Table of Content

30 November 2016, Volume 21 Issue 11

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Original Articles

Clinical analysis of 20 cases with gynura segetum-induced hepatic sinusoidal obstruction syndrome

XU Jing, ZHENG Wen-kai, LI Ping, SHENG Yun-feng, XIE Fang, DONG Yuan, YU Yue-cheng, WANG Mao-rong

2016, 21(11):  905-907. 

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Objective To investigate the clinical features, diagnostic methods and treatments of hepatic sinusoidal obstruction syndrome (HSOS) induced by gynura segetum. Methods In this retrospective cohort study, clinical data of 20 gynura segetum-induced HSOS patients from November 2011 to December 2015 in our hospital was collected. Results Most patients were the elderly, and developed in subacute onset within 4 months since receiving gynura segetum. Among all 20 cases, initial symptom was abdominal distension, and results of abdominal CT or MRI examination showed map-like density changes with narrowing or invisible hepatic veins. There was 1 case occurred with hepatomegaly and no ascites, while the other 19 cases had ascites. It showed no significant difference in liver injury between patients with or without drinking history. All patients received clinical therapy after hospitalized, 1 case was cured, and 7 cases were improved including 2 received transjugular intrahepatic portosystemic shunt. Conclusion Gynura segetum can cause HSOS, which shows characteristic performance in CT or MRI and can be improved by early anticoagulation and microcirculation therapy. Furthermore, hepatotoxicity of gynura segetum deserves more attention.

Indocyanine green test in evaluating liver reserve function and its prognostic value in patients with HBV-related liver diseases

LAI Rui-min, WU Yin-lian, DONG Jing, ZHU Yue-yong

2016, 21(11):  908-910. 

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Objective To investigate the accessing value of indocyanine green clearance test for liver functional reserve in patients with hepatitis B virus (HBV)-related liver diseases and its clinical significance. Methods Assessment of indocyanine green retention rate at 15 minutes (ICG R15) was carried out in 56 patients with chronic hepatitis B (CHB) and 144 patients with HBV-related cirrhosis, which were compared by t-test. In addition, the spearman correlation test was used to analyze the relationship among ICGR15, model for end-stage liver disease score (MELD) and Child-Turcotte-Pugh (CTP) class in cirrhosis patients. Finally, the area under the receiver operating characteristic (ROC) curve of ICG R15 and MELD score were calculated to compare their performance in assessing liver functional reserve. Results A total of 200 patients were enrolled, including 127 males and 73 females with mean age of 43±8.1 years. ICG R15 of 144 cirrhosis patients was 2.40%~60.00% with average value of 22.80±16.00, which was significantly higher than 1.40%~9.50% with average value of 4.43±2.19 in CHB patients. Among these patients, there were 70 in class A with MELD score of 4.99±2.76, 56 in class B with MELD score of 6.24±4.69 and 20 in class C with MELD score of 11.71±3.77. In terms of liver reserve function, ICG R15 showed positive correlation with MELD score and CTP class (r=0.414, r=0.67, P<0.01). AUC for ICG R15 and MELD were 0.903 and 0.634 in assessing prognosis of cirrhosis patients, respectively. Conclusion Indocyanine green clearance test could dynamically assess liver functional reserve, and its combination with MELD score could better reflect liver function and assess prognosis.

Expressions of PD and PD-L 1 in liver tissues of patients with autoimmune hepatitis and their clinic correlation

KE Kun-yu, WEI Da-hai, CHEN Li-fang, KONG Jin-feng, SUN Fang, XIONG Ke-gong

2016, 21(11):  911-914. 

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Objective To investigate the expressions of programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) in hepatic tissues of patients with autoimmune hepatitis (AIH), and to explore their roles in the pathogenesis of AIH. Methods The expressions of PD-1 and PD-L1 in hepatic tissues from 43 AIH patients and 9 healthy controls were detected by immunohistochemistry combined with computer image quantitative analysis. Results The PD-1 and PD-L1 expressions in hepatic tissues of AIH patients were 10.12±5.31% and 7.45±4.29%, respectively, which were significantly higher than those in controls (1.74±0.37% and 1.48±0.32%, respectively). The expressions of PD-1 and PD-L1 in hepatic tissues of AIH patients at active stage were 15.68±6.31% and 7.45±4.29%, respectively, which were higher than those in AIH patients in remission (6.24±3.25% and 4.78±2.43%, respectively) and healthy controls (1.74±0.37% and 1.48±0.32%, respectively). Conclusion PD-1 and PD-L1 are overexpressed in hepatic tissues of AIH patients, which reveals that PD-1 and its ligand might play an important role in the pathogenesis of AIH.

Correlation analysis between parameter of platelet in peripheral blood and liver pathological of patients with chronic hepatitis B

OU Hong-jie, PAN Ye, LIU Jia-jun, WU Xiao-lu

2016, 21(11):  915-919. 

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Objective To explore the value of platelet parameters in peripheral blood during the noninvasive assessment of liver pathology in patients with CHB. Methods A total of 787 patients with CHB were enrolled in the study. All the patients were undergone blood routine test examination and liver biopsy. The platelet parameters in peripheral blood were recorded at the same time. Apply SPSS 19.0 statistical software for data analysis. Categorical data were analyzed by Chi-square test.Normal distribution measurement data were analyzed by t-test. The relationship between the platelet parameters and the degree of liver pathology was calculated by Spearman correlation analysis and Logistic regression analysis. Results There were significant differences between different genders concerning the degree of liver pathology inflammation and fibrosis (P<0.01); similar difference existed among patients with different age groups (P=0.037, 0.01). Platelet parameters including PLT, MPV, PDW were significantly different among patients with different degree of liver pathology(t=-5.993,3.208,-3.344 and -6.955,5.812,-6.503,P<0.05). PLT, PCT, PDW were negatively related to(r=-0.37, -0.16, -0.25, P<0.01),and MPV was positively related to(r=0.22,P<0.01) the degree of liver inflammation; PLT, PCT, PDW were negatively related to the degree of liver fibrosis (r=-0.37, -0.15, -0.17,P<0.01),while MPV was positively related to it(r=0.22,P<0.01). Logistic multivariate regression analysis indicated that PLT(OR:0.987, P=0.008), PDW(OR:0.833, P=0.01)were independent predictors for the degree of liver inflammation; age (OR:1.017, P=0.049)、PLT(OR:0.989, P<0.01)、PDW(OR:0.801, P<0.01) were independent predictors for the degree of liver fibrosis. Conclusion There is a certain correlation between platelet parameters in peripheral blood and the liver pathology in patients with CHB includingthe degree of inflammation and fibrosis. They can be applied as an easy and useful method to assess the degree of liver pathology.

Clinical significances and expressions of prohibitin in patients with hepatocellular carcinoma

SHI Juan-juan, YANG Ning, WU Feng-ping, YANG Ying, LI Mei, ZHANG Xin, JIA Xiao-li, YIN Jia-feng, DANG Shuang-suo

2016, 21(11):  920-923. 

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Objective To investigate serum and tissue expressions and the clinical significances of prohibitin in patients with hepatocellular carcinoma (HCC). Methods Serum PHB levels in 82 HCC patients and 82 healthy individuals were determined by ELISA assay. The expression of PHB in the 30 pairs of HCC tissues, paracancerous tissues and normal tissues were detected by real-time PCR and immunohistochemistry assay. The clinical data were collected to determine thecorrelation between PHB and clinical features. Results Serum PHB protein level in HCC patients was significantly increased when compared with healthy individuals group (227.97 vs. 55.78 pg/mL, Z= -4.532, P=0.000). The expression of PHB in HCC patients had positive correlation with alanine aminotransferase (ALT, r=0.337, P=0.034), total bilirubin (TBil, r=0.431, P=0.006) and AFP (r=0.319, P=0.045). The positive rate of PHB in HCC tissues and paracancerous tissues were 73.3% and 86.7% that were significantly higher thanthat of the normal tissues, respectively. The PHB mRNA expression in HCC tissues and paracancerous tissues were also higher than that of the normal tissues. The expression of PHB in HCC patients had correlation with differentiation grade, TNM stage and AFP. Conclusion PHB is overexpressed in HCC patients tissues and serum and correlated with the degree of liver injury and tumor malignancy, indicating that PHB may be involved in the occurrence and progression of HCC.

The efficiency of magnetic bead adsorption for quantitative detection of hepatitis B virus DNA

ZHANG Cheng, WANG Yu, NIE Leng, MA Hong

2016, 21(11):  924-927. 

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Objective To establish a magnetic bead adsorption method to quantitatively detect hepatitis B virus (HBV) DNA, and to evaluate its efficiency. Methods Serum template of 10⁷ IU/ml HBV virus was diluted into different concentrations as serum standard panels (theoretical value), HBV DNA in which were extracted by our magnetic bead adsorption method (reagent 1), domestic automatic nucleic acids extraction with magnetic beads (reagent 2) and boiling method (reagent 3), respectively. Comparisons in extraction efficiency among those 3 methods were carried out by analyzing sensitivity, quantitative linear relationship and stability. Results Theoretical value of lower HBV DNA detection limit was 10¹ IU/mL, and the extraction results were 3.520×10¹ IU/mL by reagent 1, 9.123×10³ IU/mL by reagent 2 and 6.195×10¹ IU/mL by reagent 3. Correlation analysis between extraction results and theoretical values showed r values as 0.986 (reagent 1, P<0.001), 0.950 (reagent 2, P=0.001) and 0.979 (reagent 3, P<0.001), respectively, which revealed statistically significant differences. Average relative deviations of the 3 methods were 0.243±0.405 (reagent 1), 1.189±0.855 (reagent 2), -0.439±0.618 (reagent 3), respectively. In addition, the average relative deviation of reagent 1 for same sample at different times was 0.505±0.659. Conclusion Magnetic bead adsorption method for HBV DNA extraction has good sensitivity, quantitative linear relationship, stability and accuracy, which might be a reliable method for the quantitative detection of HBV DNA.