Background and Aims:To investigate the safety and efficacy of double plasma molecular adsorption system(DPMAS)with sequential low-dose plasma exchange(LPE)in treating early hepatitis B virus-related acute-on-chronic l...Background and Aims:To investigate the safety and efficacy of double plasma molecular adsorption system(DPMAS)with sequential low-dose plasma exchange(LPE)in treating early hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods:Clinical data of patients with HBVACLF were prospectively collected,including patients in a DPMAS with sequential LPE(DPMAS+LPE)group and those in a standard medical treatment(SMT)group.The primary endpoint was death or liver transplantation(LT)at 12 weeks of follow-up.Propensity-score matching was performed to control the effects of confounding factors on prognosis between the two groups.Results:After 2 weeks,total bilirubin,alanine aminotransferase,blood urea nitrogen levels,and Chinese Group on the Study of Severe Hepatitis B score,were significantly lower in the DPMAS+LPE group than those in the SMT group(p<0.05).After 4 weeks,laboratory parameters of the two groups were similar.The cumulative survival rate of the DPMAS+LPE group was significantly higher than that of the SMT group at 4 weeks(97.9%vs.85.4%,p=0.027),but not at 12 weeks(85.4%vs.83.3%,p=0.687).Cytokine levels were significantly lower in 12-week survival group than in the death-or-LT group(p<0.05).Functional enrichment analysis showed that downregulated cytokines were mainly involved in positive regulation of proliferation and activation of lymphocytes and monocytes,regulation of immune effect response,regulation of endotoxin response,and glial cell proliferation.Conclusion:DPMAS+LPE significantly improved the 4-week cumulative survival rate,and ameliorated the inflammatory response in patients.DPMAS+LPE may be a promising modality for patients with early HBV-ACLF.展开更多
Hepatitis E is a globally distributed infection that varies in seroprevalence between developed and developing regions.In the less developed regions of Asia and Africa,a high seropositivity rate has been reported for ...Hepatitis E is a globally distributed infection that varies in seroprevalence between developed and developing regions.In the less developed regions of Asia and Africa,a high seropositivity rate has been reported for hepatitis E virus(HEV)antibodies.Although acute hepatitis E is often self-limited and has a favorable prognosis,some populations experience severe manifestations,which may progress to liver failure.Moreover,some immunocompromised patients are at risk of developing chronic HEV infection and cirrhosis.Proactive screening,reducing misdiagnosis,improving patient management,timely anti-viral therapy for severe and chronic cases,and vaccination of high-risk groups are important measures to reduce the morbidity of hepatitis E.This review focused on the clinical presentation,management,and prevention of hepatitis E.展开更多
Background and Aims:The safety and efficacy of mesenchymal stem cells(MSCs)in the treatment of acute-onchronic liver failure(ACLF)have been validated.However,the impact of the pathological ACLF microenvironment on MSC...Background and Aims:The safety and efficacy of mesenchymal stem cells(MSCs)in the treatment of acute-onchronic liver failure(ACLF)have been validated.However,the impact of the pathological ACLF microenvironment on MSCs is less well understood.This study was designed to explore the changes in the functional properties of MSCs exposed to ACLF serum.Methods:MSCs were cultured in the presence of 10%,30%and 50%serum concentrations from ACLF patients and healthy volunteers.Then,the cell morphology,phenotype,apoptosis and proliferation of MSCs were evaluated,including the immunosuppressive effects.Subsequently,mRNA sequencing analysis was used to identify the molecules and pathways involved in MSC functional changes in the context of ACLF.Results:In the presence of ACLF serum,MSC morphology significantly changed but phenotype did not.Besides,MSC proliferation activity was weakened,while the apoptosis rate was lightly increased.Most importantly,the immunosuppressive function of MSCs was enhanced in a lowconcentration serum environment but transformed into a proinflammatory response in a high-concentration serum environment.RNA sequencing indicated that 10%serum concentration from ACLF patients mediated the PI3K-Akt pathway to enhance the anti-inflammatory effect of MSCs,while the 50%serum concentration from ACLF patients promoted the conversion of MSCs into a proinflammatory function by affecting the cell cycle.Conclusions:The 50%ACLF serum concentration is more similar to the environment in the human body,which means that direct peripheral blood intravenous infusion of MSCs may reduce the effect of transplantation.Combining treatments of plasma exchange to reduce harmful substances in serum may promote MSCs to exert a stronger anti-inflammatory effect.展开更多
Fabricating surface oxygen vacancies is considered to be an efficient method to improve the adsorption performance of sorbents.In this work,a bismuth oxychloride/biochar(BiOCl/BC)nanocomposite with abundant oxygen vac...Fabricating surface oxygen vacancies is considered to be an efficient method to improve the adsorption performance of sorbents.In this work,a bismuth oxychloride/biochar(BiOCl/BC)nanocomposite with abundant oxygen vacancies was successfully prepared by a facile ball milling method.BiOCl/BC nanocomposite was found to have excellent adsorption performance for removing reactive red-120(RR120)from aqueous solution.The effects of key adsorption parameters,such as RR120 dye concentration,solution pH(2-10),and contact time were studied by batch adsorption test.The adsorption data were well described by the Langmuir and Freundlich isotherms and pseudo-second-order kinetic models.The 50%-BiOCl/BC(50 wt%of BiOCl in composite)exhibited the best adsorptive performance(60%),much better than the pristine BM-BC(20%).The high adsorption capacity of 50%-BiOCl/BC(Langmuir maximum capacity of 116.382 mg g^(−1))can be attributed to the electrostatic effect,π-πinteractions,and hydrogen bond.This work provided a facile method to prepare semiconductor assisted biochar-based adsorbents,which would also contribute to the advance of environmental remediation.展开更多
基金This study was supported by grants from the National major science and technology project for the prevention and treatment of AIDS and viral hepatitis(2018ZX10302204-002-002 to LP,2018ZX10302205-002 to CX)Natural Science Foundation of China(No.81873572 to LP,82070611 to LP)+3 种基金Guangzhou Science and Technology Plan Projects(201904010442 to CX,202102010204 to LP)Guangdong Science and Technology Plan Projects(2020A1515010317 to CX)Sun Yat-Sen University Clinical Research 5010 Program(2018009 to CX,2020007 to LP)the Five-Year Plan of Third Affiliated Hospital of Sun Yat-Sen University(K00006 to LP).
文摘Background and Aims:To investigate the safety and efficacy of double plasma molecular adsorption system(DPMAS)with sequential low-dose plasma exchange(LPE)in treating early hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF).Methods:Clinical data of patients with HBVACLF were prospectively collected,including patients in a DPMAS with sequential LPE(DPMAS+LPE)group and those in a standard medical treatment(SMT)group.The primary endpoint was death or liver transplantation(LT)at 12 weeks of follow-up.Propensity-score matching was performed to control the effects of confounding factors on prognosis between the two groups.Results:After 2 weeks,total bilirubin,alanine aminotransferase,blood urea nitrogen levels,and Chinese Group on the Study of Severe Hepatitis B score,were significantly lower in the DPMAS+LPE group than those in the SMT group(p<0.05).After 4 weeks,laboratory parameters of the two groups were similar.The cumulative survival rate of the DPMAS+LPE group was significantly higher than that of the SMT group at 4 weeks(97.9%vs.85.4%,p=0.027),but not at 12 weeks(85.4%vs.83.3%,p=0.687).Cytokine levels were significantly lower in 12-week survival group than in the death-or-LT group(p<0.05).Functional enrichment analysis showed that downregulated cytokines were mainly involved in positive regulation of proliferation and activation of lymphocytes and monocytes,regulation of immune effect response,regulation of endotoxin response,and glial cell proliferation.Conclusion:DPMAS+LPE significantly improved the 4-week cumulative survival rate,and ameliorated the inflammatory response in patients.DPMAS+LPE may be a promising modality for patients with early HBV-ACLF.
基金supported by grants from the Natural Science Foundation of China(No.82070611)Natural Science Foundation of Guangdong Province(2020A1515010317)+5 种基金Guangdong Basic and Applied Basic Research Foundation(No.21202104030000608 and 2021A1515220029)Guangzhou Science and Technology Plan Projects(No.202102010204 and 2023B03J1287)Guangzhou Science and Technology Program Key Projects(No.2023B01J1007)Sun Yat-sen University Clinical Research 5010 Program(No.2020007 and 2018009)Transformation of Scientific and Technological Achievements Project of Sun Yat-sen University(No.82000-18843236)the Five-Year Plan of the Third Affliated Hospital of Sun Yat-sen University(No.K00006 and P02421).
文摘Hepatitis E is a globally distributed infection that varies in seroprevalence between developed and developing regions.In the less developed regions of Asia and Africa,a high seropositivity rate has been reported for hepatitis E virus(HEV)antibodies.Although acute hepatitis E is often self-limited and has a favorable prognosis,some populations experience severe manifestations,which may progress to liver failure.Moreover,some immunocompromised patients are at risk of developing chronic HEV infection and cirrhosis.Proactive screening,reducing misdiagnosis,improving patient management,timely anti-viral therapy for severe and chronic cases,and vaccination of high-risk groups are important measures to reduce the morbidity of hepatitis E.This review focused on the clinical presentation,management,and prevention of hepatitis E.
基金This study was supported by grants from the Natural Science Foundation of China(No.82070611 and 81873572)National Major Science and Technology Project for the Prevention and Treatment of AIDS and Viral Hepatitis(No.2018ZX10302204002 and 2018ZX10302205-002)+3 种基金Guangzhou Science and Technology Plan Projects(No.201904010442)Sun Yatsen University Clinical Research 5010 Program(No.2018009)Research Project on Degree and Postgraduate Education Reform in Guangdong Province(No.2018JGXM04)Young Teacher Training Program of Sun Yat-sen University(No.16ykpy40).
文摘Background and Aims:The safety and efficacy of mesenchymal stem cells(MSCs)in the treatment of acute-onchronic liver failure(ACLF)have been validated.However,the impact of the pathological ACLF microenvironment on MSCs is less well understood.This study was designed to explore the changes in the functional properties of MSCs exposed to ACLF serum.Methods:MSCs were cultured in the presence of 10%,30%and 50%serum concentrations from ACLF patients and healthy volunteers.Then,the cell morphology,phenotype,apoptosis and proliferation of MSCs were evaluated,including the immunosuppressive effects.Subsequently,mRNA sequencing analysis was used to identify the molecules and pathways involved in MSC functional changes in the context of ACLF.Results:In the presence of ACLF serum,MSC morphology significantly changed but phenotype did not.Besides,MSC proliferation activity was weakened,while the apoptosis rate was lightly increased.Most importantly,the immunosuppressive function of MSCs was enhanced in a lowconcentration serum environment but transformed into a proinflammatory response in a high-concentration serum environment.RNA sequencing indicated that 10%serum concentration from ACLF patients mediated the PI3K-Akt pathway to enhance the anti-inflammatory effect of MSCs,while the 50%serum concentration from ACLF patients promoted the conversion of MSCs into a proinflammatory function by affecting the cell cycle.Conclusions:The 50%ACLF serum concentration is more similar to the environment in the human body,which means that direct peripheral blood intravenous infusion of MSCs may reduce the effect of transplantation.Combining treatments of plasma exchange to reduce harmful substances in serum may promote MSCs to exert a stronger anti-inflammatory effect.
基金the National Natural Science Foundation of China(11864024)Jiangxi Provincial Natural Science Foundation(20202BABL214025,20202BABL214010,20212BAB214034).
文摘Fabricating surface oxygen vacancies is considered to be an efficient method to improve the adsorption performance of sorbents.In this work,a bismuth oxychloride/biochar(BiOCl/BC)nanocomposite with abundant oxygen vacancies was successfully prepared by a facile ball milling method.BiOCl/BC nanocomposite was found to have excellent adsorption performance for removing reactive red-120(RR120)from aqueous solution.The effects of key adsorption parameters,such as RR120 dye concentration,solution pH(2-10),and contact time were studied by batch adsorption test.The adsorption data were well described by the Langmuir and Freundlich isotherms and pseudo-second-order kinetic models.The 50%-BiOCl/BC(50 wt%of BiOCl in composite)exhibited the best adsorptive performance(60%),much better than the pristine BM-BC(20%).The high adsorption capacity of 50%-BiOCl/BC(Langmuir maximum capacity of 116.382 mg g^(−1))can be attributed to the electrostatic effect,π-πinteractions,and hydrogen bond.This work provided a facile method to prepare semiconductor assisted biochar-based adsorbents,which would also contribute to the advance of environmental remediation.