Changing liver stiffness predict regression in advanced fibrosis patients with chronic hepatitis B,but not in moderate fibrosis patients

Background and objective:Liver stiffness measurement(LSM)may effectively correlate to the presence of liver fibrosis,but it is controversial to use for the prediction of clinical outcomes.Therefore,we aimed to evaluate the predictive value of liver stiffness for the regression of liver fibrosis.Methods:In this study,we collected data from a clinical cohort of patients who are received anti-virus therapies for 48 weeks.180 naive chronic hepatitis B(CHB)patients,who received paired LSM and liver biopsy with pre-and post-treatments were analyzed.Two methods(FibroScan and iLivTouch)test LSM.Result:The area under the receiver operating characteristics curve(AUROC)of changing LSM for fibrosis regression is higher in advanced fibrosis patients(F5/6)than in moderate fibrosis patients(F3/4)in both FibroScan(0.719,95%CI,0.590–0.848;P=0.003;vs 0.617,95%CI,0.379–0.856,P=0.282)and iLivTouch(0.707,95%CI,0.567–0.847;P=0.011;vs 0.583,95%CI,0.422–0.744;P=0.377).A higher kappa value was received in advanced stage than in moderate stage both in FibroScan(0.392,P=0.001 vs 0.265,P=0.053)and iLivTouch(0.326,P=0.019 vs 0.030,P=0.833).Cut-off set as 4.10 kPa(sen,69.4%;spe,73.9%)in FibroScan,as 4.25 kPa(sen,56.8%;spe,72.2%)in iLivTouch.Conclusion:The changing LSM can be used for predicting the liver fibrosis regression in advanced stage of CHB patients.

Mitochondria at the Crossroads of Cholestatic Liver Injury:Targeting Novel Therapeutic Avenues

Bile acids are byproducts of cholesterol metabolism in the liver and constitute the primary components of bile.Disruption of bile flow leads to cholestasis,characterized by the accumulation of hydrophobic bile acids in the liver and bloodstream.Such accumulation can exacerbate liver impairment.This review discussed recent developments in understanding how bile acids contribute to liver damage,including disturbances in mitochondrial function,endoplasmic reticulum stress,inflammation,and autophagy dysfunction.Mitochondria play a pivotal role in cholestatic liver injury by influencing hepatocyte apoptosis and inflammation.Recent findings linking bile acids to liver damage highlight new potential treatment targets for cholestatic liver injury.

Beneficial Effects of Traditional Chinese Medicine Fuzheng Huayu on the Occurrence of Hepatocellular Carcinoma in Patients with Compensated Chronic Hepatitis B Cirrhosis Receiving Entecavir:A Multicenter Retrospective Cohort Study

Background and Aims:The application of antifibrotic drugs to treat patients with chronic liver diseases who are receiving antiviral therapies for hepatocellular carcinoma(HCC)has not been established.Here,we aimed to assess the impact of the Traditional Chinese Medicine Fuzheng Huayu(FZHY)on the occurrence of HCC in patients with hepatitis B virus-related compensated cirrhosis receiving the antiviral drug entecavir(ETV).Methods:A multicenter retrospective cohort study was performed.Compensated liver cirrhosis patients were divided into the ETV+FZHY group or the ETV group according to treatment.The cumulative incidence of HCC was analyzed using Kaplan-Meier and log-rank tests.Propensity score matching was used for confounding factors.Stratified analysis and Cox regression were used to determine the effects of FZHY on the occurrence of HCC and liver function decompensation.Results:Out of 910 chronic hepatitis B patients,458 were in the ETV+FZHY group and 452 were in the ETV group.After propensity score matching,the 5-year cumulative incidence of HCC was 9.8%in the ETV+FZHY group and 21.8%in the ETV group(p<0.01).The adjusted hazard ratio for HCC was 0.216(0.108,0.432)when FZHY treatment was>36 months.Age,diabetes,alanine aminotransferase,-glutamyl transpeptidase,albumin,hepatitis B e-antigen,and fibrosis 4 score were associated with the occurrence of HCC.FZHY decreased the risk of HCC in patients aged>45 years with a hepatitis B virus DNA level of2,000 IU/l.Conclusion:Adjunctive FZHY treatment reduced HCC occurrence in patients with hepatitis B virus cirrhosis who were treated with ETV,possibly due to the antifibrotic properties of FZHY.

Guidance for the clinical evaluation of traditional Chinese medicine-induced liver injury Issued by China Food and Drug Administration

1. Introduction Drug-induced liver injury (DILI), defined as liver injury caused by a drug and/or its metabolites, is a common clinical adverse drug reaction1–4. This type of injury can cause acute liver failure and even death in severe cases5.

Evaluation of the antioxidant activity of blueberry ethanol extracts under microwave extraction

Blueberry extract contains diversiform monomers of anthocyanins, whose antioxidant activity determines the functionality of anthocyanidins and the efficacy of extraction technology. The evaluation of the antioxidant activity of anthocyanidins of blueberry ethanol extracts (BEE) was investigated by considering the monomers' identification and thermal degradation in microwave-assisted extraction (MAE). Thirteen monomers of anthocyanins were identified from the extracts of blueberry under MAE, where the highest content was for cyanidin glycosides, and the lowest content was for the malvidin glycosides. The onset temperatures of degradation for anthocyanidins monomers in BEE were 41.07°C-48.50°C, and the glycoside contents of delphinidin, cyanidin, petunidin, peonidin, peonidin, and malvidin, in turn, decreased obviously. The degradation of anthocyanidins with extraction temperature improved, other than weakened, its antioxidant activities in BEE under MAE. The research results may provide valuable guidance for the antioxidant application of extracts from blueberries.