Non alcoholic steatohepatitis a precursor for hepatocellular carcinoma development

Hepatocellular carcinoma(HCC) is increasing in prevalence and is one of the most common cancers in the world. Chief amongst the risks of attaining HCC are hepatitis B and C infection, aflatoxin B1 ingestion, alcoholism and obesity. The later has been shown to promote non alcoholic fatty liver disease, which can lead to the inflammatory form non alcoholic steatohepatitis(NASH). NASH is a complex metabolic disorder that can impact greatly on hepatic function. The mechanisms by which NASH promotes HCC are only beginning to be characterized. Here in this review, we give an overview of the recent novel mechanisms published that have been associated with NASH and subsequent HCC progression. We will focus our discussion on inflammation and gut derived inflammation and how they contribute to NASH driven HCC.

Clinical Characteristics and Treatment for Patients with Occult Chronic Hepatitis B

Objective To observe the clinical manifestations and assess direct antiviral effect for patients with occult hepatitis B in China.Methods The study includes 15 patients with occult hepatitis B and their medical history,family history,firstdiagnosis time,confirmed-diagnosis time,laboratory report,anti-viral therapy and outcomes were analyzed.Results The average age of the patients is 38.67-year old(6 males and 9 females),2 with acute hepatitis B(2/15,13.3%),13 with no hepatitis history(13/15,86.6%),8 with family history(8/15,53.3%),6 with no family history(6/15,40%),1 with unknown family history(1/15,6.6%).Eight patients were treated with entecavir(0.5 mg/day,taken orally),with effective results and steady conditions;3 patients were treated with lamivudine(0.1 g/day,taken orally),2 of them were prescribed to take adefovir dipivoxil additionally due to drug-resistance,the other one was treated with lamivudine continuously without drug-resistance;4 cases refused anti-viral therapy.One patient’s condition remained steady,1 patient died of cirrhosis with portal hypertension and liver failure 5 years after firstdiagnosis,1 patient progressed to hepatocellular carcinoma and accepted surgery operation treatment 5 years after first-diagnosis,the other 1 patient progressed to compensatory cirrhosis 2 years after first-diagnosis and is steady from then,which indicates that occult chronic hepatitis B can progress to cirrhosis and hepatocellular carcinoma without therapy in time.Conclusions The clinical characteristics of 15 cases with occult chronic hepatitis B showed that these patients with short latency,younger age when being-struck,and light damage to liver function.The efficacy and drugresistance of nucleos(t)ide-analogue(entecavir,lamivudine,adefovir dipivoxil)in treatment of patients with occult chronic hepatitis B are similar to chronic hepatitis B.

A Retrospective, Multi-Center, Post-Marketing Observational Study to Evaluate the Effectiveness of Ademetionine 1,4-Butanedisulfonate Injection (Transmetil?) Treatment in Chinese Patients with Intrahepatic Cholestasis Caused by Viral Hepatitis

Obejective Ademetionine 1,4-butanedisulfonate [S-adenosyl-L-methionine (SAMe)/Transmetil?, Abbott] has been available in China for more than 15 years, and it has been shown to reduce serum bilirubin and transaminase levels in patients with viral hepatitis (VH). However, no large-scale studies have focused on the impact of SAMe treatment regimen on reducing the serum total bilirubin (TBil) in VH patients with intrahepatic cholestasis (IHC). The main objective of this study was to evaluate the effectiveness of intravenous SAMe (Transmetil?) treatment in reducing the serum TBil by 50%. Methods This retrospective, multi-center, cross-sectional medical record review involved patients aged≥18 years. Records of 1 280 hospitalized VH patients at 16 sites diagnosed with IHC who had received intravenous SAMe 1 000 mg or 2 000 mg q.d. for at least 7 days from January 1, 2006 to June 30, 2009, were screened and 905 records were randomly selected. Results The safety set (SS) included 834 patients and the full analysis set included 826 patients. TBil levels after 14 days injection treatment were available for 763 patients. TBil decreased≥ 50%versus baseline after 14 days treatment in 288 (37.7%) patients (95%CI 34.3%, 41.2%). Twenty-nine non-serious adverse events (non-SAEs) were reported in 19 (2.3%) patients, and 29 SAEs were reported in 10 patients (1.2%). All adverse events (AEs) were considered unrelated to the drug. Conclusions This retrospective study shows that intravenous SAMe administration in VH patients with IHC is associated with signiifcant reduction of TBil levels in more than 30%of patients 14 days after treatment initiation.

A low-cost and high-efficiency 10-in-1 test for the PCR-based screening of SARS-CoV-2 infection in low-risk areas

To the Editor:As of August 9,2020,the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has infected 19,432,244 people and caused 721,594 deaths globally.To timely identify the infected persons,nucleic acid detection screenings have been carried out for high-infection risk groups in areas known to have coronavirus disease 19(COVID-19)cases,such as Wuhan,Beijing,and Xinjiang.The rapid identification of infected patients and the implementation of quarantine measures play an important role in preventing the transmission of SARS-CoV-2.However,there are some issues associated with large-scale screening for this virus.The consumption of equipment and reagents for specimen collection and detection is high,resulting in elevated screening costs.Moreover,with the increase in the number of samples collected,the testing capabilities of medical institutions have reached a saturation point,hindering the speed and scope of large-scale screenings.For this reason,the mixed detection after RNA extraction(detection in a mixture of nucleic acids extracted from several patients)or before RNA extraction(detection in a mixture of pharyngeal swab transfer buffer obtained from different patients before nucleic acid extraction)has been proposed in many regions.[1]However,both the pooling of swab transfer buffer before nucleic acid extraction and pooling of RNA after nucleic acid extraction inevitably cause dilution of samples and decrease of detection sensitivity.However,there is still a lack of research on how to effectively improve the screening efficiency and control the decrease of sensitivity caused by dilution in an appropriate range.In this study,we designed a novel 10-in-1 test(ten pharyngeal swab samples from ten individuals were placed in one custom-made virus collection tube[CMT]for nucleic acid extraction and testing)by optimizing the current mixed acquisition technique,and after a promising pilot test.