Characterization of acute-on-chronic liver diseases: A multicenter prospective cohort study

BACKGROUND Acute-on-chronic liver disease(AoCLD)accounts for the majority of patients hospitalized in the Department of Hepatology or Infectious Diseases.AIM To explore the characterization of AoCLD to provide theoretical guidance for the accurate diagnosis and prognosis of AoCLD.METHODS Patients with AoCLD from the Chinese Acute-on-Chronic Liver Failure(ACLF)study cohort were included in this study.The clinical characteristics and outcomes,and the 90-d survival rate associated with each clinical type of AoCLD were analyzed,using the Kaplan-Meier method and the log-rank test.RESULTS A total of 3375 patients with AoCLD were enrolled,including 1679(49.7%)patients with liver cirrhosis acute decompensation(LC-AD),850(25.2%)patients with ACLF,577(17.1%)patients with chronic hepatitis acute exacer-bation(CHAE),and 269(8.0%)patients with liver cirrhosis active phase(LC-A).The most common cause of chronic liver disease(CLD)was HBV infection(71.4%).The most common precipitants of AoCLD was bacterial infection(22.8%).The 90-d mortality rates of each clinical subtype of AoCLD were 43.4%(232/535)for type-C ACLF,36.0%(36/100)for type-B ACLF,27.0%(58/215)for type-A ACLF,9.0%(151/1679)for LC-AD,3.0%(8/269)for LC-A,and 1.2%(7/577)for CHAE.CONCLUSION HBV infection is the main cause of CLD,and bacterial infection is the main precipitant of AoCLD.The most common clinical type of AoCLD is LC-AD.Early diagnosis and timely intervention are needed to reduce the mortality of patients with LC-AD or ACLF.

NO_(x) removal by non-thermal plasma reduction:experimental and theoretical investigations

Green and efficient NO_(x)removal at low temperature is still desired.NO_(x)removal via non-thermal plasma(NTP)reduction is one of such technique.This work presents the experimental and theoretical study on the NO_(x)removal via NTP reduction(NTPRD)in dielectric barrier discharge reactor(DBD).The effect of O_(2)molar fraction on NO_(x)species in the outlet of DBD,and effects of NH_(3)/NO_(x)molar ratio and discharge power of DBD on NO_(x)removal efficiency are investigated.Results indicate that anaerobic condition and higher discharge power is beneficial to direct removal of NO_(x),and the NO_(x),removal efficiency can be up to 98.5%under the optimal operating conditions.It is also found that adding NH_(3)is favorable for the reduction of NO_(x),to N_(2)at lower discharge power.In addition,the NO_(x)removal mechanism and energy consumption analysis for the NTPRD process are also studied.It is found that the reduced active species(N^(+),N^(-),N^(+),N_(2)^(*),NH_(2)^(+),etc.)generated in the NTPRD process play important roles for the reduction of NO_(x),to N_(2).Our work paves a novel pathway for NO_(x)removal from anaerobic gas in industrial application.