Background and Aims:Nonbiological artificial liver(NBAL)is frequently used as a first-line treatment for hepatitis B virus-associated acute-on-chronic liver failure(HBV-ACLF).This study aimed to compare the therapeuti...Background and Aims:Nonbiological artificial liver(NBAL)is frequently used as a first-line treatment for hepatitis B virus-associated acute-on-chronic liver failure(HBV-ACLF).This study aimed to compare the therapeutic efficacy and cost-effectiveness ratio(CER)of comprehensive medical treatment,plasma exchange(PE),and double plasma molecular adsorption system(DPMAS)plus half-dose PE(DPMAS+PE)in patients with HBV-ACLF.Methods:A total of 186 patients with HBV-ACLF randomly received comprehensive medical treatment,PE,or DPMAS+PE and were prospectively evaluated.Patients were divided into four subgroups based on the pretreatment prothrombin activity(PTA):Group I(PTA>40%),group II(PTA 30–40%),group III(PTA 20–30%),and group IV(PTA<20%).The main outcome measures were 28 day effectiveness;90 day liver transplantation-free survival;change of biochemical parameters;and CER.Results:DPMAS+PE treatment was associated with significantly higher 28 day effectiveness and 90 day liver transplantation-free survival compared with PE treatment in patients with group I liver failure.Clearance of serum total bilirubin(TBIL),AST,and creatinine(Cr)were significantly higher in the DPMAS+PE group than in the PE group.For subjects with group I liver failure,DPMAS+PE treatment had advantages of lower CER values and better cost-effectiveness.Conclusions:Compared with comprehensive medical treatment and PE alone,DPMAS with halfdose sequential PE treatment more effectively improved TBIL,AST,and Cr in HBV-ACLF patients,improved 28 day effectiveness and 90 day survival rates in patients with group I liver failure,and was more cost effective.DPMAS+PE is a viable NBAL approach for treatment of HBV-ACLF.展开更多
Monodisperse spherical SiO2 particles were successfully synthesized in 2-propanol-H2O-NH3 system by the microwave hydrothermal method using ammonia as catalyst. To investigate the influences on the size of spherical S...Monodisperse spherical SiO2 particles were successfully synthesized in 2-propanol-H2O-NH3 system by the microwave hydrothermal method using ammonia as catalyst. To investigate the influences on the size of spherical SiO2 particles, factors such as ammonia concentration, reaction temperature, stirring intensity and reactants mol ratio have been studied. The orthogonal experiments were carried out. The as-prepared SiO2 particles were characterized by X-ray diffraction （XRD）, transmission electron microscopy （TEM）, Fourier transform infrared spectroscopy （FTIR） and differential thermal analysis （DTA）. The results indicated that the size of SiO2 particles increased greatly with the increase in ammonia concentration, temperature and reactants mol ratio, but increased slightly with the increase in stirring intensity. Monodisperse spherical Si02 particles were amorphous with perfect sphere and uniform size. Hydroxyl was detected in SiO2. Kinetic parameters were calculated, and finally the reaction rate equation of dehydrated hydroxyl was obtained.展开更多
基金supported by the Natural Science Foundation of China (No.82170640,No.81974080).
文摘Background and Aims:Nonbiological artificial liver(NBAL)is frequently used as a first-line treatment for hepatitis B virus-associated acute-on-chronic liver failure(HBV-ACLF).This study aimed to compare the therapeutic efficacy and cost-effectiveness ratio(CER)of comprehensive medical treatment,plasma exchange(PE),and double plasma molecular adsorption system(DPMAS)plus half-dose PE(DPMAS+PE)in patients with HBV-ACLF.Methods:A total of 186 patients with HBV-ACLF randomly received comprehensive medical treatment,PE,or DPMAS+PE and were prospectively evaluated.Patients were divided into four subgroups based on the pretreatment prothrombin activity(PTA):Group I(PTA>40%),group II(PTA 30–40%),group III(PTA 20–30%),and group IV(PTA<20%).The main outcome measures were 28 day effectiveness;90 day liver transplantation-free survival;change of biochemical parameters;and CER.Results:DPMAS+PE treatment was associated with significantly higher 28 day effectiveness and 90 day liver transplantation-free survival compared with PE treatment in patients with group I liver failure.Clearance of serum total bilirubin(TBIL),AST,and creatinine(Cr)were significantly higher in the DPMAS+PE group than in the PE group.For subjects with group I liver failure,DPMAS+PE treatment had advantages of lower CER values and better cost-effectiveness.Conclusions:Compared with comprehensive medical treatment and PE alone,DPMAS with halfdose sequential PE treatment more effectively improved TBIL,AST,and Cr in HBV-ACLF patients,improved 28 day effectiveness and 90 day survival rates in patients with group I liver failure,and was more cost effective.DPMAS+PE is a viable NBAL approach for treatment of HBV-ACLF.
基金supported by the National Basic Research Program of China (Grant No.2007CB613603)
文摘Monodisperse spherical SiO2 particles were successfully synthesized in 2-propanol-H2O-NH3 system by the microwave hydrothermal method using ammonia as catalyst. To investigate the influences on the size of spherical SiO2 particles, factors such as ammonia concentration, reaction temperature, stirring intensity and reactants mol ratio have been studied. The orthogonal experiments were carried out. The as-prepared SiO2 particles were characterized by X-ray diffraction （XRD）, transmission electron microscopy （TEM）, Fourier transform infrared spectroscopy （FTIR） and differential thermal analysis （DTA）. The results indicated that the size of SiO2 particles increased greatly with the increase in ammonia concentration, temperature and reactants mol ratio, but increased slightly with the increase in stirring intensity. Monodisperse spherical Si02 particles were amorphous with perfect sphere and uniform size. Hydroxyl was detected in SiO2. Kinetic parameters were calculated, and finally the reaction rate equation of dehydrated hydroxyl was obtained.
