Fuzheng Huayu Capsule Improves Survival in Patients with HepatitisB-related Cirrhosis and Overt Hepatic Encephalopathy

Objective:Fuzheng Huayu(FZHY)capsules exert anti-liver fibrosis and cirrhosis effects.This study aimed to determine the effect of FZHY on the 6-month survival rate of patients with overt hepatic encephalopathy(OHE)and hepatitis B-related cirrhosis(HBC).Methods:A total of 517 patients with OHE and HBC treated between January 2008 and July 2018 were enrolled.Patients were divided into the FZHY(n=129)and control groups(n=388),and the 6-month survival rates were compared between the two groups.Propensity score matching(PSM)was used to reduce the bias caused by confounding factors.Results:In multivariable regression analysis,FZHY therapy was an independent protective factor of 6-month survival.After PSM(1:2),the FZHY and control group comprised 126 and 252 patients,respectively.The 6-month survival rate was remarkably higher in the FZHY group than in the control group(P<0.005).FZHY users,especially those with a model for end-stage liver disease score>20 and Child-Pugh class C,benefited significantly from FZHY therapy.Conclusions:Adjuvant therapy with FZHY may be associated with improved survival in patients with OHE and HBC.However,further clinical studies are required to validate our findings.

New Algorithm Rules Out Acute-on-chronic Liver Failure Development within 28 Days from Acute Decompensation of Cirrhosis

Background and Aims:Approximately 10%of patients with acute decompensated(AD)cirrhosis develop acute-on-chronic liver failure(ACLF)within 28 days.Such cases have high mortality and are difficult to predict.Therefore,we aimed to establish and validate an algorithm to identify these patients on hospitalization.Methods:Hospitalized patients with AD who developed ACLF within 28 days were considered pre-ACLF.Organ dysfunction was defined accord-ing to the chronic liver failure-sequential organ failure as-sessment(CLIF-SOFA)criteria,and proven bacterial infec-tion was taken to indicate immune system dysfunction.A retrospective multicenter cohort and prospective one were used to derive and to validate the potential algorithm,re-spectively.A miss rate of<5%was acceptable for the calcu-lating algorithm to rule out pre-ACLF.Results:In the deri-vation cohort(n=673),46 patients developed ACLF within 28 days.Serum total bilirubin,creatinine,international normalized ratio,and present proven bacterial infection at admission were associated with the development of ACLF.AD patients with≥2 organ dysfunctions had a higher risk for pre-ACLF patients[odds ratio=16.58195%confidence interval:(4.271-64.363),p<0.001].In the derivation co-hort,67.5%of patients(454/673)had≤1 organ dysfunction and two patients(0.4%)were pre-ACLF,with a miss rate of 4.3%(missed/total,2/46).In the validation cohort,65.9%of patients(914/1388)had≤1 organ dysfunction,and four(0.3%)of them were pre-ACLF,with a miss rate of 3.4%(missed/total,4/117).Conclusions:AD patients with≤1 organ dysfunction had a significantly lower risk of developing ACLF within 28 days of admission and could be safely ruled out with a pre-ACLF miss rate of<5%.

Novel Donor-Acceptor Copolymers Based on Dithienosilole and Ketone Modified Thieno[3,4-b]thiophene for Photovoltaic Application

Two novel donor-acceptor （D-A） copolymers containing dithienosilole （DTS） donor unit and ketone modified thieno[3,4-b]thiophene （TT） acceptor unit, namely, poly{4,4＇-bis（2-ethylhexyl）dithieno[3,2-b：2＇,Y-d]silole-5,5＇-diyl- alt-l-（thieno[3,4-b]thiophen-2-yl）-2-ethylhexan-l-one} （PDTSTT） and poly{4,4＇-bis（2-ethylhexyl）dithieno[3,2- b：2＇,3＇-d]silole-5,5＇-diyl-alt- 1-（4,6-bis（4-ethylhexylthien-2-yl）thieno[3,4-b]thiophen-2-yl）-2-ethylhexan- 1-one} （PD- TSDTTT）, were synthesized for the application in polymer solar cells （PSCs）, and the effects of thiophene bridge on the structural geometry and photovoiltaie performance have been investigated. The polymer PDTSTT and PDTSDTTT have the electrochemical bandgaps of 1.54 and 2.02 eV, together with low-lying HOMO energy levels of-5.47 and -5.37 eV, respectively. Molecular geometry simulation result shows that compared with PDTSTT, the insertion of thiophene bridge in PDTSDTTT can well relieve the steric hindrance between the TT and DTS unit, as confirmed by the reduced dihedral angle between DTS and DTTT unit. Under the illumination of AM 1.5G, 100 mW/cm2, the PSC based on PDTSDTTT/PC61BM （1 ： 1, w ： w） demonstrates a power conversion efficiency of 1.0%, which is significantly improved in comparison with the device based on PDTSTT/PC61BM （1 ： 2, w ： w） under the same experimental condition. This is because the enhanced planarity and increased effective conjugation of the main chain in PDTSDTTT promote the more favorable morphology for charge transportation, although PDTSTT possesses the broader absorption band than PDTSDTTT.