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Table of Content

    31 May 2019, Volume 24 Issue 5
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    Original Articles
    Efficacy analysis of ascites drainage in 25 patients with liver cirrhosis complicated with intra-abdominal hypertension under bladder pressure monitoring
    ZHANG Jun-chang, XU Biao, KUANG Zhi-dan, MOU Jin-song
    2019, 24(5):  497-498. 
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    Objective To investigate the efficacy of ascites drainage in treating intra-abdominal hypertension (IAH) under bladder pressure monitoring.Methods From January 2017 to June 2018, 25 patients with liver cirrhosis complicated with IAH in our hospital were enrolled. The abdominal pressure of patients was relieved by ascites drainage under bladder pressure monitoring. Bladder pressure and volume of ascites drainage were detected during treatment. Lactic acid level, acute physiology and chronic health evaluation system II (APACHEII) score and cardiac ejection fraction were detected on admission and 24 hours after admission.Results All the 25 IAH patients were classified into 4 grades according to intra-abdominal pressure, including 9 cases of grade Ⅰ, 7 cases of grade Ⅱ, 6 cases of grade Ⅳ and 3 cases of grade Ⅳ. Bladder pressure decreased significantly when draining 1 000 to 2 000 mL of ascites, then slowed down gradually with more drainage. The average bladder pressure of all the patients was 23.1 cmH2O on admission, dropped to 8 cmH2O with an average drainage of 3 350 mL, and increased to 10.9 cmH2O after 24 hours. After abdominal decompression, lactic acid level, APACHE II score and bladder pressure decreased significantly (P<0.01), while cardiac ejection fraction increased significantly (P<0.01).Conclusion Abdominal decompression by ascites drainage under bladder pressure monitoring can effectively improve tissue perfusion and cardiac ejection function, and prevent the deterioration of disease. This method is convenient, safe and able to be widely used for clinical application.
    Expression of toll-like receptor 3 and 4 in peripheral blood mononuclear cells from patients with hepatitis B virus -related acute-on-chronic pre-liver failure
    SU Jin-liang, CHEN Hui, ZHU Li, LU Min-Jia, LI Ming
    2019, 24(5):  499-502. 
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    Objective To investigate the changes and significance of the expression level of toll-like receptor 3 (TLR3) and toll-like receptor 4 (TLR4) in peripheral blood mononuclear cells (PBMC) from patients with hepatitis B virus (HBV)-related acute-on-chronic pre-liver failure (pre-ACLF).Methods The expression of TLR3 and TLR4 in PBMC from 30 patients with pre-ACLF, 30 patients with chronic hepatitis B (CHB) and 15 healthy controls was detected by flow cytometry. Meanwhile, the diagnostic value of TLR3 and TLR4 in pre-ACLF was evaluated by the receiver operating characteristic (ROC) curves.Results The levels of TLR3 and TLR4 from PBMC in pre-ACLF group were significantly higher than those in CHB and control groups (P<0.05). The area under ROC curves of TLR3 and TRL4 were 0.830 (95% confidence interval: 0.728 ~ 0.932) and 0.977 (95% confidence interval: 0.948 ~ 1.000), respectively.Conclusion Detection the levels of TLR3 and TLR4 may contribute to the diagnosis of HBV-related pre-ACLF.
    Comparison of the effects of tenofovir and telbivudine combined with dual immunization regimen on blocking mother-to-child transmission of HBV during pregnancy
    CAO Xiang-yun, Guan Yan-ping, LI Qian, ZHOU Xiao-min, LIU Gao-wei
    2019, 24(5):  503-506. 
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    Objective To compare the blocking effects of tenofovir and telbivudine combined with dual immunization regimen on maternal-fetal transmission of hepatitis B virus (HBV) during pregnancy.Methods A total of 82 HBV-infected pregnant women admitted to our hospital from January 2016 to July 2018 were randomly divided into tenofovir group and telbivudine group, 41 cases each. The 2 groups started taking drugs at 28 weeks of gestation, the tenofovir group receiving tenofovir 300 mg once daily, the telbivudine group receiving telbivudine 600 mg once daily. Breastfeeders stopped medication after delivery, and those who did not breastfeed were given medication until 4 weeks after delivery. Both 2 groups of infants were injected with hepatitis B immunoglobulins and hepatitis B vaccines. The serum alanine aminotransferase (ALT) and HBV DNA levels of the pregnant women 1 day before taking medication and within 3 days before delivery, the hepatitis B surface antigen (HBsAg) positive rate, hepatitis B e antigen (HBeAg) positive rate, incidence of HBV DNA ≥100 IU/mL of the infants at birth and 1 year after birth, pregnancy outcomes and adverse reactions were compared between the 2 groups.Results The serum ALT and HBV DNA levels within 3 days before delivery were significantly lower than 1 day before taking medication in both groups (P<0.05). The serum ALT and HBV DNA levels in the tenofovir group within 3 days before delivery were significantly lower than those in the telbivudine group (32.65 ± 6.91 vs 43.25 ± 7.11 U/L, 2.89 ± 0.56 vs 3.67 ± 0.67 IU/mL, P<0.05). There were no significant differences in HBsAg positive rate, HBeAg positive rate or incidence of HBV DNA≥100 IU/ml between the 2 groups at birth or 1 year after birth (P>0.05). No abortion, postpartum hemorrhage, liver or kidney dysfunction were observed during the treatment in the 2 groups. There were no significant differences in the incidence rates of premature delivery, cesarean section, fetal malformation, maternal anemia, pregnancy-induced hypertension and maternal high serum bile acid between the 2 groups (P>0.05).Conclusion Both tenofovir and telbivudine combined with dual immunization regimen can effectively inhibit HBV replication, reduce serum viral load and block HBV mother-to-child transmission. The former has higher clinical value, which has stronger inhibitory effect on HBV and is beneficial to improve liver function.
    The diagnostic value of combined determining of serum AFP and DCP on early detection of HCC
    ZHOU Yu-chen, YUAN Guo-sheng, HU Cheng-guang, LIU Jun-wei, REN Yan-yu, TANG Cui-rong, YU Yue-cheng, YANG Ding-hua
    2019, 24(5):  507-509. 
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    Objective To evaluate the sensitivity and specificity of combined detection of alpha-fetoprotein (AFP) and decarboxylprothrombin (DCP) for the diagnosis of hepatocellular carcinoma (HCC).Methods 75 patients with HCC and 53 patients without HCC were selected as study subjects. Serum AFP and DCP levels were measured simultaneously. The receiver operating characteristic curves (ROC) curves of AFP, DCP and their combined detection were plotted to calculate and evaluate the best serological markers for the diagnosis of HCC.Results The area under the ROC curve for AFP and DCP diagnosis of HCC was 0.789 and 0.882, respectively. When the diagnostic threshold of AFP was reduced to 22.6 ng/mL, the corresponding diagnostic efficiency was the best (sensitivity was 66.7%, specificity was 88.7%); The optimum critical value of DCP for the diagnosis of HCC was 39.0 mAu/ml, the corresponding sensitivity was 72.0% and the specificity was 94.3%. The sensitivity and specificity of combined detection of AFP and DCP for the diagnosis of HCC were 77.3% and 90.6% respectively.Conclusion DCP has important value for the differential diagnosis of HCC. Lowering the AFP diagnostic threshold accompanied with DCP detection can improve the identification rate of HCC.
    Effects of Emodin on Hepatocyte Injury and Hepatic Inflammation in NASH Rats Based on SIRT3/FXO1 Signaling Pathway
    KOU Xiao-ni, XIE Xing-ke, HAO Ming-xia, WU Wei, BIAN Qian, MA Wen-jun
    2019, 24(5):  510-514. 
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    Objective To investigate the effects of emodin on hepatocyte injury and hepatic inflammation in non-alcoholic steatohepatitis (NASH) rats based on Sirtuin 3 (SIRT3)/forkhead box O1 (FOXO1) signaling pathway.Methods A total of 100 Sprague-Dawley rats were randomly divided into 5 groups, including control group, model group, low-, medium- and high-dose emodin groups. NASH models were established by feeding high-fat diets for 12 weeks. And then 3 emodin groups received the corresponding treatments, while the control group and model group were given the same volume of normal saline. At the end of the experiment, hepatic steatosis, inflammation, ballooning degeneration and nonalcoholic fatty liver disease activity score (NAS) were evaluated, and many other indexes were detected, including levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), messenger ribonucleic acid, expression of SIRT3, FOXO1, caspase-3, caspase-6, and caspase-9 in rat liver tissues.Results The scores of steatosis, inflammation and ballooning degeneration, NAS, levels of AST, ALT, TNF-α, IL-6, caspase-3, caspase-6, and caspase-9 in 3 emodin groups were lower than those in model group. With the increase of the dosage of emodin in each dose group, the scores and levels gradually decreased. While the mRNA and protein levels of SIRT3 and FOXO1 in 3 emodin groups were higher than those in model group. The higher dose emodin the rats had received, the higher the expression levels of SIRT3 and FOXO1 became. Furtheremore, all the parameters changed in a dose-dependent manner (P<0.05).Conclusion Emodin reduce the hepatic inflammation and hepatocyte apoptosis, and alleviate hepatocytes injury in NASH rats through increasing the expression of SIRT3 and FOXO1.
    Expression and significance of BATF in nonalcoholic steatohepatitis
    TANG Ying-yue, LI Jing, LEI Xiao-hong, LI Chun-min, ZENG Min-de, MAO Yi-min
    2019, 24(5):  515-518. 
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    Objective To investigate the expression of BATF in liver and explore its relationship with nonalcoholic steatohepatitis (NASH) progression by using NASH mouse model induced by a methionine-choline-deficient (MCD) diet.Methods C57BL/6 mice were given MCD diets for 8 weeks to establish NASH models. The expression of BATF in liver macrophage was detected by quantitative real-time polymerase chain reaction, immunohistochemistry and flow cytometry.Results Compared with non-specific control (NC) group, the messenger ribonucleic acid expression level of BATF and proinflammatory cytokines,such as tumor necrosis factor-α and interleukin-1β in MCD group, were significantly up-regulated. Besides, BATF was mainly expressed in the nuclei of inflammatory interstitial cells in MCD group. The proportion of F4/80-positive Kupffer cells in MCD group was significantly higher than that in NC group, which was mainly cluster of differentiation 11c-positive M1 Kupffer cells. BATF expression was significantly positively correlated with levels of alanine aminotransferase and aspartate aminotransferase, steatosis, lobular inflammation, ballooning and nonalcoholic fatty liver disease active score.Conclusion BATF is involved in the progression of NASH and might has a potential value in predicting the progress of NASH.