BACKGROUND： The prognostic prediction of liver transplantation（LT） guides the donor organ allocation. However, there is currently no satisfactory model to predict the recipients’ outcome, especially for the patien...BACKGROUND： The prognostic prediction of liver transplantation（LT） guides the donor organ allocation. However, there is currently no satisfactory model to predict the recipients’ outcome, especially for the patients with HBV cirrhosis-related hepatocellular carcinoma（HCC）. The present study was to develop a quantitative assessment model for predicting the post-LT survival in HBV-related HCC patients.METHODS： Two hundred and thirty-eight LT recipients at the Liver Transplant Center, First Affiliated Hospital, Zhejiang University School of Medicine between 2008 and 2013 were included in this study. Their post-LT prognosis was recorded and multiple risk factors were analyzed using univariate and multivariate analyses in Cox regression.RESULTS： The score model was as follows： 0.114×（Child-Pugh score）-0.002×（positive HBV DNA detection time）＋0.647×（number of tumor nodules）＋0.055×（max diameter of tumor nodules）＋0.231×ln AFP＋0.437×（tumor differentiation grade）.The receiver operating characteristic curve analysis showed that the area under the curve of the scoring model for predicting the post-LT survival was 0.887. The cut-off value was 1.27, which was associated with a sensitivity of 72.5% and a specificity of 90.7%, respectively.CONCLUSION： The quantitative score model for predicting post-LT survival proved to be sensitive and specific.展开更多
BACKGROUND: Plasma D(-)-lactate and diamine oxidase (DAO) can reflect patients' intestinal mucosal condition. We evaluated the changes of plasma D (-)-lactate, DAO and endotoxin activities and their significance i...BACKGROUND: Plasma D(-)-lactate and diamine oxidase (DAO) can reflect patients' intestinal mucosal condition. We evaluated the changes of plasma D (-)-lactate, DAO and endotoxin activities and their significance in patients with liver cirrhosis. METHODS: Fifty liver cirrhosis patients were enrolled into experimental group and 30 healthy people into control group. The plasma levels of D(-)-lactate, DAO and endo- toxin were detected spectrophotographically. RESULTS: The level of D(-)-lactate was significantly high- er in the experimental group than that in the control group (P<0.01). Significant differences of D (-)-lactate levels were observed in Child-Pugh subgroups of the experimen- tal group (P <0. 01). The level of DAO was significantly higher in the experimental group than that in the control group (P <0.01), but the level of DAO in Child-Pugh sub- group C was significantly lower than that in Child-Pugh subgroup B (P<0.01). The level of endotoxin was signifi- cantly increased in the experimental group except Child Pugh subgroup A (P<0.01). The plasma levels of D(-) lactate, DAO and endotoxin were positively correlated with each other (P<0.01). CONCLUSIONS: The data suggest that both plasma D(-) lactate and DAO activity are sensitive markers for early diagnosis of gut failure and endotoxemia in patients with liver cirrhosis. The impairment of intestinal barrier func- tion may be one of the critical reasons for deterioration of liver cirrhosis.展开更多
AIM： To measure circulating angiotensins at different stages of human cirrhosis and to further evaluate a possible relationship between renin angiotensin system （RAS） components and hemodynamic changes. METHODS： P...AIM： To measure circulating angiotensins at different stages of human cirrhosis and to further evaluate a possible relationship between renin angiotensin system （RAS） components and hemodynamic changes. METHODS： Patients were allocated into 4 groups： mild-to-moderate liver disease （MLD）, advanced liver disease （ALD）, patients undergoing liver transplantation, and healthy controls. Blood was collected to determine plasma renin activity （PRA）, angiotensin （Ang） Ⅰ, Ang Ⅱ, and Ang-（1-7） levels using radioimmunoassays. During liver transplantation, hemodynamic parameters were determined and blood was simultaneously obtained from the portal vein and radial artery in order to measure RAS components. RESULTS： PRA and angiotensins were elevated in ALD when compared to MLD and controls （P 〈 0.05）. In contrast, Ang Ⅱ was significantly reduced in MLD. Ang-（1-7）/Ang Ⅱ ratios were increased in MLD when compared to controls and ALD. During transplantation, Ang Ⅱ levels were lower and Ang-（1-7）/Ang Ⅱ ratios were higher in the splanchnic circulation than in the peripheral circulation （0.52 ± 0.08 vs 0.38 ±0.04, P 〈 0.02）, whereas the peripheral circulating Ang Ⅱ/Ang Ⅰ ratio was elevated in comparison to splanchnic levels （0.18 ±0.02 vs 0.13 ±0.02, P 〈 0.04）. Ang-（1-7）/ Ang Ⅱ ratios positively correlated with cardiac output （r = 0.66） and negatively correlated with systemic vascular resistance （r = -0.70）. CONCLUSION： Our findings suggest that the relationship between Ang-（1-7） and Ang Ⅱ may play a role in the hemodynamic changes of human cirrhosis.展开更多
Objective:To document Toxoplasma gondii(T.gondii) antibody status in patients with liver disease,blood samples were taken from 180 hepatic patients and 180 healthy controls.Methods:Toxoplasma IgG antibody was detected...Objective:To document Toxoplasma gondii(T.gondii) antibody status in patients with liver disease,blood samples were taken from 180 hepatic patients and 180 healthy controls.Methods:Toxoplasma IgG antibody was detected using enzyme-linked immunosorbent assay and histopathological assessment of liver biopsy METAVIR score was applied.Results:Anti-T.gondii IgG antibodies were found in 32.8%of patients and in 22.2%of controls(P=0.02).Toxoplasma seropositivity was significantly associated with lymphadenopathy,history of blood transfusion and reflex impairment in patients.Chronic hepatitis C virus(HCV)and chronic HCV-related cirrhosis groups compared to chronic HBV and chronic HBV-related cirrhosis groups expressed significantly higher prevalence of T.gondii seropositivity(odds ratio(OR) =4;95%confidence interval(CI):1.3-12.6;P=0.013,OR=4.8;95%CI:1.5-14.9;P=0.006,respectively).Within the chronic HCV group,T.gondii seropositivity significantly associated disease evolution as regards to METAVIR histopathological system for fibrosis and inflammation(OR=19.4;95%CI:2.3-165.2;P=0.0008,OR=0.29;95%CI:0.1-0.8;P=0.01,respectively).Albumin,international normalized ratio(INR) and platelets count were the laboratory parameters significantly altered in Toxoplasma-positrvc chronic HCV patients(P=0.00 l,0.03,0.04,respectively).Child-Pugh scoring for cirrhosis in chronic HCV group placed the majority of seropositive patient in class C with significant statistical difference compared to Child A reference group(OR= 0.08;95%67:0.01-0.5;P=0.003).Conclusions:Toxoplasma seropositivity was high in patients with cirrhosis and associated higher grades of inflammation and necrosis signifying disease evolution,suggesting that cirrhotic patients may thus form a risk group for toxoplasmosis.展开更多
目的探讨乙肝病毒(Hepatitis B Virus,HBV)感染患者血清中乙型肝炎病毒脱氧核苷酸(HBV-DNA)载量与乙肝五项指标的相关性。方法选取沛县人民医院于2022年1月—2023年1月收治的100例HBV感染患者作为研究对象,所有患者均接受HBV-DNA载量与...目的探讨乙肝病毒(Hepatitis B Virus,HBV)感染患者血清中乙型肝炎病毒脱氧核苷酸(HBV-DNA)载量与乙肝五项指标的相关性。方法选取沛县人民医院于2022年1月—2023年1月收治的100例HBV感染患者作为研究对象,所有患者均接受HBV-DNA载量与乙肝五项指标检测,并按照其HBV-DNA载量进行分组,分别为<50 IU/mL组69例、50~<10^(4) IU/mL组10例、10^(4)~10^(10) IU/mL组21例,对比3组检测结果。结果10^(4)~10^(10) IU/mL组乙型肝炎e抗体(Hepatitis B Virus e Antibody,HBeAb)、乙型肝炎e抗原(Hepatitis B e Antigen,HBeAg)、乙型肝炎表面抗原(Hapatitis B Surface Antigen,HBsAg)指标高于50~<10^(4) IU/mL组、<50 IU/mL组,50~<10^(4) IU/mL组各指标水平高于<50 IU/mL组,差异有统计学意义(P均<0.05)。相关性分析后显示,HBeAb、HBeAg、HBsAg与HBV-DNA载量呈正相关(r=0.512、0.549、0.673,P均<0.05)。结论HBV-DNA载量与HBeAb、HBeAg、HBsAg指标之间有正性关联,可为评估HBV感染程度提供一定参考依据。展开更多
基金supported by grants from National S&T Major Project(2012ZX10002017)the Foundation for Innovative Research Groups of the National Natural Science Foundation of China(81121002)the National Natural Science Foundation of China(81200331)
文摘BACKGROUND： The prognostic prediction of liver transplantation（LT） guides the donor organ allocation. However, there is currently no satisfactory model to predict the recipients’ outcome, especially for the patients with HBV cirrhosis-related hepatocellular carcinoma（HCC）. The present study was to develop a quantitative assessment model for predicting the post-LT survival in HBV-related HCC patients.METHODS： Two hundred and thirty-eight LT recipients at the Liver Transplant Center, First Affiliated Hospital, Zhejiang University School of Medicine between 2008 and 2013 were included in this study. Their post-LT prognosis was recorded and multiple risk factors were analyzed using univariate and multivariate analyses in Cox regression.RESULTS： The score model was as follows： 0.114×（Child-Pugh score）-0.002×（positive HBV DNA detection time）＋0.647×（number of tumor nodules）＋0.055×（max diameter of tumor nodules）＋0.231×ln AFP＋0.437×（tumor differentiation grade）.The receiver operating characteristic curve analysis showed that the area under the curve of the scoring model for predicting the post-LT survival was 0.887. The cut-off value was 1.27, which was associated with a sensitivity of 72.5% and a specificity of 90.7%, respectively.CONCLUSION： The quantitative score model for predicting post-LT survival proved to be sensitive and specific.
文摘BACKGROUND: Plasma D(-)-lactate and diamine oxidase (DAO) can reflect patients' intestinal mucosal condition. We evaluated the changes of plasma D (-)-lactate, DAO and endotoxin activities and their significance in patients with liver cirrhosis. METHODS: Fifty liver cirrhosis patients were enrolled into experimental group and 30 healthy people into control group. The plasma levels of D(-)-lactate, DAO and endo- toxin were detected spectrophotographically. RESULTS: The level of D(-)-lactate was significantly high- er in the experimental group than that in the control group (P<0.01). Significant differences of D (-)-lactate levels were observed in Child-Pugh subgroups of the experimen- tal group (P <0. 01). The level of DAO was significantly higher in the experimental group than that in the control group (P <0.01), but the level of DAO in Child-Pugh sub- group C was significantly lower than that in Child-Pugh subgroup B (P<0.01). The level of endotoxin was signifi- cantly increased in the experimental group except Child Pugh subgroup A (P<0.01). The plasma levels of D(-) lactate, DAO and endotoxin were positively correlated with each other (P<0.01). CONCLUSIONS: The data suggest that both plasma D(-) lactate and DAO activity are sensitive markers for early diagnosis of gut failure and endotoxemia in patients with liver cirrhosis. The impairment of intestinal barrier func- tion may be one of the critical reasons for deterioration of liver cirrhosis.
基金Supported by Fundacode Amparo à Pesquisa do Estado de Minas Gerais, Conselho Nacional de Desenvolvimento Científico e Tecnológico, FAPEMIG/CNPQ-PRONEX (Grupos de Excelência),Ministério de Ciência e Tecnologia/CNPq/ FAPEMIG-INCT-Nano-Biofar
文摘AIM： To measure circulating angiotensins at different stages of human cirrhosis and to further evaluate a possible relationship between renin angiotensin system （RAS） components and hemodynamic changes. METHODS： Patients were allocated into 4 groups： mild-to-moderate liver disease （MLD）, advanced liver disease （ALD）, patients undergoing liver transplantation, and healthy controls. Blood was collected to determine plasma renin activity （PRA）, angiotensin （Ang） Ⅰ, Ang Ⅱ, and Ang-（1-7） levels using radioimmunoassays. During liver transplantation, hemodynamic parameters were determined and blood was simultaneously obtained from the portal vein and radial artery in order to measure RAS components. RESULTS： PRA and angiotensins were elevated in ALD when compared to MLD and controls （P 〈 0.05）. In contrast, Ang Ⅱ was significantly reduced in MLD. Ang-（1-7）/Ang Ⅱ ratios were increased in MLD when compared to controls and ALD. During transplantation, Ang Ⅱ levels were lower and Ang-（1-7）/Ang Ⅱ ratios were higher in the splanchnic circulation than in the peripheral circulation （0.52 ± 0.08 vs 0.38 ±0.04, P 〈 0.02）, whereas the peripheral circulating Ang Ⅱ/Ang Ⅰ ratio was elevated in comparison to splanchnic levels （0.18 ±0.02 vs 0.13 ±0.02, P 〈 0.04）. Ang-（1-7）/ Ang Ⅱ ratios positively correlated with cardiac output （r = 0.66） and negatively correlated with systemic vascular resistance （r = -0.70）. CONCLUSION： Our findings suggest that the relationship between Ang-（1-7） and Ang Ⅱ may play a role in the hemodynamic changes of human cirrhosis.
文摘Objective:To document Toxoplasma gondii(T.gondii) antibody status in patients with liver disease,blood samples were taken from 180 hepatic patients and 180 healthy controls.Methods:Toxoplasma IgG antibody was detected using enzyme-linked immunosorbent assay and histopathological assessment of liver biopsy METAVIR score was applied.Results:Anti-T.gondii IgG antibodies were found in 32.8%of patients and in 22.2%of controls(P=0.02).Toxoplasma seropositivity was significantly associated with lymphadenopathy,history of blood transfusion and reflex impairment in patients.Chronic hepatitis C virus(HCV)and chronic HCV-related cirrhosis groups compared to chronic HBV and chronic HBV-related cirrhosis groups expressed significantly higher prevalence of T.gondii seropositivity(odds ratio(OR) =4;95%confidence interval(CI):1.3-12.6;P=0.013,OR=4.8;95%CI:1.5-14.9;P=0.006,respectively).Within the chronic HCV group,T.gondii seropositivity significantly associated disease evolution as regards to METAVIR histopathological system for fibrosis and inflammation(OR=19.4;95%CI:2.3-165.2;P=0.0008,OR=0.29;95%CI:0.1-0.8;P=0.01,respectively).Albumin,international normalized ratio(INR) and platelets count were the laboratory parameters significantly altered in Toxoplasma-positrvc chronic HCV patients(P=0.00 l,0.03,0.04,respectively).Child-Pugh scoring for cirrhosis in chronic HCV group placed the majority of seropositive patient in class C with significant statistical difference compared to Child A reference group(OR= 0.08;95%67:0.01-0.5;P=0.003).Conclusions:Toxoplasma seropositivity was high in patients with cirrhosis and associated higher grades of inflammation and necrosis signifying disease evolution,suggesting that cirrhotic patients may thus form a risk group for toxoplasmosis.
文摘目的探讨乙肝病毒(Hepatitis B Virus,HBV)感染患者血清中乙型肝炎病毒脱氧核苷酸(HBV-DNA)载量与乙肝五项指标的相关性。方法选取沛县人民医院于2022年1月—2023年1月收治的100例HBV感染患者作为研究对象,所有患者均接受HBV-DNA载量与乙肝五项指标检测,并按照其HBV-DNA载量进行分组,分别为<50 IU/mL组69例、50~<10^(4) IU/mL组10例、10^(4)~10^(10) IU/mL组21例,对比3组检测结果。结果10^(4)~10^(10) IU/mL组乙型肝炎e抗体(Hepatitis B Virus e Antibody,HBeAb)、乙型肝炎e抗原(Hepatitis B e Antigen,HBeAg)、乙型肝炎表面抗原(Hapatitis B Surface Antigen,HBsAg)指标高于50~<10^(4) IU/mL组、<50 IU/mL组,50~<10^(4) IU/mL组各指标水平高于<50 IU/mL组,差异有统计学意义(P均<0.05)。相关性分析后显示,HBeAb、HBeAg、HBsAg与HBV-DNA载量呈正相关(r=0.512、0.549、0.673,P均<0.05)。结论HBV-DNA载量与HBeAb、HBeAg、HBsAg指标之间有正性关联,可为评估HBV感染程度提供一定参考依据。
