biopsies.AIM To observe the clinicopathological features and outcomes of 11 patients with CHB infection complicated by PBC.METHODS Eleven patients with CHB and PBC who underwent liver biopsy at the Zhenjiang Third Hospital,affiliated with Jiangsu University,and Wuxi Fifth People’s Hospital,from January 2005 to September 2020,were selected.All patients initially visited our hospital with CHB and were pathologically diagnosed with CHB and PBC.RESULTS Only five had elevated alkaline phosphatase levels,nine were positive for antimitochondrial antibody(AMA)-M2,and two were negative for AMA-M2.Two had jaundice and pruritus symptoms,10 had mildly abnormal liver function,and one had severely elevated bilirubin and liver enzyme levels.The pathological characteristics of CHB complicated by PBC overlapped with those of PBCautoimmune hepatitis(AIH).When necroinflammation of the portal area is not obvious,the pathological features of PBC are predominant,similar to the features of PBC alone.When the interface is severe,biliangitis will occur,with a large number of ductular reactions in zone 3.Unlike the PBC-AIH overlap pathology,this pathology is characterized by a small amount of plasma cell infiltration.Unlike PBC,lobulitis is often observed.CONCLUSION This is the first large case series to show that the rare pathological features of CHB with PBC are similar to those of PBC-AIH and small duct injury was observed.展开更多
AIM To assess the diagnostic value of FIB-4, aspartate aminotransferase-to-platelet ratio index(APRI), and liver stiffness measurement(LSM) in patients with hepatitis B virus infection who have persistently normal ala...AIM To assess the diagnostic value of FIB-4, aspartate aminotransferase-to-platelet ratio index(APRI), and liver stiffness measurement(LSM) in patients with hepatitis B virus infection who have persistently normal alanine transaminase(PNALT).METHODS We enrolled 245 patients with chronic hepatitis B: 95 in PNALT group, 86 in intermittently elevated alanine transaminase(PIALT1) group [alanine transaminase(ALT) within 1-2 × upper limit of normal value(ULN)], and 64 in PIALT2 group(ALT > 2 × ULN). All the patients received a percutaneous liver biopsy guided by ultrasonography. LSM, biochemical tests, and complete blood cell counts were performed.RESULTS The pathological examination revealed moderate inflammatory necrosis ratios of 16.81%(16/95), 32.56%(28/86), and 45.31%(28/64), and moderate liverfibrosis of 24.2%(23/95), 33.72%(29/86), and 43.75%(28/64) in the PNALT, PIALT1, and PIALT2 groups, respectively. The degrees of inflammation and liver fibrosis were significantly higher in the PIALT groups than in the PNALT group(P < 0.05). No significant difference was found in the areas under the curve(AUCs) between APRI and FIB-4 in the PNALT group; however, significant differences were found between APRI and LSM, and between FIB-4 and LSM in the PNALT group(P < 0.05 for both). In the PIALT1 and PIALT2 groups, no significant difference(P > 0.05) was found in AUCs for all comparisons(P > 0.05 for all). In the overall patients, a significant difference in the AUCs was found only between LSM and APRI(P < 0.05).CONCLUSION APRI and FIB-4 are not the ideal noninvasive hepatic fibrosis markers for PNALT patients. LSM is superior to APRI and FIB-4 in PNALT patients because of the influence of liver inflammation and necrosis.展开更多
AIM:To investigate the prevalence of nature tyrosinemethionine-aspartic acid-aspartic acid motif mutations in chronic hepatitis B(CHB)patients and to evaluate the efficacy of lamivudine.METHODS:A total of 1268 CHB pat...AIM:To investigate the prevalence of nature tyrosinemethionine-aspartic acid-aspartic acid motif mutations in chronic hepatitis B(CHB)patients and to evaluate the efficacy of lamivudine.METHODS:A total of 1268 CHB patients were recruited from the outpatient and inpatient departments of six centers.Tyrosine-methionine-aspartic acid-aspartic acid(YMDD)mutations were analyzed using the hepatitis B virus(HBV)drug resistance line probe assay.Forty voluntary patients were selected from those with positive or negative natural YMDD mutations to undergo treatment with lamivudine.RESULTS:YMDD mutations were detected in 288(22.71%)of the 1268 CHB patients.Multivariate analysis revealed that the patients’HBV DNA level(P=0.0282)and hepatitis B e antigen status(P=0.0133)were also associated with natural YMDD mutations.The rates of normalization of alanine aminotransferase levels and HBV DNA nondetection at 6,24,36,and 48 wk were compared between the patients with natural YMDD mutations and those without,and the differences were not significant.However,there was a significant difference in the cumulative emergence rates of virological breakthrough at 48 wk in the patients with natural YMDD mutations and those without(32.5%vs 12.5%,P=0.032).CONCLUSION:Naturally occurring YMDD mutationsare detectable in a large proportion of CHB patients;breakthrough hepatitis tended to occur in patients with natural YMDD mutations.展开更多
AIM:To investigate the virological relapse rate in hepatitis B e antigen(HBeAg)-negative patients after antiviral therapy discontinuation and analyze the factors associated with virological relapse.METHODS:Among patie...AIM:To investigate the virological relapse rate in hepatitis B e antigen(HBeAg)-negative patients after antiviral therapy discontinuation and analyze the factors associated with virological relapse.METHODS:Among patients diagnosed with chronic hepatitis B infection between May 2005 and July2010,204 were eligible for analysis.The Kaplan-Meier method and log-rank test were used to calculate the cumulative rate of relapse and compare cumulative relapse rates between groups.The Cox proportional hazards regression model was used to evaluate the predictive factor of virological relapse.RESULTS:The 2 and 1 year cumulative risks of virological relapse after antiviral therapy discontinuation were 79.41%(162/204) and 43.82%(71/162),respectively.Multivariate analysis revealed that only post treatment hepatitis B surface antigen(HBsAg)level was associated with virological relapse {P= 0.011).The cumulative risk of virological relapse was higher in the patients with HBsAg levels ≥1500 IU/L than in those with HBsAg levels < 1500 IU/L(P= 0.0013).The area under the curve was 0.603(P= 0.033).The cutoff HBsAg value for predicting virological relapse was 1443IU/L CONCLUSION:We found that the virological relapse rate remained high after antiviral therapy discontinuation in the HBeAg-negative patients and that the post treatment HBsAg levels predicted virological relapse.展开更多
BACKGROUND The artificial liver support system(ALSS)is an effective treatment method for liver failure,but it requires deep venous intubation and long-term indwelling catheterization.However,the coagulation mechanism ...BACKGROUND The artificial liver support system(ALSS)is an effective treatment method for liver failure,but it requires deep venous intubation and long-term indwelling catheterization.However,the coagulation mechanism disorder of basic liver failure diseases,and deep venous thrombosis(DVT)often occur.AIM To evaluate the risk factors for DVT following use of an ALSS and establish a risk assessment score.METHODS This study was divided into three stages.In the first stage,the risk factors for DVT were screened and the patient data were collected,including ALSS treatment information;biochemical indices;coagulation and hematology indices;complications;procoagulant use therapy status;and a total of 24 indicators.In the second stage,a risk assessment score for DVT after ALSS treatment was developed.In the third stage,the DVT risk assessment score was validated.RESULTS A total of 232 patients with liver failure treated with ALSS were enrolled in the first stage,including 12 with lower limb DVT.Logistic regression analysis showed that age[odds ratio(OR),1.734;P=0.01],successful catheterization time(OR,1.667;P=0.005),activity status(strict bed rest)(OR,3.049;P=0.005),and D-dimer level(≥500 ng/mL)(OR,5.532;P<0.001)were independent risk factors for DVT.We then established a scoring system for risk factors.In the validation group,a total of 213 patients with liver failure were treated with ALSS,including 14 with lower limb DVT.When the cutoff value of risk assessment was 3,the specificity and sensitivity of the risk assessment score were 88.9%and 85.7%,respectively.CONCLUSION A simple risk assessment scoring system was established for DVT patients with liver failure treated with ALSS and was verified to have good sensitivity and specificity.展开更多
BACKGROUND Spinal metastasis of hepatocellular carcinoma(HCC) is rare, with an extremely poor prognosis and results in severe pain. Argon-helium cryotherapy is a local ablation method for HCC.CASE SUMMARY A 54-year-ol...BACKGROUND Spinal metastasis of hepatocellular carcinoma(HCC) is rare, with an extremely poor prognosis and results in severe pain. Argon-helium cryotherapy is a local ablation method for HCC.CASE SUMMARY A 54-year-old man was diagnosed with HCC related to hepatitis B one year ago and underwent surgical tumor resection and tenofovir antiviral treatment.However, a new lesion developed on the right liver after 1 mo. Transarterial chemoembolization was performed four times. One month ago, the patient developed back pain, and metastasis on the 11 th thoracic vertebra was detected.Argon-helium cryoablation was performed to treat the right occupancy and metastatic lesion, which immediately alleviated the pain and prolonged survival.CONCLUSION The use of argon-helium cryoablation for thoracic vertebrae with metastasis of HCC achieved favorable results.展开更多
Objective To explore the prevention of IL-18 or anti-IL-18-m Ab to the immune liver fibrosis model induced by repeated injection of concanavalin A in BALB/c mice and its mechanism.Methods Total of 120 BALB/c mice were...Objective To explore the prevention of IL-18 or anti-IL-18-m Ab to the immune liver fibrosis model induced by repeated injection of concanavalin A in BALB/c mice and its mechanism.Methods Total of 120 BALB/c mice were divided into four groups, control group mice(Ga) were injected weekly with normal saline, concanavalin A group was divided into Gb, Gc, Gd. All mice were injected with concanavalin A(15 mg/kg) once a week. Moreover, Gc, Gd mice were injected weekly with IL-18(7.5 mg/kg) and anti-IL-18-m Ab(10 mg/kg) 2 hours before treatment with concanavalin A, respectively. Twenty-four hours after concanavalin A challenge at 1, 5, 12 and 20 weeks, 3 mice were killed by vena orbitalis, repectively. The sera were storaged at 4℃ for detecting of up TNF-α and IFN-γ by ELISA. The liver of mice in different groups were excised and fixed in 10% formalin for HE staining and Masson staining or frozen in liquid nitrogen for immunohistochemical staining for α-SMA. After extracting of total RNA from liver tissue, MMP-2 and TIMP-1A messenger RNA were amplified by reverse transcription polymerase chain reaction(PCR). Products were electrophoresed on agrose gel containing ethidium bromide and visualized under ultraviolet light. Densitometric RT-PCR data were standardized with β-actin signals. Results After experiment, the number of dead mice of Ga, Gb, Gc and Gd were 0, 6, 15 and 3, respectively. There were significant difference on each group(P < 0.05). At the fifth week of experiment, hepatocellular necrosis in IL-18 administered group mice had become widespread throughout the lobule. Evidence of liver fibrosis was observed during this period. However, at the twelfth week of experimemt, bridging fibrosis and large fibrosis strip in the parenchyma with hepatocellular necrosis was detectable in Gb, but at twentieth week, only the small fibrosis strip had been found in anti-IL-18-mA b administered group mice by HE staining and Masson staining. The serum levels of TNF-α and IFN-γ in IL-18 administered group were higher than that in concanavalin A group and anti-IL-18 administered groups(P < 0.05). Moreover, immunohistochemical staining for α-SMA indicated that the semi-quantu scores in IL-18 administered group were more than concanavalin A group and anti-IL-18-mA b administered groups(P < 0.05). MMP-2-mR NA, TIMP-1- mR NA expression levels increased signifigantly compared with concanavalin A group and anti-IL-18-mA b administered group(P < 0.05).Conclusions The immune liver fibrosis model induced by repeated injection of concanavalin A in BALB/c mice could be worsened by IL-18 administration and block by anti-IL-18 mA b administraion.展开更多
Power scaling based on traditional ytterbium-doped fibers(YDFs)is limited by optical nonlinear effects and transverse mode instability(TMI)in high-power fiber lasers.Here,we propose a novel long tapered fiber with a c...Power scaling based on traditional ytterbium-doped fibers(YDFs)is limited by optical nonlinear effects and transverse mode instability(TMI)in high-power fiber lasers.Here,we propose a novel long tapered fiber with a constant cladding and tapered core(CCTC)along its axis direction.The tapered-core region of the fiber is designed to enhance the stimulated Raman scattering(SRS)threshold and suppress higher-order mode resonance in the laser cavity.The CCTC YDF was fabricated successfully with a modified chemical vapor deposition(MCVD)method combined with solution doping technology,which has a cladding diameter of 400µm and a varying core with a diameter of~24μm at both ends and~31μm in the middle.To test the performance of the CCTC fiber during high-power operation,an all-fiber laser oscillator based on a CCTC YDF was investigated experimentally.As a result,a maximum output power of 3.42 kW was achieved with an optical-to-optical efficiency of 55.2%,although the TMI effect was observed at an output power of~3.12 kW.The measured beam quality(M^(2)factor)was~1.7,and no sign of the Raman component was observed in the spectrum.We believe that CCTC YDF has great potential to simultaneously mitigate the SRS and TMI effects,and further power scaling is promising by optimizing the structure of the YDF.展开更多
Strong ionic character endows all-inorganic perovskite nanocrystals(NCs)with particular optoelectronic features when interacting with common polar solvents,such as water.However,the interaction mechanism of water affe...Strong ionic character endows all-inorganic perovskite nanocrystals(NCs)with particular optoelectronic features when interacting with common polar solvents,such as water.However,the interaction mechanism of water affecting perovskite NCs is still lack of in-depth understanding.This study systematically explores the roles of water on CsPbBr_(3) nanocrystals(CNCs)by finely controlling the polymer coating degree of polydimethylsiloxane-based polyurea(PDMS-PUa).Through this coating,the effect of water on CNCs is found to experience from“fluorescence quenching”owing to irreversible crystal decomposition towards“forward fluorescence reversibility”by crystal destruction and recrystallization.With gradually enhanced coating,a phenomenon of“reverse fluorescence reversibility”is further observed in that water begins to passivate the CNCs’defect states.Finally,“fluorescent balance”can be achieved with a thick enough coating,where water can hardly contact with the CNCs.Inspired by the fluorescence reversible mechanism discovered,a new wearable intelligent sensing skin is demonstrated by using the CsPbBr_(3)/PDMS-PUa composite as raw material.Both water contact and humidity change can be perceived through photoluminescence(PL)intensity,corresponding to stimuli-responsive sensory nerves of human skin.It is expected that these findings will shed some new lights on perovskite NCs.展开更多
基金Supported by the Preventive Medicine research projects of Jiangsu Province,No.Y2012016the Social Development Project of Zhenjiang City,No.SH2014060
文摘AIM To understand the prevalence of hepatitis C virus(HCV) infection in blood donors over a nearly 27-year interval and to explore the factors that affect the outcome of HCV infection.METHODS A retrospective and cross-sectional study was conducted.The participants,mostly plasma donors,were selected from three administrative villages in the Jiangsu province in Eastern China.A questionnaire was administered among the villagers who had a history of blood donation from the late 1980 s to the early 1990 s.All participants underwent physical examination,liver B-ultrasonography,and liver stiffness measurement.In addition,10 m L of blood was collected from each participant to measure simple liver function parameters(albumin,alanine aminotransferase,aspirate aminotransferase),blood factors(platelet),and for hepatitis B surface antigen,anti HCV,and antihuman immunodeficiency virus detection.HCV RNA detection,HCV genotyping,and other tests were carried out in anti HCV-positive patients.RESULTS After a median of 27 years(25-31 years) from the last blood donation to the time of survey,a total of 1694 participants were investigated,and the anti HCVpositive individuals were categorized into three groups:blood donors(n = 12,3.3%),plasma donors(n = 534,68.5%),and mixed donors(n = 324,58.8%).A total of 592(68.05%) patients had detectable HCV RNA,and 91.9% had genotype 1 b.A total of 161(27.2%,161/592) patients with chronic HCV were considered to have cirrhosis with a liver stiffness measurement level higher than 12 k Pa.Multiple logistic(binary) regression analysis results showed that platelet and Ig G levels were associated with cirrhosis.CONCLUSION The nearly 27-year interval investigation revealed that chronic hepatitis C infection is a very serious public health problem in Eastern China.Plasma donation and subsequent return of blood cells to the donor are the main causes of hepatitis C infection.The main HCV genotype is 1 b.Nearly 28% of cases progressed to cirrhosis.Age,especially over 60 years,and regular drinking habits were risk factors associated with cirrhosis.
基金the Social Development Project of Jiangsu Province,No.BE2020775Chinese Federation of Public Health Foundation,No.GWLM202002.the Medical Ethics Committee of the Third Hospital of Zhenjiang Affiliated Jiangsu University(No.202238).
文摘BACKGROUND Only a few cases of chronic hepatitis B(CHB)with primary biliary cholangitis(PBC)have been reported based on histological evidence from liver biopsies.AIM To observe the clinicopathological features and outcomes of 11 patients with CHB infection complicated by PBC.METHODS Eleven patients with CHB and PBC who underwent liver biopsy at the Zhenjiang Third Hospital,affiliated with Jiangsu University,and Wuxi Fifth People’s Hospital,from January 2005 to September 2020,were selected.All patients initially visited our hospital with CHB and were pathologically diagnosed with CHB and PBC.RESULTS Only five had elevated alkaline phosphatase levels,nine were positive for antimitochondrial antibody(AMA)-M2,and two were negative for AMA-M2.Two had jaundice and pruritus symptoms,10 had mildly abnormal liver function,and one had severely elevated bilirubin and liver enzyme levels.The pathological characteristics of CHB complicated by PBC overlapped with those of PBCautoimmune hepatitis(AIH).When necroinflammation of the portal area is not obvious,the pathological features of PBC are predominant,similar to the features of PBC alone.When the interface is severe,biliangitis will occur,with a large number of ductular reactions in zone 3.Unlike the PBC-AIH overlap pathology,this pathology is characterized by a small amount of plasma cell infiltration.Unlike PBC,lobulitis is often observed.CONCLUSION This is the first large case series to show that the rare pathological features of CHB with PBC are similar to those of PBC-AIH and small duct injury was observed.
文摘AIM To assess the diagnostic value of FIB-4, aspartate aminotransferase-to-platelet ratio index(APRI), and liver stiffness measurement(LSM) in patients with hepatitis B virus infection who have persistently normal alanine transaminase(PNALT).METHODS We enrolled 245 patients with chronic hepatitis B: 95 in PNALT group, 86 in intermittently elevated alanine transaminase(PIALT1) group [alanine transaminase(ALT) within 1-2 × upper limit of normal value(ULN)], and 64 in PIALT2 group(ALT > 2 × ULN). All the patients received a percutaneous liver biopsy guided by ultrasonography. LSM, biochemical tests, and complete blood cell counts were performed.RESULTS The pathological examination revealed moderate inflammatory necrosis ratios of 16.81%(16/95), 32.56%(28/86), and 45.31%(28/64), and moderate liverfibrosis of 24.2%(23/95), 33.72%(29/86), and 43.75%(28/64) in the PNALT, PIALT1, and PIALT2 groups, respectively. The degrees of inflammation and liver fibrosis were significantly higher in the PIALT groups than in the PNALT group(P < 0.05). No significant difference was found in the areas under the curve(AUCs) between APRI and FIB-4 in the PNALT group; however, significant differences were found between APRI and LSM, and between FIB-4 and LSM in the PNALT group(P < 0.05 for both). In the PIALT1 and PIALT2 groups, no significant difference(P > 0.05) was found in AUCs for all comparisons(P > 0.05 for all). In the overall patients, a significant difference in the AUCs was found only between LSM and APRI(P < 0.05).CONCLUSION APRI and FIB-4 are not the ideal noninvasive hepatic fibrosis markers for PNALT patients. LSM is superior to APRI and FIB-4 in PNALT patients because of the influence of liver inflammation and necrosis.
基金Supported by Zhenjiang Municipal Science and Technology Commission,No.SH2009016
文摘AIM:To investigate the prevalence of nature tyrosinemethionine-aspartic acid-aspartic acid motif mutations in chronic hepatitis B(CHB)patients and to evaluate the efficacy of lamivudine.METHODS:A total of 1268 CHB patients were recruited from the outpatient and inpatient departments of six centers.Tyrosine-methionine-aspartic acid-aspartic acid(YMDD)mutations were analyzed using the hepatitis B virus(HBV)drug resistance line probe assay.Forty voluntary patients were selected from those with positive or negative natural YMDD mutations to undergo treatment with lamivudine.RESULTS:YMDD mutations were detected in 288(22.71%)of the 1268 CHB patients.Multivariate analysis revealed that the patients’HBV DNA level(P=0.0282)and hepatitis B e antigen status(P=0.0133)were also associated with natural YMDD mutations.The rates of normalization of alanine aminotransferase levels and HBV DNA nondetection at 6,24,36,and 48 wk were compared between the patients with natural YMDD mutations and those without,and the differences were not significant.However,there was a significant difference in the cumulative emergence rates of virological breakthrough at 48 wk in the patients with natural YMDD mutations and those without(32.5%vs 12.5%,P=0.032).CONCLUSION:Naturally occurring YMDD mutationsare detectable in a large proportion of CHB patients;breakthrough hepatitis tended to occur in patients with natural YMDD mutations.
基金Supported by Natural Science Foundation of Jiangsu Province,China,No.BK2011515Medical Project of Health Department Jiangsu Province,No.H201248+1 种基金Preventive Medicine research projects of Jiangsu Province,No.Y2012016the Social Development Project of Zhenjiang City,No.SH2013056
文摘AIM:To investigate the virological relapse rate in hepatitis B e antigen(HBeAg)-negative patients after antiviral therapy discontinuation and analyze the factors associated with virological relapse.METHODS:Among patients diagnosed with chronic hepatitis B infection between May 2005 and July2010,204 were eligible for analysis.The Kaplan-Meier method and log-rank test were used to calculate the cumulative rate of relapse and compare cumulative relapse rates between groups.The Cox proportional hazards regression model was used to evaluate the predictive factor of virological relapse.RESULTS:The 2 and 1 year cumulative risks of virological relapse after antiviral therapy discontinuation were 79.41%(162/204) and 43.82%(71/162),respectively.Multivariate analysis revealed that only post treatment hepatitis B surface antigen(HBsAg)level was associated with virological relapse {P= 0.011).The cumulative risk of virological relapse was higher in the patients with HBsAg levels ≥1500 IU/L than in those with HBsAg levels < 1500 IU/L(P= 0.0013).The area under the curve was 0.603(P= 0.033).The cutoff HBsAg value for predicting virological relapse was 1443IU/L CONCLUSION:We found that the virological relapse rate remained high after antiviral therapy discontinuation in the HBeAg-negative patients and that the post treatment HBsAg levels predicted virological relapse.
基金Supported by China Public Health Alliance,No.GWLM202031.
文摘BACKGROUND The artificial liver support system(ALSS)is an effective treatment method for liver failure,but it requires deep venous intubation and long-term indwelling catheterization.However,the coagulation mechanism disorder of basic liver failure diseases,and deep venous thrombosis(DVT)often occur.AIM To evaluate the risk factors for DVT following use of an ALSS and establish a risk assessment score.METHODS This study was divided into three stages.In the first stage,the risk factors for DVT were screened and the patient data were collected,including ALSS treatment information;biochemical indices;coagulation and hematology indices;complications;procoagulant use therapy status;and a total of 24 indicators.In the second stage,a risk assessment score for DVT after ALSS treatment was developed.In the third stage,the DVT risk assessment score was validated.RESULTS A total of 232 patients with liver failure treated with ALSS were enrolled in the first stage,including 12 with lower limb DVT.Logistic regression analysis showed that age[odds ratio(OR),1.734;P=0.01],successful catheterization time(OR,1.667;P=0.005),activity status(strict bed rest)(OR,3.049;P=0.005),and D-dimer level(≥500 ng/mL)(OR,5.532;P<0.001)were independent risk factors for DVT.We then established a scoring system for risk factors.In the validation group,a total of 213 patients with liver failure were treated with ALSS,including 14 with lower limb DVT.When the cutoff value of risk assessment was 3,the specificity and sensitivity of the risk assessment score were 88.9%and 85.7%,respectively.CONCLUSION A simple risk assessment scoring system was established for DVT patients with liver failure treated with ALSS and was verified to have good sensitivity and specificity.
文摘BACKGROUND Spinal metastasis of hepatocellular carcinoma(HCC) is rare, with an extremely poor prognosis and results in severe pain. Argon-helium cryotherapy is a local ablation method for HCC.CASE SUMMARY A 54-year-old man was diagnosed with HCC related to hepatitis B one year ago and underwent surgical tumor resection and tenofovir antiviral treatment.However, a new lesion developed on the right liver after 1 mo. Transarterial chemoembolization was performed four times. One month ago, the patient developed back pain, and metastasis on the 11 th thoracic vertebra was detected.Argon-helium cryoablation was performed to treat the right occupancy and metastatic lesion, which immediately alleviated the pain and prolonged survival.CONCLUSION The use of argon-helium cryoablation for thoracic vertebrae with metastasis of HCC achieved favorable results.
文摘Objective To explore the prevention of IL-18 or anti-IL-18-m Ab to the immune liver fibrosis model induced by repeated injection of concanavalin A in BALB/c mice and its mechanism.Methods Total of 120 BALB/c mice were divided into four groups, control group mice(Ga) were injected weekly with normal saline, concanavalin A group was divided into Gb, Gc, Gd. All mice were injected with concanavalin A(15 mg/kg) once a week. Moreover, Gc, Gd mice were injected weekly with IL-18(7.5 mg/kg) and anti-IL-18-m Ab(10 mg/kg) 2 hours before treatment with concanavalin A, respectively. Twenty-four hours after concanavalin A challenge at 1, 5, 12 and 20 weeks, 3 mice were killed by vena orbitalis, repectively. The sera were storaged at 4℃ for detecting of up TNF-α and IFN-γ by ELISA. The liver of mice in different groups were excised and fixed in 10% formalin for HE staining and Masson staining or frozen in liquid nitrogen for immunohistochemical staining for α-SMA. After extracting of total RNA from liver tissue, MMP-2 and TIMP-1A messenger RNA were amplified by reverse transcription polymerase chain reaction(PCR). Products were electrophoresed on agrose gel containing ethidium bromide and visualized under ultraviolet light. Densitometric RT-PCR data were standardized with β-actin signals. Results After experiment, the number of dead mice of Ga, Gb, Gc and Gd were 0, 6, 15 and 3, respectively. There were significant difference on each group(P < 0.05). At the fifth week of experiment, hepatocellular necrosis in IL-18 administered group mice had become widespread throughout the lobule. Evidence of liver fibrosis was observed during this period. However, at the twelfth week of experimemt, bridging fibrosis and large fibrosis strip in the parenchyma with hepatocellular necrosis was detectable in Gb, but at twentieth week, only the small fibrosis strip had been found in anti-IL-18-mA b administered group mice by HE staining and Masson staining. The serum levels of TNF-α and IFN-γ in IL-18 administered group were higher than that in concanavalin A group and anti-IL-18 administered groups(P < 0.05). Moreover, immunohistochemical staining for α-SMA indicated that the semi-quantu scores in IL-18 administered group were more than concanavalin A group and anti-IL-18-mA b administered groups(P < 0.05). MMP-2-mR NA, TIMP-1- mR NA expression levels increased signifigantly compared with concanavalin A group and anti-IL-18-mA b administered group(P < 0.05).Conclusions The immune liver fibrosis model induced by repeated injection of concanavalin A in BALB/c mice could be worsened by IL-18 administration and block by anti-IL-18 mA b administraion.
基金the National Natural Science Foundation of China(Nos.61735007 and 61705266).
文摘Power scaling based on traditional ytterbium-doped fibers(YDFs)is limited by optical nonlinear effects and transverse mode instability(TMI)in high-power fiber lasers.Here,we propose a novel long tapered fiber with a constant cladding and tapered core(CCTC)along its axis direction.The tapered-core region of the fiber is designed to enhance the stimulated Raman scattering(SRS)threshold and suppress higher-order mode resonance in the laser cavity.The CCTC YDF was fabricated successfully with a modified chemical vapor deposition(MCVD)method combined with solution doping technology,which has a cladding diameter of 400µm and a varying core with a diameter of~24μm at both ends and~31μm in the middle.To test the performance of the CCTC fiber during high-power operation,an all-fiber laser oscillator based on a CCTC YDF was investigated experimentally.As a result,a maximum output power of 3.42 kW was achieved with an optical-to-optical efficiency of 55.2%,although the TMI effect was observed at an output power of~3.12 kW.The measured beam quality(M^(2)factor)was~1.7,and no sign of the Raman component was observed in the spectrum.We believe that CCTC YDF has great potential to simultaneously mitigate the SRS and TMI effects,and further power scaling is promising by optimizing the structure of the YDF.
基金We acknowledge the support from the National Natural Science Foundation of China(No.62175032)the Fujian Provincial Natural Science Foundation Project(No.2021J01579).
文摘Strong ionic character endows all-inorganic perovskite nanocrystals(NCs)with particular optoelectronic features when interacting with common polar solvents,such as water.However,the interaction mechanism of water affecting perovskite NCs is still lack of in-depth understanding.This study systematically explores the roles of water on CsPbBr_(3) nanocrystals(CNCs)by finely controlling the polymer coating degree of polydimethylsiloxane-based polyurea(PDMS-PUa).Through this coating,the effect of water on CNCs is found to experience from“fluorescence quenching”owing to irreversible crystal decomposition towards“forward fluorescence reversibility”by crystal destruction and recrystallization.With gradually enhanced coating,a phenomenon of“reverse fluorescence reversibility”is further observed in that water begins to passivate the CNCs’defect states.Finally,“fluorescent balance”can be achieved with a thick enough coating,where water can hardly contact with the CNCs.Inspired by the fluorescence reversible mechanism discovered,a new wearable intelligent sensing skin is demonstrated by using the CsPbBr_(3)/PDMS-PUa composite as raw material.Both water contact and humidity change can be perceived through photoluminescence(PL)intensity,corresponding to stimuli-responsive sensory nerves of human skin.It is expected that these findings will shed some new lights on perovskite NCs.
