Network meta-analysis of the compensatory effect of different Chinese herbal compounds combined with Entecavir in the treatment of hepatitis B cirrhosis

Objective:To evaluate the efficacy and safety of different Chinese herbal compounds combined with Entecavir in the treatment of hepatitis B cirrhosis during the compensatory period by using mesh meta-analysis.Methods:PubMed,CNKI,Wanfang and VIP databases were searched by computer,and the retrieval time was from the establishment of each database to October 5,2022.According to inclusion and exclusion criteria,literature search was conducted independently by two researchers.RevMan5.4.1 software provided by Cochrane was used for evaluation,and Stata16.0 software was used for statistical analysis.Results:A total of 34 RCTs were included,involving 16 TCM compounds and 1543 patients.The results of network meta-analysis showed that ALT indexes of liver function were listed as Yiqi Jiedu Tongluo Method>Luoshugan Tablet>Anluo Huaxian Wan>Qishenrugan Capsule>Qingganhuaji Decoction>Ganshuang Granules>Compound Biejia Rugan Tablet>Rougan Sanjie Decoction>Shugan Jianpi Decoction>Shenqi Fuzheng Huayu Decoction>Peituhua Decoction>Shugan Jianpi Huoxu prescription>Rhubarb Zhezhan Capsule combined with Entecavir treatment respectively;The order of HA index of liver fibrosis was Heluo Shugan Tablet>Shugan Jianpi Huoxui prescription>Anluo Huaxian Wan>Compound Biejia Ruangan Tablet>Rougan Sanjie Decoction>Ganshuang Granules>Danji Huoxui Decoction>Yiqi Jiedu Tongluo Method>Rhubarb Zhezhe Capsule>Fuzheng Huayu Table>Shugan Jianpi Decoction>Rougan Huayu Decoction>Peitu Huayu Decoction>Qingganhuaji Prescription>Shenqi Fuzheng Huayu prescription combined with Entecavir respectively;In order of adverse reactions from best to worst,Shuganjianpi Decoction,Qishenrugangan Capsule,Ganshuang Granules,Peituhuazhi Decoction,compound Biejiruganpian,and He Shugan Pian combined with entecavir,respectively;The effective rate of treatment was listed as Ganshuang Granules>Compound Biejia Ruangan Tablets>uoshugan Tablets>Rougansanjie Decoction>Rhubarb Zhezhe Capsules>Yiqi Jiedu Tongluo Method>Qingganhuaji prescription>Anluo Huaxia Wan>Shugan Jianpi Decoction>Fuzheng Huayu tablets>Peituhuazhi Decoction>Shenqi Fuzheng Huayu prescription combined with Entecavir respectively.Conclusion:Entecavir combined with supplementing qi and detoxifying and dredging collages is the best method to recover ALT index of liver function during the compensation period for hepatitis B cirrhosis;Entecavir combination and Luoshugan tablet were the best treatment for HA index of hepatic fibrosis;Entecavir combined with Shuganjianpi Decoction was the best treatment for adverse reactions;The best treatment efficiency was Entecavir combined with Ganshuang granules.

Impact of Nursing Interventions Based on Self- Efficacy Theory on HAMA and HAMD Scores in Patients with Hepatitis B Cirrhosis

Objective:To explore the effect of nursing interventions based on self-efficacy theory guidance on psychological stress indicators in patients with hepatitis B cirrhosis.Methods:70 patients with hepatitis B cirrhosis from October 2023 to May 2024 were selected and grouped by random number table.The observation group received nursing intervention based on self-efficacy theory,while the control group received routine nursing.The differences in psychological stress indicators,self-efficacy indicators,and nursing satisfaction were compared between the two groups.Results:Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)scores of the observation group were significantly lower than those of the control group(P<0.05);Chronic Disease Self-Efficacy Scale(CDSES)scores of the observation group were significantly higher than those of the control group(P<0.05);and nursing satisfaction scores of the observation group were significantly higher than those of the control group(P<0.05).Conclusion:Hepatitis B cirrhosis patients receiving nursing care based on self-efficacy theory can stimulate patients'self-efficacy,calm their emotions,and their overall satisfaction is high.

Correlation Between NLRP3 Inflammasome and GP73 Levels and Hepatitis B Cirrhosis with Esophageal Varices Rupture

Objective:To investigate the correlation between NOD-like receptor family protein 3(NLRP3)inflammasome and Golgi protein 73(GP73)levels and hepatitis B cirrhosis with esophageal varices(EV)rupture.Methods:The subjects of this study were 145 patients with hepatitis B cirrhosis and varices who were treated in our hospital in recent years.Endoscopic examination was performed on the patients.The patients were divided into two groups according to whether there was EV rupture:rupture group and non-rupture group.The correlation between plasma NLRP3 and GP73 levels and hepatitis B cirrhosis with EV rupture was analyzed.Results:Through observation,comparing the levels of NLRP3 and GP73 between the two groups,the levels of NLRP3 and GP73 were significantly higher in the rupture group than in the non-rupture group(P<0.05).Logistic regression analysis showed that NLRP3 and GP73 levels and Child-Pugh classification were related risk factors of hepatitis B cirrhosis with EV rupture.Conclusion:NLRP3 inflammasome and GP73 levels are closely related to hepatitis B cirrhosis with EV rupture.The corresponding evaluation aids in predicting EV rupture and bleeding in patients with hepatitis B cirrhosis.

Impact of Fuzheng Huayu tablet on antiviral effect of entecavir in patients with hepatitis B cirrhosis

Background:Fuzheng Huayu tablet is a traditional Chinese medicine(TCM)used for the treatment of liver fibrosis and cirrhosis.However,whether the combination with Fuzheng Huayu tablet could affect the antiviral efflcacy of nucleos(t)ide remains a concern.The objective of this trial was to explore the impact of Fuzheng Huayu tablet on antiviral effect of entecavir in patients with hepatitis B cirrhosis.Methods:A prospective,randomized control trial was conducted.Patients with compensated hepatitis B cirrhosis were randomly divided into the treatment group(entecavir capsule plus Fuzheng Huayu tablet)and the control group(entecavir capsule plus simulant of Fuzheng Huayu),and followed up for 48 weeks.The dynamic changes of HBV DNA load,the rate of serological conversion of HBeAg,liver function,renal function and liver stiffness measurement(LSM)were monitored.The general clinical data and adverse events were also recorded.Results:There was no significant difference in the rate of virological response and cumulative virological response between the treatment group and the control group(P>0.05).After 48 weeks of treatment,the HBeAg seroconversion rate,biochemical response rate and LSM value were 21.05%and 4.76%(P=0.164),86.96%and 65.96%(P=0.017),9.5 kpa and 10.6 kpa(P=0.827)in the treatment group and the control group,respectively.No serious adverse events related to the study therapy occurred during the trial.Conclusions:The antiviral entecavir combined with Fuzheng Huayu tablet did not affect the antiviral efflcacy of entecavir,but could improve the rate of biochemical response,and had a tendency to improve the rate of serological conversion of HBeAg and liver fibrosis in patients with hepatitis B cirrhosis.Fuzheng Huayu tablet is clinically safe for patients with hepatitis B cirrhosis.

Hepatitis B cirrhosis combined with Budd-Chiari syndrome treated by liver transplantation:Case report and literature review

Objective:To summarize and analyze the clinical treatment experience of hepatitis B cirrhosis combined with Budd-Chiari syndrome.Methods:Data was obtained from a patient who were diagnosed with hepatitis B cirrhosis combined with Budd-Chiari syndrome.We retrospectively analyzed the clinical character of the patient.Results:The patient was diagnosed with Budd-Chiari syndrome incidentally during operation.so the patient underwent orthotopic liver transplanation,in which the liver and retrohepatic vena cava were resected,and recovered uneventfully.Conclusion:Orthotopic liver transplantation is not only an ideal treatment but also improves the prognosis of patients for hepatitis B cirrhosis combined with Budd-Chiari syndrome.

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.

Correlations of portal hypertensive gastropathy of hepatitis B cirrhosis with other factors

Objective: To study the clinical relations of portal hy- pertensive gastropathy (PHG) of hepatitis B cirrho- sis to other factors. Methods: Three groups of subjects were studied pro- spectively at our hospital from March 2000 to March 2001: 159 hepatitis B cirrhotic patients with portal hypertension, 114 hepatitis B cirrhotic patients with- out portal hypertension, and 97 control subjects. Free portal vein pressure (FPP) was measured dur- ing surgery. Liver function was assessed by Pugh's modification of Child's criteria. The area of liver collagen fibrin was studied using color image analysis system. Esophageal varices were identified by Dagra- di grading. Gastric varices were identified according to Northern Italian Endoscopic Council (NIEC) grading. Hypersplenism was assessed with the reduc- tion of WBC, HGB and PLT. Hepatitis B virus in the gastric mucosa was detected by immunizing histo- chemistry. Helicobacter pylori (H. pylori) organisms were identified by rapid urease testing and/or exami- nation of the stained biopsy specimens (haematoxylin and eosin). To analyze the correlation between these endoscopic signs at the gastric level and other fac- tors. Results: The differences of FPP among the three groups (patients with grade Ⅰ, Ⅱ, and Ⅲ gastropa- thy) were not significant. There was no correlation between Child-Pugh classification grading and the se- verity of gastropathy (P=0. 153). The differences of the area of liver collagen fibrin among the three grade gastropathy were not statistically significant (P =0. 801). There was a significant difference in the prevalence of severe PHG among grade Ⅰ, Ⅱ, Ⅲ, Ⅳ and Ⅴ esophageal varices (P<0. 001). PHG was present in a similar percentage of patients with gas- tric varices compared with those without gastric vari- ces (P=0. 209). There was a significant difference in the severity between PHG and hypersplenism (P= 0. 003). Seven patients with PHG had no microscopic evidence of hepatitis B virus infection in the gastric wall. There was no correlation between Child-Pugh classification grading and infection of H. pylori (P= 0. 7491). Conclusions: The most important element causing PHG is the increased portal pressure as a prerequi- site. In addition, other factors may contribute to the development of PHG. PHG often occurs in patients with the presence of esophageal varices. There is a marked correlation between the severity of PHG and hypersplenism. Hepatitis B virus and H. pylori infec- tion are unlikely to be involved in the pathogenesis of PHG. The development of PHG is less influenced ei- ther by the severity of liver disease (Child-Pugh grade) and cirrhosis or by the presence or non pre- sence of gastric varices.

Effects of entecavir on platelet function, PTA and HBV-DNA levels in patients with hepatitis B cirrhosis

Objective: To explore the effect of entecavir on platelet function, PTA and HBV-DNA levels in patients with hepatitis B cirrhosis. Methods: A total of 132 patients with hepatitis B cirrhosis admitted in our hospital from September 2012 to May 2016 were randomly divided into control group (n=66) and observation group (n=66). The two groups were treated with routine treatment, such as reducing enzyme activity and protecting liver function. The control group was treated with lamivudine on the basis of routine treatment and the observation group was treated with entecavir. The changes of liver function, liver fibrosis, platelet index, PTA and HBV-DNA expression level in the two groups were compared. Results: Before treatment, there was no significant difference between alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), type III procollagen (PC III), laminin (LN), type IV collagen (IV-C), hyaluronidase (HA), platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), prothrombin activity (PTA) and hepatitis B virus RNA (HBV-DNA). After treatment, ALT, AST, TBIL, PC III, IV-C, LN and HA in both groups were significantly decreased than those before the treatment, and the decrease of PC III, IV -C, LN and HA in observation group was more significant than that of the control group;PLT and PTA in both groups were significantly increased than before treatment, while MPV, PDW and HBV-DNA were obviously decreased than before treatment, and PLT and PTA in the observation group were remarkably increased than control group, while MPV, PDW, and the control group were significantly lower than those in the control group. Conclusions: Entecavir in the treatment of hepatitis B liver cirrhosis, can reduce the HBV-DNA level, and then obviously enhance the liver function, inhibit the development of liver fibrosis, correct the abnormal platelet parameters and improve coagulation function.

Correlation of Fibroscan parameter with serum inflammation indexes, collagen metabolism indexes and fibrosis indexes in patients with hepatitis b cirrhosis

Objective:To study the correlation of Fibroscan parameter with serum inflammation indexes, collagen metabolism indexes and fibrosis indexes in patients with hepatitis b cirrhosis. Methods:Patients who were diagnosed with hepatitis b cirrhosis in Dongfeng Hospital Affiliated to Hubei University of Medicine between June 2014 and August 2017 were selected as cirrhosis group for the research, patients who were diagnosed with chronic viral hepatitis b and without liver cirrhosis were selected as the HBV group, and healthy volunteers who received physical examination in Dongfeng Hospital Affiliated to Hubei University of Medicine during the same period were selected as the control group for the research;Fibroscan was performed to determine the liver stiffness measurement (LSM), and serum was collected to determine the inflammation indexes, collagen metabolism indexes and fibrosis indexes.Results:LSM levels as well as serum sICAM1, sP-selectin, MIF, MMP2, MMP9, CatS, TGFβ1, HA, LN, PC-III and IV-C contents of cirrhosis group and CHB group were significantly higher than those of control group whereas serum IL-21, IFN-γ, TIMP1 and TIMP2 contents were lower than those of control group;LSM level as well as serum sICAM1, sP-selectin, MIF, MMP2, MMP9, CatS, TGFβ1, HA, LN, PC-III and IV-C contents of cirrhosis group was significantly higher than those of CHB group whereas serum IL-21, IFN-γ, TIMP1 and TIMP2 contents lower than those of CHB group;LSM level in cirrhosis group was positively correlated with serum sICAM1, sP-selectin, MIF, MMP2, MMP9, CatS, TGFβ1, HA, LN, PC-III and IV-C contents, and negatively correlated with serum IL-21, IFN-γ, TIMP1 and TIMP2 contents.Conclusion: The Fibroscan parameter LSM of hepatitis b cirrhosis has evaluation value for inflammatory response, collagen metabolism and fibrosis process in the course of cirrhosis.

Analysis of the Clinical Value of Baogan Lishui Decoction and Conventional Western Medicine in Treating Hepatitis B Cirrhosis Refractory Ascites

The objective of this study was to investigate the clinical effect of combination treatment of Chinese medicine Baogan Lishui decoction and western medicine on hepatitis B(Hep B)cirrhosis-related refractory ascites.The control group was given conventional western medicine therapy while the observation group was given same conventional western medicine therapy with additional of Chinese medicine Baogan Lishui decoction.The total effective of clinical treatment on Hep B cirrhosis-related refractory ascites in observation group was higher than that of the control group which was 88.89%compared to 71.11%,respectively,and it was significant different(P<0.05).The combination treatment of Chinese medicine Baogan Lishui decoction and conventional western medicine can significantly increase the treatment effect on Hep B cirrhosis refractory ascites,and thus increases the quality and safety of life.

Effect of the reduced glutathione antioxidation combined with conventional antiviral drugs on hepatic fibrosis in patient with hepatitis b cirrhosis

Objective: To study the effect of the reduced glutathione antioxidation combined with conventional antiviral drugs on hepatic fibrosis in patient with liver cirrhosis. Methods: A total of 300 patients with hepatitis b cirrhosis who were treated in Shangluo Central Hospital between August 2012 and August 2016 were collected and divided into the control group (n=159) who received conventional antiviral therapy and the observation group (n=141) who received reduced glutathione antioxidation combined with conventional antiviral drug therapy. The differences in serum levels of fibrosis indicators, inflammatory factors and oxidative stress indexes were compared between the two groups of patients before and after treatment. Results: Before treatment, differences in serum levels of fibrosis indexes, inflammatory factors and oxidative stress indexes were not statistically significant between two groups of patients. After treatment, serum HA, Ⅳ-C, LN, PCⅢ, PCT, IL-6, IL-22, IL-31, TNF-α and MDA levels of both groups of patients were lower than those before treatment while GSH-Px and T-SOD levels were higher than those before treatment, and serum HA, Ⅳ-C, LN, PCⅢ, PCT, IL-6, IL-22, IL-31, TNF-α and MDA levels of observation group after treatment were lower than those of control group while GSH-Px and T-SOD levels were higher than those of control group. Conclusion: Reduced glutathione antioxidation combined with conventional antiviral drugs can effectively inhibit the fibrosis process in patients with hepatitis b cirrhosis, which is because that it reduces the degree of inflammation and oxidative stress reaction.

Influence of antiviral drugs combined with antioxidant therapy on liver injury and fibrosis process in patients with chronic hepatitis B cirrhosis

Objective:To study the influence of antiviral drugs combined with antioxidant therapy on liver injury and fibrosis process in patients with chronic hepatitis B cirrhosis.Methods: A total of118 patients with chronic hepatitis B cirrhosis who were treated in Dongying Hospital for Infectious Diseases between May 2013 and February 2016 were retrospectively analyzed and divided into the control group (n=60) who underwent routine antiviral therapy and the observation group (n=58) who underwent antiviral drugs combined with antioxidant therapy. Serum levels of oxidative stress indexes, liver function indexes and liver fibrosis indexes were compared between two groups of patients before and after treatment.Results:Before treatment, there were no significant differences in serum oxidative stress indexes, liver function indexes and liver fibrosis indexes between two groups of patients. 3 months after treatment, serum oxidative stress index SOD level in observation group was higher than that in control group while AOPPs level was lower than that in control group;serum liver function indexes AST, ALT and TBIL levels in observation group were lower than those in control group while ALB level was higher than that in control group;serum liver fibrosis indexes HA,Ⅳ-C, PCIII and LN levels in observation group were lower than those in control group.Conclusion:Antiviral drugs combined with antioxidant therapy can significantly reduce oxidative stress injury in patients with chronic hepatitis B cirrhosis so as to protect the liver function and inhibit the liver fibrosis process.

Observation on the effect of adefovir dipivoxil in combined with lamivudine in the treatment of hepatitis B cirrhosis

Objective:To explore the effect of adefovir dipivoxil in combined with lamivudine on the liver function in patients with hepatitis B cirrhosis and the antiviral efficacy.Methods:A total of 156 patients with hepatitis B cirrhosis who were admitted in our hospital were included in the study and randomized into the treatment group and the control group with 78 cases in each group. The patients in the treatment group were given adefovir dipivoxil in combined with lamivudine, while the patients in the control group were given entecavir. After 12-month treatment, the efficacy was evaluated. The liver function, serum virology indicators, and AFP before and after treatment in the two groups were compared. The adverse reactions during the treatment process were recorded.Results: The serum GTP, ALT, AST, and TBIL levels after treatment in the two groups were significantly reduced when compared with before treatment (P<0.05);moreover, ALT and TBIL levels in the treatment group were significantly lower than those in the control group (P<0.05). HBeAg, HBV-DNA, and AFP levels after treatment in the two groups were significantly reduced when compared with before treatment (P<0.05), HBeAg and AFP levels in the treatment group were significantly lower than those in the control group (P<0.05), and the comparison of HBV-DNA between the two groups was not statistically significant (P>0.05). ALT normalization rate and HBeAg negative conversion rate after treatment in the treatment group were significantly higher than those in the control group (P<0.05). The comparison of HBV-DNA negative conversion rate and HBeAg conversion rate between the two groups was not statistically significant (P>0.05). No obvious drug adverse reactions and liver function damage occurred during the treatment process in the two groups. Conclusions:Adefovir dipivoxil in combined with lamivudine can significantly improve the liver function and serum virology indicators in patients with hepatitis B cirrhosis, with antiviral efficacy significantly superior to that by entecavir.

Effect of Qianggan Pills combined with antiviral treatment on the fibrosis indexes, immune and inflammatory response in patients with compensated hepatitis b cirrhosis

Objective:To study the effect of Qianggan Pills combined with antiviral treatment on the fibrosis indexes, immune and inflammatory response in patients with compensated hepatitis b cirrhosis.Methods:A total of 88 patients with compensated hepatitis b cirrhosis treated in our hospital between April 2013 and March 2016 were collected and divided into observation group and control group according to single blind randomized control. Observation group of patients accepted Qianggan Pills combined with antiviral treatment and control group of patients received antiviral treatment alone. After 6 months of treatment, chemiluminescence method was used to detect serum fibrosis indexes, flow cytometer was used to detect peripheral blood T lymphocyte subset levels, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of inflammatory factors.Results: Before treatment, differences in fibrosis indexes, immune and inflammatory response indexes were not statistically significant between two groups of patients;after 6 months of treatment, serum LN, HA andⅣ-C levels of observation group were lower than those of control group, peripheral blood CD3+ and CD4+T lymphocyte levels as well as CD4+/CD8+ ratio were higher than those of control group, and CD8+ T lymphocyte level was lower than that of control group;serum PCT and CRP levels were lower than those of control group while IL-10 and IL-13 levels were higher than those of control group.Conclusion:Qianggan Pills combined with antiviral treatment can inhibit the fibrosis process, strengthen the body's immune function and also relieve systemic inflammatory response in patients with compensated hepatitis b cirrhosis.

Effect of Dahuang Zhechong pill combined with antiviral therapy on serum virus replication indexes as well as immunity and inflammation indexes in patients with chronic hepatitis B cirrhosis

Objective:To study the effect of Dahuang Zhechong pill combined with antiviral therapy on serum virus replication indexes as well as immunity and inflammation indexes in patients with chronic hepatitis B cirrhosis.Methods: A total of 104 patients with chronic hepatitis B cirrhosis who were treated in our hospital between May 2013 and April 2016 were selected and randomly divided into combined treatment group and western medicine treatment group who accepted Dahuang Zhechong pill combined with entecavir treatment and entecavir monotherapy respectively. Before and after treatment, the HBV-DNA loads, liver fibrosis index and immune cell levels as well as inflammatory cytokine levels were determined.Results:HBV-DNA loads of both groups of patients at 48 weeks after treatment were significantly lower than those before treatment, and the HBV-DNA loads were not significantly different between the two groups after treatment;serum HA, LN, PC-III, IV-C, IL-15, IL-16 and TGF-β1 levels as well as peripheral blood Treg cell levels of both groups at 24 weeks and 48 weeks after treatment were significantly lower than those before treatment while peripheral blood NK cell levels were higher than those before treatment, and serum HA, LN, PC-III, IV-C, IL-15, IL-16 and TGF-β1 levels as well as peripheral blood Treg cell levels of combined treatment group were significantly lower than those of western medicine treatment group while peripheral blood NK cell levels were higher than those of western medicine treatment group. Conclusion:Dahuang Zhechong pill combined with antiviral treatment of chronic hepatitis B cirrhosis can regulate the immune response and inflammatory reaction without affecting the inhibiting effect of antiviral drugs on viral replication.

Effects of adjuvant therapy with anluohuaxian capsule on serum inflammatory factors, hepatic fibrosis indexes and immune function in patients with hepatitis B cirrhosis

Objective: To investigate the effect of adjuvant therapy with anluohuaxian capsule on the treatment of hepatitis B cirrhosis, and its influence on serum inflammatory factors, liver fibrosis indexes and immune function. Methods: A total of 112 cases of hepatitis B cirrhosis patients were divided into the control group (n=55) and observation group (n=57) according to the random data table, patients in the two groups were given routine treatment, on this basis, the control group received the treatment of Adefovir Dipivoxil Tablets, and the observation group was treated with Adefovir Dipivoxil Tablets combined with Anluo Huaxian pill treatment, two groups were treated for 48 weeks. The levels of serum inflammatory factors, liver fibrosis indexes and immune function indexes of the two groups were compared before and after treatment. Results: Before treatment, There was no significant difference between the two groups of TNF-α, IL-6, hs-CRP, IVC, HA, PIIIP, LN, CD3+, CD4+, CD8+and CD4+/CD8+ levels. After treatment, TNF-α, IL-6, hs-CRP, IVC, HA, PIIIP, LN, CD3+, CD4+, CD8+and CD4+/CD8+ levels in the observation group and control group were significantly lower than those before treatment in the same group, and levels in the observation group after treatment were significantly lower than the control group;Compared with the group before treatment, the levels of CD3+, CD4+ and CD4+/CD8+ of two groups after treatment were significantly increased, and the observation group was significantly higher than the control group. Conclusion: Adjuvant therapy with anluohuaxian capsule on the treatment of hepatitis B cirrhosis, can effectively reduce the inflammatory stress reaction, reduce the level of serum liver fibrosis index and improve the immune function, and has important clinical value.

Effects of Lactobacillus paracasei N1115 on gut microbial imbalance and liver function in patients with hepatitis B-related cirrhosis

BACKGROUND Hepatitis B cirrhosis(HBC)is a chronic disease characterized by irreversible diffuse liver damage and aggravated by intestinal microbial imbalance and metabolic dysfunction.Although the relationship between certain single probiotics and HBC has been explored,the impact of the complex ready-to-eat Lactobacillus paracasei N1115(LP N1115)supplement on patients with HBC has not been determined.AIM To compare the changes in the microbiota,inflammatory factor levels,and liver function before and after probiotic treatment in HBC patients.METHODS This study included 160 HBC patients diagnosed at the General Hospital of Ningxia Medical University between October 2018 and December 2020.Patients were randomly divided into an intervention group that received LP N1115 supplementation and routine treatment and a control group that received routine treatment only.Fecal samples were collected at the onset and conclusion of the 12-wk intervention period.The structure of the intestinal microbiota and the levels of serological indicators,such as liver function and inflammatory factors,were assessed.RESULTS Following LP N1115 intervention,the intestinal microbial diversity significantly increased in the intervention group(P<0.05),and the structure of the intestinal microbiota was characterized by an increase in the proportions of probiotic microbes and a reduction in harmful bacteria.Additionally,the intervention group demonstrated notable improvements in liver function indices and significantly lower levels of inflammatory factors(P<0.05).CONCLUSION LP N1115 is a promising treatment for ameliorating intestinal microbial imbalance in HBC patients by modulating the structure of the intestinal microbiota,improving liver function,and reducing inflammatory factor levels.

Chronic hepatitis B virus infection in Eastern Ethiopia:Clinical characteristics and determinants of cirrhosis

BACKGROUND Chronic hepatitis B(CHB)virus infection is a major cause of liver-associated morbidity and mortality,particularly in low-income countries.A better understanding of the epidemiological,clinical,and virological characteristics of CHB will guide appropriate treatment strategies and improve the control and management of CHB in Ethiopia.AIM To investigate the characteristics of CHB in Eastern Ethiopia and assess the efficacy and safety of antiviral treatment.METHODS This cohort study included 193 adults who were human immunodeficiency virus-negative with CHB between June 2016 and December 2019.Baseline assessments included chemistry,serologic,and viral markers.χ^(2) tests,Mann-Whitney U tests,and logistic regression analyses were used to identify the determinants of cirrhosis.Tenofovir disoproxil fumarate(TDF)was initiated using treatment criteria from the Ethiopian CHB pilot program.RESULTS A total of 132 patients(68.4%)were men,with a median age of 30 years[interquartile range(IQR):24-38].At enrollment,60(31.1%)patients had cirrhosis,of whom 35(58.3%)had decompensated cirrhosis.Khat use,hepatitis B envelope antigen positivity,and a high viral load were independently associated with cirrhosis.Additionally,66 patients(33.4%)fulfilled the treatment criteria and 59(30.6%)started TDF.Among 29 patients who completed 24 months of treatment,the median aspartate aminotransferase to platelet ratio index declined from 1.54(IQR:0.66-2.91)to 1.10(IQR:0.75-2.53)(P=0.002),and viral suppression was achieved in 80.9%and 100%of patients after 12 months and 24 months of treatment,respectively.Among the treated patients,12(20.3%)died within the first 6 months of treatment,of whom 8 had decompensated cirrhosis.CONCLUSION This study highlights the high prevalence of cirrhosis,initial mortality,and the efficacy of TDF treatment.Scaling up measures to prevent and control CHB infections in Ethiopia is crucial.

Beneficial Effects of Traditional Chinese Medicine Fuzheng Huayu on the Occurrence of Hepatocellular Carcinoma in Patients with Compensated Chronic Hepatitis B Cirrhosis Receiving Entecavir:A Multicenter Retrospective Cohort Study

Background and Aims:The application of antifibrotic drugs to treat patients with chronic liver diseases who are receiving antiviral therapies for hepatocellular carcinoma(HCC)has not been established.Here,we aimed to assess the impact of the Traditional Chinese Medicine Fuzheng Huayu(FZHY)on the occurrence of HCC in patients with hepatitis B virus-related compensated cirrhosis receiving the antiviral drug entecavir(ETV).Methods:A multicenter retrospective cohort study was performed.Compensated liver cirrhosis patients were divided into the ETV+FZHY group or the ETV group according to treatment.The cumulative incidence of HCC was analyzed using Kaplan-Meier and log-rank tests.Propensity score matching was used for confounding factors.Stratified analysis and Cox regression were used to determine the effects of FZHY on the occurrence of HCC and liver function decompensation.Results:Out of 910 chronic hepatitis B patients,458 were in the ETV+FZHY group and 452 were in the ETV group.After propensity score matching,the 5-year cumulative incidence of HCC was 9.8%in the ETV+FZHY group and 21.8%in the ETV group(p<0.01).The adjusted hazard ratio for HCC was 0.216(0.108,0.432)when FZHY treatment was>36 months.Age,diabetes,alanine aminotransferase,γ-glutamyl transpeptidase,albumin,hepatitis B e-antigen,and fibrosis 4 score were associated with the occurrence of HCC.FZHY decreased the risk of HCC in patients aged>45 years with a hepatitis B virus DNA level of≥2,000 IU/l.Conclusion:Adjunctive FZHY treatment reduced HCC occurrence in patients with hepatitis B virus cirrhosis who were treated with ETV,possibly due to the antifibrotic properties of FZHY.

Elimination of hepatitis B as a public health threat:Addressing the challenge and taking action

Despite the significant efforts made in recent years,the latest data from the World Health Organization indicates that there are substantial challenges in achieving the elimination of hepatitis B virus(HBV)infection by 2030.The article in the World Journal of Hepatology by Ismael et al highlighted the limited accessibility to screening and antiviral treatment for HBV infection in eastern Ethiopia.Therefore,the editorial comments on this article will focus on the current challenges and recent efforts in the prevention and treatment of chronic hepatitis B,particularly emphasizing the expansion of screening and antiviral therapy,as well as feasible strategies to improve accessibility for HBV testing,antiviral therapy,and adherence enhancement.