Short Term Efficacy of Entecavir in the Treatment of Decompensated Chronic Hepatitis B Cirrhosis

Objective:To explore the effect of entecavir on patients with decompensated chronic hepatitis B cirrhosis.Methods:From October 2007 to December 2019,100 patients with decompensated chronic hepatitis B cirrhosis who were treated in our hospital were selected to carry out this study.The clinical data of the patients were analyzed.According to whether entecavir treatment was carried out,100 patients were divided into two groups,50 cases in the control group and 50 cases in the observation group.The control group was treated with conventional drugs,and the observation group was treated with entecavir.Liver function indexes,liver fibrosis indexes,HBV-DNA negative conversion rate and incidence of adverse reactions were compared between the two groups.Results:Compared with the control group,the liver function indexes of the observation group were lower,P<0.05;Compared with the control group,the observation group was better,P<0.05;The negative rate of HBV-DNA in the observation group was lower than that in the control group(P<0.05);There was no difference in the incidence of adverse reactions between the two groups,P>0.05.Conclusion:Entecavir can not only improve the liver function,but also enhance the shortterm treatment effect,without increasing adverse reactions,and has high safety,which is worthy of recommendation.

Acute-on-chronic liver failure：recent update

Acute on chronic liver failure（ACLF） was first described in 1995 as a clinical syndrome distinct to classic acute decompensation.Characterized by complications of decompensation,ACLF occurs on a background of chronic liver dysfunction and is associated with high rates of organ failure and significant short-term mortality estimated between45%and 90%.Despite the clinical relevance of the condition,it still remains largely undefined with continued disagreement regarding its precise etiological factors,clinical course,prognostic criteria and management pathways.It is concerning that,despite our relative lack of understanding of the condition,the burden of ACLF among cirrhotic patients remains significant with an estimated prevalence of 30.9%.This paper highlights our current understanding of ACLF,including its etiology,diagnostic and prognostic criteria and pathophysiology.It is evident that further refinement of the ACLF classification system is required in order to detect high-risk patients and improve short-term mortality rates.The field of metabolomics certainly warrants investigation to enhance diagnostic and prognostic parameters,while the use of granulocyte-colony stimulating factor is a promising future therapeutic intervention for patients with ACLF.

Efficacy observation of Yiguanjian decoction combined adefovir Dipivoxil tablet in treating HBeAg negative chronic viral hepatitis B active compensated liver cirrhosis patients

Objective To explore clinical efficacy of Yiguanjian Decoction(YD)combined Adefovir Dipivoxil Tablet(ADT)in treating HBe Ag negative chronic viral hepatitis B(CVHB)active compensated liver cirrhosis(LC)patients.Methods Totally 68 HBe Ag negative CVHB active compensated LC patients initially treated were assigned to the treatment group and the control group

Diagnostic Efficacy and Possible Underlying Mechanisms of Noninvasive Clinical Markers in Hepatocellular Carcinoma

Background and Aims:In this study,we aimed to evaluate the diagnostic values of alpha-fetoprotein(AFP),soluble AXL(sAXL),des-γ-carboxy prothrombin(DCP),the aspartate aminotransferase-to-platelet ratio index(APRI),and the gamma-glutamyl transpeptidase-to-platelet ratio(GPR)in hepatocellular carcinoma(HCC)and the possible underlying mechanisms of the correlations between them.Methods:We collected serum samples from 190,128,and 75 patients with HCC,cirrhosis,and chronic viral hepatitis,and from 82 healthy subjects.Serum levels of AFP,sAXL,and DCP were determined,and APRI and GPR values were calculated.Receiver operating characteristic(ROC)curves were used to analyze the diagnostic value of single and combined biomarkers.Results:We detected significant differences between the HCC group and other groups regarding serum AFP,sAXL,DCP,and APRI levels.GPR significantly differed between the HCC group and other groups,except for the liver cirrhosis group.AFP,sAXL,DCP,APRI,and GPR had positive correlations with each other,and AFP showed a higher area under the curve(AUC)and Youden index values,while APRI and DCP showed the highest sensitivity and specificity.Also,when AFP was combined with sAXL,DCP,APRI,and GRP,the highest AUC(0.911)and a higher net reclassification improvement value were obtained compared with those obtained for the individual biomarkers.Conclusions:AFP,sAXL,DCP,APRI,and GPR are independent risk factors for HCC,and the diagnostic performance of AFP combined with sAXL,DCP,APRI,and GPR for HCC diagnosis was superior to that of the individual biomarkers.