Table of Content

31 July 2016, Volume 21 Issue 7

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Original Articles

Efficacy and predictive factors of sequential-combination therapy of Peglyated interferon followed with nucleoside analogues for HBeAg positive chronic hepatitis B patients

CHEN Lu, ZHOU Hui-juan, GUO Si-min, ZHAO Gang-de, MO Rui-dong, GUO Qing, TANG Wei-liang, CAI Wei, WANG Hui, XIE Qing

2016, 21(7):  528-531. 

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Objective To investigate the efficacy and predictive factors of sequential-combination therapy based on respond guided treatment (RGT) for the Peg-IFN-α treated HBeAg positive chronic hepatitis B (CHB) patients.Methods According to the 24-week treatment results, 87 patients who received Peg-IFN-α as their initial treatment were divided into four groups to receive different treatments. In patients with early response (group a), Peg-IFN-α treatment was extended to 48 weeks. Among patients with non-early response (NER), 20 patients remained on Peg-IFN-α monotherapy for another 24 weeks (group b), 17 received Peg-IFN-α monotherapy up to totally 96 weeks (group c) and 25 received entecavir (ETV) added onging Peg-IFN-α therapy up to totally 96 weeks (group d).Results The reductions of HBsAg and HBV DNA were more obvious in a and d group than those in b and c group, respectively ( a versus b, P=0.0194, 0.041 and d versus c, P= 0.0008, 0.0035). At the endpoint of patients with 96-weeks treatment (group c and d), the rates of HBsAg (less than 1000 IU/mL) and HBeAg loss were significantly higher than those in group B (P=0.0384). Moreover, HBeAg decreased more obviously in group d than that in group c, with no statistically significance in HBeAg loss and seroconversion. Baseline HBsAg level was speculated to be a predictive factor for the efficiency, because patients with HBsAg ≥ 1500 IU/mL achieved more HBV DNA loss and HBeAg decrease in group d than those in group c (P=0.0228 and 0.0237).Conclusion Sequential and combining treatment could make patients achieve more HBsAg and HBV DNA loss, with no significant difference in HBeAg loss or serum conversion. Meanwhile, 96-week Peg-IFN-α monotherapy or sequential Peg-IFN-α plus ETV therapy could lead to more HBeAg loss, and we further demonstrate that the baseline level of HBsAg would be an important predict factor for the efficacy.

Effect of percutaneous transhepatic variceal embolization and partial splenic embolization on acute gastrointestinal hematorrhea caused by portal hypertension

LIU Xiao-liang

2016, 21(7):  532-535. 

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Objective To investigate the effect of percutaneous transhepatic variceal embolization (PTVE) combined with partial splenic embolization (PSE) on acute gastrointestinal hematorrhea caused by portal hypertension.Methods One hundred and twenty-four patients with acute gastrointestinal hematorrhea caused by portal hypertension in our hospital from August 2012 to March 2014 were retrospectively analyzed. Fifty-nine patients merely received PTVE in control group, while sixty-five patients received PSE after PTVE in treatment group. Portal venous pressure, postoperative complications, rebleeding rate (6-month, 12-month, 18-month) and 1-year mortality were compared between the two groups.Results Compared to pre-operation, the portal venous pressure significantly increased in control group (t=0.195, P=0.846), but significantly decreased (t=5.182, P<0.01) in treatment group after operation. Comparing with control group, treatment group showed significantly higher postoperative hospital days (t=2.909, P=0.004), and significantly lower postoperative complications, rebleeding rate (6-month, 12-month, 18-month) and 1-year mortality (χ²=32.887, P<0.01, χ²=5.740,7.986,19.569, P<0.05 and χ²=5.673, P<0.05), respectively.Conclusion Sequential combination therapy of PTVE with PSE brings obvious advantage of easy operation and minimal wound during operation. For patients with acute gastrointestinal hematorrhea caused by portal hypertension, it has not only shown good performance on hemostasis, but also decreased the portal venous pressure and rebleeding rate after operation.

Clinical value of autoimmune antibody detection for diagnosis of drug-induced liver injury

LU Ren-jie, TANG Feng-lei, ZHENG Zhong-wei, ZHU Shan-mei

2016, 21(7):  536-538. 

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Objective To investigate the clinical significance of autoimmune antibody (AA) detection in the differential diagnosis of drug-induced liver injury (DILI), and its positive rate among different patients of DILI.Methods Clinical data of patients with primary diagnosis of DILI, including age, gender, disease onset time, AA, liver function index, varieties of hepatotoxic drugs, was collected for correlation analysis with AA positive rate.Results There were no differences in AA positive rate among different clinical types in respect of gender, age, liver injury type and Child score , and so on. However, AA positive rate showed positive correlation with Child score. Patients with medication time ≥ 30 days had significantly higher positive rate of AA than those with medication time < 30 days.Conclusion For DILI patients, the positive rate of AA had a positive correlation with the medication time, which suggested that AA detection might have significant referential value for abnormal liver function patients with prolong medication, but not differential diagnosis of western or Chinese drugs-induced liver injury.

Epidemiology analysis of relationship between Fibrotouch tests and demographic features in chronic hepatopathy patients

YE Pei-yan, LU Yun-fei, CHEN Xiao-rong, YANG Zong-guo

2016, 21(7):  539-541. 

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Objective To analyze the relationship between Fibrotouch tests and demographic features in chronic liver diseases.Methods Demographic features of chronic hepatopathy patients, including gender, age and body mass index (BMI), and parameters of Fibrotouch tests were collected and statistically analyzed.Results Compared to the male, female patients had significantly lower liver stiffness and fat attenuation (all P<0.001). Age, BMI and fat attenuation were positively associated with liver stiffness, with Spearman’s correlation coefficient as 0.301, 0.187 and 0.107, respectively (all P<0.001). Additionally, age and BMI were statistically positively related with fat attenuation, with Spearman’s correlation coefficient as 0.121 and 0.695, respectively (all P<0.001).Conclusion Age, gender and BMI were associated with Fibrotouch results, which might help Fibrotouch in diagnosis of chronic liver diseases.

SLCO1B1 and SLCO1B3 gene mutations in a Chinese boy with Rotor syndrome: a case report

ZHANG Zhi-hua, ZHENG Bi-xia, LI Mei, JIN Yu, LIN Qian

2016, 21(7):  542-544. 

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Objective To investigate the SLCO1B1 and SLCO1B3 gene mutations and clinical features in a Chinese patient with Rotor syndrome.Methods The clinical data of the patient was collected. Genomic DNA was extracted from peripheral white blood cells and subjected for second-generation sequencing to screen 4000 known genes for single genetic diseases. Then the detected mutations were confirmed by Sanger sequencing analysis.Results The main clinical manifestations were recurrent yellowish skin and sclera. Laboratory examinations showed as hyperbilirubinemia with both direct and indirect bilirubin elevating. SLCO1B1 gene c.1738 C>T homozygous mutation and SLCO1B3 gene c.360_481 del homozygous mutation were found by high throughput sequencing. C.1738 C>T mutation, a nonsense mutation reported in references, was speculated to causes the conversion of 580th amino acid codons from arginine to a stop codon in protein. And C.360_481 del mutation was a frameshift mutation that caused the nucleotide deletion from 360 th to 481 th in the protein coding region, but it was neither reported in the references nor recorded in SNP database. The frameshift caused deletion of 40 amino acids and code shifting of open reading frame, which might lead to the protein function loss.Conclusion SLCO1B1 and SLCO1B3 gene mutations result in dysfunction of organic anion transporting polypeptide OATP1B and OATP1B3, which is the molecular genetics foundation in the case of Rotor syndrome. This is the first report of Rotor syndrome with SLCO1B1 and SLCO1B3 gene mutations analysis in Chinese population.

Effect of cyclin dependent kinase submit 1 on proliferation of hepatocellular carcinoma(HCC) BEL-7405 cells

JIN Yu-ting, ZHANG Jiang, WU Hao-yu, XIA Qiang

2016, 21(7):  545-548. 

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Objective To investigate the expression of cyclin dependent kinase submit 1 (CKS1) in hepatocellular carcinoma (HCC) and its effect on the proliferation of HCC cell line, BEL-7405.Methods The expression of CKS1 in 65 pairs of HCC tissues and normal tissues was measured by immunohistochemistry (IHC). Meanwhile, the expression of CKS1 in 7 different HCC cell lines and normal liver cell line was analyzed by western blot. Furthermore, a small interfering RNA (siRNA) targeting CKS1 was constructed and transfected into human HCC cells BEL-7405. The effects of CKS1 knockdown on cell proliferation and gene expression were assessed by CCK-8 assay, tablet cloning assay and western blot analysis, respectively.Results CKS1 expression was extremely higher in HCC tissue than that in normal liver tissue (P<0.05). Proliferation of siRNA-transfected BEl-7405 cells (siRNA-transfected group) was extremely inhibited comparing to that of negative control or blank group (P<0.05).Conclusion The expression of CKS1 in HCC tissues and cell lines was significantly higher than that normal liver tissue or cell line, respectively. Additionally, CKS1 plays an important role in proliferation of BEL-7405 HCC cell lines, which might be a novel anti-tumor target for HCC.